Briefing: Getting the Rural Picture

January 2001

Ever since hundreds of rural hospitals closed in the 1980s following the introduction of new Medicare payment policies, there has been a movement to forge a rational health policy for the unique conditions of the rural environment. In the past decade, many rural-friendly programs and special measures have been initiated and rural health has gained some recognition as a needed corrollary to national health policymaking.

The January 31, 2001 forum by the Capital Area Rural Health Roundtable offered newcomers a retrospective briefing on rural programs and policies, particularly national Medicare and Medicaid-related initiatives to support rural providers.

Mary Wakefield, Ph.D., director of the Center for Health Policy Research & Ethics, offered an overview of the common factors affecting very diverse rural communities that include low density, underinsurance, and a shortage of providers. Other Roundtable speakers reviewed the development of safety-net providers, such as Community Health Centers, Rural Health Clinics, and a variety of Medicare payment adjustments for specific kinds of rural hospitals.

Bill Finerfrock, of Capitol Associates, covered the historic significance of Medicare and Medicaid to rural services and the development of safety-net providers, while Kathleen Dalton, Ph.D., a former rural hospital CFO and currently a researchr at the University of North Carolina, discussed the impact of the Balanced Budget Act on rural hospital systems. Tom Morris, MPA, a policy coordinator for the federal Office of Rural Health Policy, HRSA, reviewed details of BBA and subsequent legislation affecting Medicare payment for post-actue care.

Capital Area Rural Health Roundtable
Center for Health Policy Research & Ethics
George Mason University
Fairfax, Virginia
703-993-1907