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Rural Colorado Portfolio

Rural Colorado Portfolio. Legislature. Rural Community. Determinants of Health. Individual biology Access to health care Health behaviors Socioeconomic factors Physical environment What can public policy impact? What should public money buy?. Rural is NOT Urban.

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Rural Colorado Portfolio

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  1. Rural Colorado Portfolio

  2. Legislature Rural Community

  3. Determinants of Health • Individual biology • Access to health care • Health behaviors • Socioeconomic factors • Physical environment • What can public policy impact? • What should public money buy?

  4. Rural is NOT Urban • Think about the impact of your policy on a rural community. Think small town. • The social, political, and behavioral factors/determinants are different. • Some policy may target rural life • Some policy may explicitly avoid rural life • ASK someone from a rural community

  5. For Instance - access • Currently “limited-scope” radiology technicians must show proficiency through successful completion of a rigorous test. • Proposed change in the requirements would require all folks to take a semester-long course to be able to take x-rays. • This added requirement would drastically decrease the access to radiology services in rural ambulatory sites. • Course costs • Time away from the office • Travel distance

  6. You call a patient; get the wrong number, but it was someone you needed to talk to anyway. Bob Yanni Rural Is…

  7. Pay for performance • Pay for performance? • Pay for outcome. Pay for better living. • Pay for performance is not a physician/provider/practice level issue • System level performance • Consider broader initiatives • Public-private collaborations

  8. For Instance THE NEW YORK TIMES NATIONALFRIDAY, JULY 11, 2003 • Because many patients are transferred out of rural hospitals and into urban hospitals (In the case of acute heart attack, transferred patients are often younger and healthier), this may disproportionately move money away from rural care towards urban hospitals Medicare to Pay Bonuses For Best of Hospital Care

  9. Rural Is… • They hold a ribbon cutting for a traffic light

  10. Balancing the Rural Portfolio • Look outside the “medical” sector for improved health care. • Baby Bear Hugs (home visitation) in Northeast Colorado drastically reducing infant mortality • Hispanic Access in West Yuma County improving CSAP scores • Reward local solutions • Support the translation and export of those solutions to other rural communities • Resource ≠ Dollars invested • Volunteerism, time, energy, commitment, that extra mile

  11. The good panel discussant Never Ask for Money Sell an idea Ask for the money

  12. The State Legislature makes lots of healthcare policy • You are part of a Balanced Rural Portfolio

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