Joanie Defibaugh is a shining example of type of commitment to her community.
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Rural hospitals are an intergral and important part of the communities they serve. In addition to providing much needed access to medical services, rural hospitals create and support local jobs. Often, they are the largest employer and are a key part of the community's social fabric. In many ways, rural hospitals provide an outsized benefit from their urban counterparts-- having a hospital is one way of putting a rural community "on the map."
Just as rural communities differ, so do their hospitals. Some community hospitals were originally organized as district or county hospitals. However, not every hospital with a "public" organizational structure receives public funding. In fact, public funding for Missouri hospitals has been on the decline for decades. That is why strong hospital boards-- composed of leaders with a close connection to the communities they serve-- are so important. Hospital boards must allocate funds with a keen eye to the unique health needs of their communities.
The past few years have been difficult for hospitals, especially rural hospitals. Many rural hospitals provide services to populations who are on average poorer, less likely to have insurance coverage, more likely to have chronic conditions and older than their urban counterparts. Rural hospitals also may be more dependent on payments from Medicare and Medicaid, and these programs do not always cover the full cost of providing services. In some cases, rural hospitals are able to receive additional payments or more favorable reimbursement based on their locations or federal designations to offset these structural disadvantages. However, these benefits do not apply uniformly to every rural hosptial.
Building a strong rural health framework is vital to the state's well-being, and rural hospitals have been moving aggressively to adapt and innovate to meet the challenges of a changing market. Upgradeed facilities, community-centered program development, quality improvement and expanded access to physician specialists through partnerships with urban hospitals and through telemedicine are part of this shift. In addition, rural hospitals are transforming themselves through the deployment of new information technology systems.
Primary care access is an emerging concern for rural residents. Rural physicians are older, and they often see more patients more productive than physicians in urban areas because of limited number of practicing physicians in rural communities. As a result, rural communities are more susceptible to physician retirement. In the coming decade, replacing a physician will be a significant challenge for rural hospitals. This is compounded by an expected increase in the demand for health services driven by an aging rural population and anticipated increases in insured citizens becasue of health care reform. Strong rural hospitals are vital in communities' efforts to attract and help retain primary care physicians.
These changes are critical because Missourian's health indicators for tobacco use, obesity, diabetes and heart disease are higher in Missouri than many other states. And, these behaviors can lead to chronic health conditions and increased need for health services.
There isn't a "cookie cutter" approach to the long-term success of rural hospitals. The best rural hospitals reflect the communities they serve.
Imagine your rural hospital disappears from the landscape. Think about how this would affect your community. For many, this would mean losing access to the care provided by hosptials 24/7, 365 days a year.
Strong communities need strong hospitals. And, rural communities are stronger because of the rural hospitals that serve them.
The Missouri Hospital Association is a not-for-profit association in Jefferson City that represents 154 Missouri hospitals. In addition to representation and advocacy on behalf of its membership, the association offers continuing education programs on current health care topics and seeks to educate the public about health care issues.