Demonstrating and Improving the Value of Rural Health Services Ty - PowerPoint PPT Presentation

Demonstrating and Improving the Value of Rural Health Services Ty Borders, PhD Professor and Chair, Health Services Management Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy Editor, The Journal of Rural Health

Value of Health Services Efficiency Quality Access

Quality • Challenges to measure and improve • CAH example – Questions raised about mean quality 1 – Many relevant quality of care indicators – 75% of CAHs now publicly report 2 • Increasing emphasis on patient-centered care – HRQL, consumer assessments, patient preferences 1 Joynt et al. JAMA (2011) ; 2 Casey et al. JRH (2013)

Efficiency • Small capacity constraints • CAH example – Federal govt. has considered eliminating – Some CAHs less efficiently operated 3 – But eliminating special payments would lead to worse financial performance 4 • Increasing pressures for system linkages ? 3 Gautam et al. JRH (2013) ; 4 Holmes et al. JRH (2013)

Access • Mixed evidence of R/U disparities in physician services access 5-6 • Addiction and mental health – Substance use a major public health issue 7 – Large R/U disparities in mental health – Addiction and mental health Tx lacking 8 • Opportunities for integrating into PCMH ? 5 Xu and Borders J H Care Poor Unders (2008); 6 Borders Am J Med Qual (2011); 7 Gfroerer et al. JRH (2007) ; 8 Borders & Booth JRH (2007)

Closing Comments • Will continue to face tough decisions about how to allocate resources across R/U areas • Rural providers will need to find innovative ways to improve quality, efficiency, & access • Need good science (HSR) to inform decisions