Viewpoint

Aliceann Wolhbruck, Executive Director, NADO Research Foundation

Keeping people and places in good health is critically important to the well being of rural America. As the cover story illustrates, adequate rural health care is essential not only for individuals but also for community and economic development.

Health care is another example of the differences between urban and rural areas. Most metropolitan regions have a large number of hospitals and other health care providers such as health maintenance organizations (HMOs) who compete for patients. In many small towns and rural regions, one hospital is not only the provider of health care but also a major employer. Many small hospitals have severe financial problems.

Because of the large number of elderly in rural areas, Medicare payments are very important to the survival of rural hospitals and home health care agencies, and to the retention of doctors in small communities. Congress is now debating Medicare reimbursement rates, which are lower in rural areas.

In rural communities, health care is a critical component of regional economic development planning and strategy. A variety of approaches are needed not only to assure adequate care for rural residents but also to sustain the economy and employment in small town America. Regional development organizations such as the Barren River Area Development District are playing an important role in bringing together a wide array of organizations and individual to keep rural communities healthy.

The newly enacted farm bill (P.L. 107-171) provides a new opportunity for organizations to come together on a multi- county regional basis through the Rural Strategic Investment Program. “This program is designed to promote regional collaborations among local stakeholders to meet the diverse and pressing needs of rural communities,” according to NADO President John Bruner. The focus of the plans is expected to address the basic infrastructure and public service needs, including health care, in rural regions. This new federal initiative offers rural communities the opportunity to develop innovative approaches to health care and other vital services.

Rural regional development organizations are also looking forward to the release of the HHS Rural Task Force report outlining the department’s plans for rural health care policy and programs. Improving the health of both individuals and communities will require a broad array of services, programs and innovative approaches.

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