As we close out 2017 and move into 2018, we find ourselves grappling with an increasingly destabilized healthcare system. While much focus has been on larger issues such as the Delivery System Reform Incentive Payment Program (DSRIP), Disproportionate Share Hospital (DSH) adjustment payments and the reauthorization process of the Children’s Health Insurance Program (CHIP), there has been significant disruption brought on by many less noticeable factors that include both state and federal policy changes and funding cuts. The cumulative effect of these dynamics exceeds destabilization and presents the clear and dangerous prospect of a significantly compromised healthcare delivery system.
Rural communities are most vulnerable to healthcare delivery destabilization, whether the cause is from large systemic factors or numerous smaller ones. This is due to the fact that rural healthcare delivery is already strained by travel distances to services, inadequate numbers of providers, and high rates of poverty. Compounding this problem, is that rural communities have higher rates of smoking, veteran suicide, infant mortality, youth suicide, mental, behavioral and developmental disorders in children, and cancers related to modifiable risks. Not surprisingly, rural communities also have higher rates for the five leading causes of death in the United States—heart disease, cancer, unintentional injury (including vehicle accidents and opioid overdoses), chronic lower respiratory disease, and stroke (CDC 2017).
Most of you reading this article find the above information of no surprise. You know it, you have heard it before, and you live and work with the realities and challenges it presents.
NYSARH represents and supports its membership, which is comprised of stakeholders in rural healthcare. The NYSARH Board of Directors is a cross-section of that membership. As such, we all feel deeply the effects of healthcare destabilization and funding cuts. The NYSARH Board has determined that to effectively manage and navigate through an increasingly destabilized rural healthcare delivery system, we must first ensure that we, as Board and Membership, are united in thought, aligned in priority, and organized in structure to serve with effect as the voice of rural health, and influence positive change for rural health in New York State.
To this end, NYSARH has done the following:
Conducted a strategic planning process with the Board of Directors
Committed to re-engineering the administrative staffing of the organization, to take effect January 2018
Created an enhanced infrastructure for meetings, actions and deliverables for all NYSARH Committees
Conducted a rural health stakeholder survey investigating the impact of funding cuts
Initiated formal research based on the stakeholder survey regarding the impact on health and regional economies related to rural health funding in New York State,
These actions are enhancing NYSARH’s organizational stability, capacity to deliver services specific to the Strategic Plan, ability to influence rural health policy, and capability to position itself in developing key partnerships in New York State. We are all facing an environment of disruption and great challenge. Now more than ever it is important that we come together to create the collective capacity, vision, strength and determination to serve and advance rural health needs and interests. Together we can accomplish much in this direction. The time is now.