How Health Plans Can Improve Rural Members’ Access to Care

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By Lee Horner, Stratus Video President, Telehealth

Addressing geographic isolation can be critical for payers seeking to improve members’ access to care for rural populations. Rural members face a variety of obstacles to accessing health care according to the National Rural Health Association, including:

  • Physician availability:  Rural residents have less access to physicians vs. urban area populations.   According to the US Department of Health and Human Services, the patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people vs. 53.3 physicians per 100,000 in urban areas
  • Health situation:   Rural residents have more frequent occurrences of diabetes and coronary heart disease than non-rural areas.  A study published in the Royal Society for Public Health found that prevalence of diabetes was 8.6% higher for rural residents vs. non-rural residents. The prevalence of coronary heart disease was 38.8% higher for residents living in rural areas vs. residents in urban areas.  Not surprisingly, 19.5% of rural adults describe their health status as fair/poor vs. 15.6% of their urban counterparts according to the Rural Health Information Hub.
  • Financial resources: The rural population tend to be poorer. The Rural Health Information Hub reported that the per capita income in rural areas is $9,242 lower than the average per capita income in the US.  People who live in rural America rely more heavily on the Supplemental Nutrition Assistance Program (SNAP) benefits program. According to the Center for Rural Affairs, 14.6% of rural households receive SNAP benefits vs. 10.9% of urban households.
  • Transportation Availability:  Given their remote location, rural residents have transportation difficulties reaching care and need to travel considerable distances to reach a provider or a hospital.   Being able to drive to a follow-up appointment, having a reliable method of transportation, and the cost associated with travel expenses may present challenges for rural members.

 

Nearly 20% of Medicare patients are readmitted within 30 days. 34% of Medicare patients are readmitted within 90 days and 56% within 1 year.  64% of these patients receive no care between discharge and readmission.  For rural Medicare patients, the situation can be even more dire as these members experience barriers which prevent them from accessing follow-up care on a timely and convenient manner.

Payers seeking to better manage their rural members can use a video-based telehealth platform to enable care that is accessible and available for this member population.  By using video to conduct virtual visits,  a case manager can be more easily accessible to rural members who no longer need to travel long distances to receive follow-up care.  Virtual visits can also be conducted based on the members’ and care providers’ availability. As shortages of health professionals (for primary care and specialties) exist in rural communities, intelligent call routing can quickly align members’ requests for follow-up care with available care providers.

A vital rural community is dependent on the health of its population. Access to medical care does not guarantee good health; however, access to healthcare is critical for a population's well-being and optimal health.  Health Plans should continue to embrace telehealth and video-based care conversations to augment and accelerate their current methods of delivering follow-up care to rural members.  The demand for better member outcomes can be addressed by an increase in access to care team members via the usage of video technology.

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