Report offers telehealth as a solution to rural healthcare challenges

By Eric Wicklund
10:29 AM

A new report indicates rural Americans face an increasing need for quality healthcare at a time when access is proving difficult – and points to telemedicine and telehealth as a possible solution.

The report, issued July 27 by the UnitedHealth Center for Health Reform & Modernization, finds that people living in rural locations face greater difficulty accessing healthcare than their urban and suburban neighbors. In addition, the report indicated rural Americans experience more chronic conditions – such as diabetes and heart disease – and will be more likely to participate in Medicaid and other government-subsidized insurance programs by 2014.

The solution? The Minnetonka, Minn.-based health plan, which serves more than 75 million people worldwide, points to telemedicine and telehealth technologies.

[See also: Survey analysis: Telemedicine crucial part of health IT.]

“The next few years will be times of considerable stress on rural healthcare, but also times of great opportunity, since across the country there are already impressive examples of high-quality care, tailored to the distinctive needs of the local community,” said Simon Stevens, UnitedHealth Group’s executive vice president and chairman of the UnitedHealth Center for Health Reform & Modernization, in a press release. “The challenge for all involved in rural America now is to build on that track record of innovation and self-reliance, so as to ensure that all Americans – wherever they live – can live their lives to the healthiest and fullest extent possible.”

The report, “Modernizing Rural Health Care: Coverage, Quality and Innovation,” features a survey, conducted by Harris Interactive, of 2,000 patients and 1,000 primary care physicians nationwide and an analysis from the Lewin Group. It projects an increase of about 8 million insured rural residents by 2019, thanks to Medicaid expansion and state insurance exchanges called for in health reform.

The report calls for new incentives and reimbursement models for rural physicians, a bigger role for nurse practitioners and physician assistants, greater provider collaboration across rural locations and with urban providers, the use of mobile health clinics, rural adoption of electronic health records, market incentives for rural areas and more engagement by rural residents on wellness and preventive health measures.

[See also: UnitedHealthcare, Project HOPE battle chronic disease with mobile telehealth unit.]

To achieve these goals, the report recommends:

  • Expanding rural broadband connectivity to enable telemedicine growth;
  • Improving and aligning reimbursement across payers to encourage more telemedicine use;
  • Improving the availability of telemedicine programs; and
  • Reducing regulatory barriers to the use of telemedicine.

According to the study, there are 65 primary care physicians per 100,000 rural Americans, compared to 105 physicians per 100,000 urban and suburban Americans. Those numbers aren’t going to get better – nearly 80 percent of the rural physicians surveyed expect a primary care shortage in the near future, while 66 percent of the urban physicians foresee a shortage.

In terms of quality, nearly 63 percent of urban and suburban patients surveyed assessed their healthcare experiences as “excellent” or “very good,” while 49 percent of rural Americans approved of the quality of their healthcare services. Of those who rated their healthcare quality as “fair” or “poor,” 24 percent were rural residents and 12 percent were urban/suburban residents.

The news isn’t all gloomy for rural residents. According to the survey, 84 percent of rural physicians are accepting new Medicaid patients, compared to 65 percent of urban physicians, and 59 percent of rural physicians expect to accept new Medicaid patients in 2014, compared to 44 percent of urban physicians.