- Sharing clinicians between larger academic medical centers and rural health centers is a cost-effective method for improving rural patient care access in medically underserved areas, according to new research.
The research, presented at the American College of Surgeons Clinical Congress 2017, found that the exchange between academic medical center providers and rural providers resulted in $4.7 million in net revenue and easier care access.
Patient care access is a serious hurdle in rural regions. Patients often face traveling extraordinary distances to obtain quality treatment. And when patients do access care within less densely populated areas, they often face clinician shortage problems. Rural regions are also hindered by limited funds, which can result in less high quality care.
The clinician exchange, led by researchers from Texas Tech University Health Sciences, alleviated that problem.
The pilot program involved sharing doctors in five different hospitals, including ones from academic medical centers and practices in rural areas of West Texas. With ample access to quality treatments, patient satisfaction scores increased.
This was likely a result of reduced patient transfers, which can be arduous, cumbersome, and generally unpleasant for patients in genuine need of care.
Patient transfers reduced by 70 percent during the pilot, the research team found. On a 10-point scale, average patient satisfaction scores increased by one point.
These increases in patient satisfaction and patient care access are perhaps the most important results of the pilot, shared study lead Saju Joseph, MD, FACS.
"I'm a big believer that patients shouldn't have to travel very far to get quality care, especially if it's something that can be delivered close to home," Joseph said in a statement.
The pilot also made it easier for patients to partner with their family members during the patient care process. With treatments happening closer to home, family stakeholders were more easily able to visit patients during recovery, an immeasurable benefit to care, Joseph said.
There were also financial benefits to the pilot program, Joseph and his team found. The pilot reduced rural clinics’ costs associated with recruiting skilled surgeons. The partnership also reduced the number of patient transfers, the research team said, and was mutually beneficial.
Academic medical centers often rely on Graduate Medical Education funding to balance some medical costs associated with treating low-income patients from rural areas. But with Graduate Medical Education funds presently shrinking, redistributing the share of rural health cases has helped academic institutions.
In addition to financial gains for rural and academic medical centers, counties within Texas benefitted from the program, Joseph pointed out.
"The way Texas works is unique because the counties pay for some patient transfers," he explained. "For one small town, saving that money on transfers provided them money to pave their main road. These improvements really show the community that there is something positive going on."
Joseph and his team estimate that the partnership will produce $7 million in cost savings for the state of Texas.
"It's a win-win situation for everybody," Joseph said. "As, surgeons, we need to champion the idea of providing high quality care with low costs and providing a community benefit."
This strategy aligns with one that was recently proposed by the American Hospital Association. In multiple resources published starting in December 2016, AHA has advocated for reallocating the workforce to meet the specific needs of patients living in rural areas.
Other healthcare stakeholders are advocating for a similar strategy. Multiple bills are circulating Congress and state legislatures are calling for medical students to receive incentive payments for practicing in rural areas.
With nearly 57 million patients living in rural regions, ensuring convenient access to quality healthcare is a pressing issue for industry leaders. Healthcare stakeholders must identify strategies for both overcoming geographic care barriers as well as the scarce resource issues patients in rural regions face.