Rural Healthcare: What to Expect in 2016

Posted on Mon, Feb 22, 2016
Rural Healthcare: What to Expect in 2016

EmCare cares for more than 1.5 million patients in 170 rural hospitals around the country, and more than 2,000 clinicians dedicate their practice to this critical need. EmCare Physician Services (EPS) is the EmCare division which manages rural, community and other small-volume hospitals and medical centers. Bill Yarbrough, Chief Executive Officer of EmCare Physician Services, provides his insight on what rural hospitals and clinicians can expect this year.
What trends do you foresee in 2016 for healthcare in general and rural medicine specifically?

We’ll see the cost of coverage increase, affecting patients’ decisions on the affordability of coverage, and where and how they’ll seek care. The use of technology will increase to help address costs and barriers to access to care, particularly in rural and other underserved areas. In the healthcare in general, we’ll see even more consolidation and partnership among healthcare entities and an increased focus on post-acute care management.

Will the presidential election affect healthcare?

The election could have an impact on non-Medicaid expansion states in that there’s a significant difference in access to and affordability of coverage/care for patients, particularly in rural areas. From a national perspective, certain elements of the Accountable Care Act (ACA) may change depending on the composition of Congress or the White House.
What will be the top challenges for rural hospitals in 2016?

  • The ACA will continue to cause a negative financial impact in Medicare and Medicaid, which represents a large percent of rural hospitals’ of payor mix. We may see some regulatory fixes, such as removing the 96-hour conditional payment for critical access hospitals.
  • Rural hospitals will need to consolidate services, particularly for specialty care and referrals, to remain competitive. This may mean further horizontal integration of hospitals via mergers and partnering with systems.
  • And, rural hospitals will be challenged to expand the use of telemedicine for specialty consultation.

What will be the top challenges for rural physicians in 2016?
  • Declining reimbursement makes becoming employees of hospitals and healthcare entities more attractive. It’s expected that 75 percent of physicians will be employed by 2020.
  • Becoming proficient using the technology expected for documentation while trying to stay engaged with patients amidst the shift to pay for performance will be a noted challenge. 

What changes do you foresee with the rural patient population?
  • More patients are transitioning back to self-pay due to affordability/usability of exchange healthcare coverage. There will be a continued shift toward higher deductible plans and copays. In fact, only 4 percent of healthcare consumers selected high-deductible plans in 2006, compared with 22 percent in 2014.
  • Telehealth will be used more by patients for routine, preventive, primary and psychiatric care.
  • Bundling of post-acute services will be more difficult for care coordination for rural patients.

Bill Yarbrough, Chief Executive Officer of EmCare Physician Services (EPS), joined the company in 1989 has had a dedicated focus on meeting the needs of community hospitals. He previously served as EmCare’s EPS Chief Operating Officer and Vice President of Client Services.  His prior experience includes leadership positions in Spectrum Healthcare and Professional Anesthesia Services.

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