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July 31st, 2021

kcca conventionCounty commissioners from across the state listen to a discussion about rural health care during Wednesday’s portion of the Kansas County Commissioner Association’s annual conference at the Conference Center in Liberal. L&T photo/Robert PierceROBERT PIERCE • Leader & Times

 

For years, rural health care has been a problem in Kansas, and representatives from some state health agencies were on hand to talk about the future of the state’s rural health care system this week at the Kansas County Commissioner Association’s annual conference in Liberal.

David Jordan, president of the United Methodist Health Ministry Fund, said the state has a number of challenges when it comes to health care.

“We faced the demographic challenge,” he said. “Our communities are getting older. Our communities are growing at a slower pace, and our communities are growing more diverse, which creates an opportunity, but there’s longstanding health disparities like this. Beyond our changing demographics, we face challenges with a high uninsured rate in rural communities and in general, the funding changes for health care.”

Jordan said, though, work is being done at both the state and federal level to help fix the problems.

“The legislature and Washington have taken an important step forward by authorizing the Rural Emergency Hospital program, which would allow Kansas hospitals to look at participating in a model that would allow us to better finance health care in rural communities and get rid of some of the administrative data errors that prevent that now,” he said. 

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Jordan said over the next two years, it will be important for Kansas communities to look at participating in the Rural Emergency Hospital program as a way to respond to the challenging health care system in rural communities. 

“Right now, Kansas has more financially vulnerable hospitals than any other state in the country,” he said. “We hope some of those hospitals will say the Rural Emergency Hospital program passed by Congress and passed by the Kansas Legislature makes sense for us. It will allow us the right size care in our community too from changing demographics to the uninsured to the needs we have.”

Jordan said leaders in Kansas communities are thinking about the Rural Emergency Hospital option changing health care models to take advantage of a program he says will pay better and be a better fit for communities.

“I think part of it is a local solution,” he said. “Does this solution makes sense for us? At the state level, there is the need to expand Medicaid. We have a high uninsured rate, particularly in rural Kansas. A number of rural community hospitals are suffering because we haven’t expanded Medicaid, and expanding Medicaid will help not just by helping improve coverage, but also by bringing money back to rural communities to finance.”

With other areas of the state’s budget such as transportation and education also needing funding, getting more money for health care becomes even harder. Jordan said this is why expanding Medicaid in Kansas is so important.

“If the state were to expand Medicaid, it would cost, based on the last two-year estimate, $20 million over two years,” he said. “It would cost $20 million to bring back $1.2 billion. Largely, we’d be getting a huge amount of federal dollars that would then trickle into our local community. We spending more to fill gaps for mental health services and other health care services at the state level because we haven’t expanded Medicaid. Expanding Medicaid would solve financing on a number of issues and not having to create a situation where you either fund education or fund health care. We’d be able to do both.”

Jordan said Kansas’ future is inextricably linked to the ability to sustain health care in rural communities. 

“We need to make sure we have health care in our communities so people can continue to get care where they live, but also health care supports many jobs and businesses in our rural communities,” he said. “That’s critical to our future as well.”

Adding to the state’s health care problem, Jordan said, is a growing number of government regulations.

“Regulation is a challenge in health care from a couple of standpoints,” he said. “One, there’s workforce challenges the state faces, along with demographic challenge, the uninsured rate.”

“Many of our hospitals are critical access hospitals, where they can only use the space in those hospitals in a certain way,” he said. “We do need to look at how we can get rid of these regulatory and administrative barriers. Kansas communities know what services they need versus being prohibited from doing it from a DC bureaucrat.”

Jordan said the problems created by health care have forced leaders to think outside the box, particularly when it comes to ways to get ahead of issues.

“How can we make sure we’re having this conversation now?” he said. “I think the Kansas Hospital Association’s taken leadership over the last decade to recognize this was going to be a challenge to develop this new model. The work they did helped to form the federal law and the state law, and it’s critical we’re driving this from a state level. That’s how we’re going to get the health care system we deserve.”

If the Rural Emergency Hospital program is the direction communities want to go, Jordan said today’s hospitals will likely not change much under the program.

“I think in many ways, it’s going to look similar to what’s happening now,” he said. “What will happen is we’ll be delivering health care that’s appropriate for the community versus being driven by unneeded regulations. In many ways, it’s building the health care system for the future the community needs versus being responsive to out of date administrative regulation.”

Kansas Hospital Association Vice President of Education and Special Projects Jennifer Findley said the Rural Emergency Hospital program is a unique opportunity for the state to continue being a leader in the industry.

“Kansas has always been a pioneer in trying new health care models,” she said. “The critical access hospital model many of our communities use today started in Kansas. We were one of the early states to try that, and I think we can do that again with this new opportunity.”

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