Terry Hill, Senior Advisor for Leadership and Policy
After being asked to compose a blog on the evolution of
health care over the thirty plus years of my career, I procrastinated until the
last minute. Looking backward has always
been a challenge for me, whether it's logging in technical assistance, filling
out travel vouchers for payment or just expounding on the good old days of
yesteryear. I always like to think about
what lies ahead. Perhaps the future
roads are growing shorter, but I'm just as excited as ever to explore what's
around the next curve or what's beyond the next great obstacle.
Using my road metaphor, there have been a lot of curvy
roads and a lot of formidable obstacles for rural health care in the past thirty
years. Difficulty recruiting and
retaining physicians and other primary care providers has been constant. Complexity has increased during this period
as thousands of new drugs have been launched, thousands of new medical
procedures have been used and thousands of new medical devices have been
approved. Technology expansion has been
another constant, as medical technology, telehealth technology and health information
technology have become commonplace in even our smallest most remote
facilities. The accelerating rate of
change in health care has been challenging for rural health providers, and at
times it has seemed that the next curve in the road would lead to a steep drop-off or at least an impassible road ahead. But somehow, we've always made it past the obstacles, thanks largely to
the determination, resiliency and innovation of our rural health providers and
their advocates. We do this work,
either directly or indirectly, because people living in small towns across
America depend on health care being available when it's needed. We do the work because it's an opportunity
to contribute and provide meaning to our professional lives.
The road ahead in 2013 and beyond is sure to be
especially bumpy, and maybe even hazardous for all health care providers. Dramatic transitions to a new payment system
based on value, with new requirements for better quality, better population
health and lower costs is already taking place. Rural health can not only survive in the ensuing era of health reform,
it can lead the way. I am optimistic
that new health care delivery models will be employed as effectively in rural
as in urban, and that new partnerships will be formed between rural and urban
health care organizations based on mutual value, rather than on strict referral
of patients. In short, rural will find a
meaningful place in the new health system.
The time for beginning the new road trip is now. Rural providers must start to plan their
future destination, and begin to equip themselves with the necessary
technology, quality processes and
efficiencies to be successful down the road. They should not pull off at the next rest stop to wait for further
instructions. The road to value does not
come with a GPS nor even a detailed roadmap. As has been done so many times in the past, we'll have to forge our way
past or through the obstacles, with limited resources and expertise, and arrive at a future system that is worth
celebrating. Better health, better
care, lower cost; I plan to be around to contribute at least in
some small way to that final destination.
