Introduction for Day 2

The COVID-19 pandemic has challenged the health care infrastructure and highlighted disparities in health and health care access across the country. Rural communities, which are disproportionately impacted by hospital closures, health care workforce shortages, and social and economic barriers to health and health care access, will face unique challenges to economic recovery.

Stakeholders, policymakers, local organizations have developed promising rural-specific initiatives, but financial and implementation challenges remain. What will health care delivery look like in rural communities after the pandemic? How can rural hospitals remain financially viable and adequately serve their communities? What innovative public-private partnerships and cross-sector collaborations can address barriers to improving health outcomes in rural communities? How should rural communities and health care facilities leverage existing assets to improve health outcomes and financial stability?

Innovation in Health

Moderator: Mark Holmes, Director, Sheps Center at the University of North Carolina, Chapel Hill

Panelists:

• Caitlin Cain, Vice President of LISC, Executive Director of Rural LISC
• Antony Chiang, Former CEO, Dogwood Health Trust
• Alana Knudson, Co-Director, Walsh Center for Rural Health Analysis, NORC at the University of Chicago

Summary: Holmes began the panel on financing rural health by discussing the disparities and the need for alliances between rural and urban health care. He asked the panelists about the future of rural health care, the financial viability of rural hospitals, and how collaborations can break down rural health barriers.

Cain argued that a diversified rural economy is a social barometer of success. She emphasized that addressing people's individual physical and mental health needs will allow them to succeed and give back to their community. Cain explained that a cross-sector regional approach is the best way to improve the public health sector. She believes now is the time to tackle systemic issues because people want to make a difference in their communities.

Chiang praised rural communities for their resilience during the pandemic. He explained that broadband investment has led to population growth and more diverse economies in rural communities. He stated that rural hospitals have become more financially viable because of increased public and private funding of health insurance, which decreased the coverage gap and allowed hospitals to reallocate funding.

Knudson emphasized how access to broadband has created changes in how and where people live and work. She described how the pandemic highlighted flaws in public health infrastructure and explained that rural community members should be making their own health care financing decisions. She noted that one positive of the pandemic is increased participation in telehealth, which allows people to access health care despite traditional barriers like distance.

Richmond Fed Research

• Rural Hospital Closures and the Fifth District
• What's Lost when Rural Hospitals Close
• Hospital Access in the Fifth District and COVID-19

Other Useful Resources and Reading

• A Guide for Rural Health Care Collaboration and Coordination –by Alana Knudson
• Rebuilding the Foundation of Rural Community Health After COVID-19 – by Alana Knudson, et al
• Rural Hospital Closures and Growth in Employment and Wages
• The Consequences of Medicare Pricing: An Explanation of Treatment Choice