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Mapping Out Future for Rural Health Care

The problems faced by rural health providers go far beyond whether or not patients have insurance coverage, according to Danny Fernandez, legislative advocate for the National Rural Health Association, who spoke at the 10th annual conference of the California State Rural Health Association this week in Sacramento .

“At some point, ‘national health reform’ morphed into ‘national health insurance reform,’  ” Fernandez said. But it’s not just about making sure everyone’s insured, he said. “Our overall message to Capitol Hill was, if you don’t have access to a provider, then it doesn’t matter if you do or don’t have insurance coverage.”

That is probably the number one problem in rural areas throughout the state and nation, he said, along with a general lack of funding for rural health care. National health care reform, Fernandez said, might be able to address both concerns — by increasing funds through better insurance, and by offering incentives and programs to get medical providers into rural areas.

But several national reform programs may not work for rural practices, Fernandez said. Overtaxed clinics will need to decide whether they can take on installation of electronic medical records, figure out how to handle meaningful-use requirements and deal with possible cuts in Medicare reimbursement rates.

Today, the CSRHA board meets to conclude the three-day conference, to set priorities for what it wants to tackle next.

The piece of national health care reform that might mean the most to rural health care may also be one of the pieces of reform that’s threatened, Fernandez said.

“A lot of the workforce programs were authorized but not appropriated,” he said. Those workforce plans could help ease the greatest need in rural medicine, Fernandez said: a need for more health care providers.

But with the recent election, and control of the House of Representatives going Republican, no one knows if the authorized workforce program will get federal money to become reality, Fernandez said.

“No legislation is perfect, this legislation is not perfect,” Fernandez said. “It’s up to us to fight for what’s in it. And we continue to fight for what’s left out.”

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