CEO Update: 100 Acre Woods

Christopher Robin and Winnie the Pooh light up the screen again.  I was so excited to see the movie that was inspired by the classic film I grew up watching, Winnie the Pooh.  It’s one of my favorite movies because it teaches us to look out for one another, be there for each other and to realize you can do whatever you set your mind to do.  Sounds a lot like rural healthcare.

One of the ways that CRHC takes the lessons that Winnie the Pooh has taught us is to raise awareness and celebrate what we care about. For us, that is rural Colorado.  This is the 9^th year celebrating Safety Net Clinic Week, a week dedicated to promoting awareness of Rural Health Clinics, the populations they serve, and highlighting the unique challenges they face.  We currently have 48 federally certified Rural Health Clinics in 33 counties in Colorado.  Rural Health Clinics are diverse in nature, set-up as non-profits, for-profits, county, town or hospital operated, serving patients in their community from all income levels and payer types (whether that is privately insured, publicly insured and those without the ability to pay).  What you might not know about Rural Health Clinics is that they receive no federal funding outside of their Medicare or Medicaid payment, which puts them at risk financially.  That’s because Rural Health Clinics serve an older, sicker, poorer population where the largest payers are Medicare and Medicaid (serving an average of 28%, Medicaid and 25%, Medicare). Some counties are home to a much higher percentage of Medicaid patients. Costilla County, for example, had 78% of their residents on either Medicare or Medicaid in 2016! Typically this reimbursement from Medicare and Medicaid does not fully cover the costs, which means that they must seek other forms of funding such as grants, donations and staffing models that include volunteers.  Despite all these challenges, rural health clinics still provide over a million visits a years to approximately 344,000 rural and underserved Coloradans.

This year CRHC highlighted three clinics and three key takeaways.  As you view the videos, we hope that you engage in the conversation and help us raise awareness of rural health clinics and the populations they serve.  Remember the lessons Winnie the Pooh taught us about community and remember that together we can create rural sustainability.

Centennial Family Medicine, Ordway

• 3 Key Takeaways:

1. Advanced Practice Providers, like Family Nurse Practitioners, provide a broad scope of services and increase access to healthcare in rural area.
2. A rural healthcare provider is a valuable community resource, providing healthcare services close to home and serving as a local economic resource.
3. Rural Health Clinics are underpaid – Karen’s clinic receives an encounter rate of $83.45 per Medicare patient and $110.36 per Medicaid patient.  However, the cost to Karen’s clinic is $102.70 per visit.

Mountain Medical Center, Ridgway

• 3 Key Takeaways:

1. Unique funding models for rural health clinics, like the Regional Service Authority, provide community funded financial sustainability for rural health clinics.
2. What would the impact of the nearby clinic closure have been on Ouray County if Mountain Medical wasn’t there to take on over 800 new patients?
3. True integration of mental and physical health will not be achieved without addressing regulatory barriers and providing access to sustainable funding.

Antonito Medical Clinic, Antonito

• 3 Key Takeaways:

1. Provider burnout is a significant issue for rural healthcare providers; the health of a provider impacts the health of the community they serve.
2. Recruitment of rural health providers takes time, over three years for the Antonito Clinic. A focus on homegrown talent helps ensure providers will stay and community members will trust them.
3. The opioid crisis has especially difficult for rural communities, as they have less resources and provide care for an underserved population.

You can view the videos online here: https://coruralhealth.org/safety-net-clinic-week