Symposium recap: Challenges and opportunities for rural health care

Iowa has a large and intricate safety net in place to provide care for the nearly 36 percent of the state's 3.1 million people who are living in a rural area. There are 84 critical access hospitals — facilities with 25 or fewer beds that receive a special reimbursement rate from the Centers for Medicare and Medicaid Services to help compensate for lower patient volumes — scattered across Iowa with a handful of larger, more regional facilities and more than 100 health clinics serving  rural populations.

But these critical health care providers deal with a number of challenges – from recruiting primary care providers, dentists and mental health providers to balancing tight budgets with patient needs. What's more, conversations taking place at the national level regarding repeal of the Affordable care Act and potential funding cuts to both the traditional Medicaid population and 150,000 Iowans – many living in rural areas – who obtained Medicaid through the 2014 expansion would only further exacerbate these issues.

Those living in rural areas are typically older, poorer and sicker than people who live in more urban areas. In Iowa, the average age of rural residents is eight years older than urban residents — 43.6 years old compared with 35.3, according to the most recent U.S. Census numbers. Many have multiple chronic illnesses such as heart problems or diabetes.

All of these issues to access and affordability were discussed June 6 at The Gazette's second and final Iowa Ideas Health Care Symposium in Cedar Rapids. The event featured Keith Mueller, interim dean at the University of Iowa's College of Public Health, and Dr. Tim Sagers, Medical Director for the Business Health Services Group at Mercy Medical Center.

The two experts discussed the role of telemedicine in expanding access and specialty care to rural areas – something they view as increasingly important but argue it needs better reimbursement rates from insurance companies to become better utilized – as well as changing payment and delivery models taking place within the health care system that will provide more coordinated, whole person care.

More on rural health care:

-- Interactive map of Iowa's critical access hospitals and rural health care clinics

-- How the American Health Care Act could impact rural areas

-- Rural counties could be left with few options for individual health plans as Medica considers pulling out of Iowa