The importance of access to rural healthcare was the topic for Choptank Community Health System CEO Sara Rich’s May 17 testimony at a hearing titled, “Improving Health Care Access in Rural Communities: Obstacles and Opportunities” before the Senate Committee on Finance Health Care Subcommittee.
Presiding over the Subcommittee hearing were Chairman U.S. Senator Ben Cardin (D-Md.) and ranking member U.S. Senator Steve Daines (R-Mt.). Rich provided testimony on behalf of the nation’s community health centers and was one of four national healthcare leaders providing testimonials.
According to the Centers for Disease Control, “Rural Americans face numerous health disparities compared with their urban counterparts.” To combat these obstacles, rural communities and providers including Choptank Health are pioneering innovative approaches to increase access to high-quality health care.
“Community health centers are the key to providing access to high-quality, affordable, and equitable health care,” said Rich. “Community Health Centers, like Choptank, work to figure out how we can best meet the needs of the communities we serve and are constantly reinventing how we provide access to care so we can meet our mission.”
Choptank Health serves more than 30,000 rural residents of Maryland’s Eastern Shore with medical, dental, and school-based health services in Caroline, Dorchester, Kent, Queen Anne’s, and Talbot counties.
“In the U.S., nearly 20% of residents live in rural areas, but only 10% of healthcare providers work in these areas,” said Rich during her testimony. “Twenty-five percent of Maryland’s total population lives in an officially designated rural area, with all five counties in the Choptank service area designated as rural.”
“Caroline, Dorchester, and Kent Counties have a Health Professional Shortage Designation (HPSA) for dental, mental health, and primary care,” Rich said. “In addition, Talbot County has a HPSA designation for dental care.
“Rural areas often share similar characteristics that are unique from other geographic designations,” said Rich. “These include distance to obtaining services, lack of transportation, healthcare access and availability, and poorer health outcomes.
Rich’s testimony shared how Choptank Health has been implementing innovative approaches to address and overcome obstacles to rural healthcare access, including workforce shortages, broadband access, transportation, and Medicaid redetermination.
Rich cited Choptank Health’s recent expansions in behavioral health, prenatal care, and women’s health as one way the Federally Qualified Health Center is addressing the area’s shortages of providers.
Rich says the need for reliable internet services became even more critical, especially in rural areas during the COVID-19 pandemic. “Virtual visits accounted for 65-70% of medical visits during the COVID-19 pandemic,” she says.
“Often, the planned virtual visit was converted to a phone visit so that the provider could connect with their patient,” Rich says. “Audio-only visits are a lifeline to some of our most vulnerable patients who face multiple obstacles in obtaining health care including chronic disease, transportation, and internet access.”
Rich’s testimony on Medicaid redetermination included how states will now have to begin eligibility redeterminations for Medicaid enrollees with the unwinding of the COVID-19 public health emergency and that estimates from Geiger Gibsonindicate that nationally up to 15 million Medicaid enrollees will lose coverage.
“Community health centers provide care for 1 in 6 Medicaid beneficiaries,” said Rich.
“States, including Maryland, are partnering with community health centers to provide outreach and education to patients who need to renew coverage depending on their eligibility or to find new coverage,” she says, “Choptank is developing messaging to share with patients at check-in and has members of the population health department reaching out to patients who are due to reapply for coverage.”
Rich also shared how providing health care in a rural area requires thinking outside the traditional healthcare delivery models, a practice she says is embraced by community health centers like Choptank Health.
Choptank Health’s strategies include expanding School-Based Health Centers both in the scope of service and in the number of sites, building a robust primary care delivery system for preventative health with the Maryland Primary Care Program, and garnering the power of partnerships to expand equity outreach.
“Choptank Community Health System has community in our name for good reason—community is at the core of everything we do,” said Rich. “When local agencies and community partners work together, the result is healthier communities.”
Rich concluded her testimony by sharing opportunities to increase rural health access for the Senate’s consideration.
Rich joined Choptank Community Health in 2007 as the vice president of community programs and eventually became senior vice president and COO in 2015. In 2017, she was appointed by the Choptank Community Health System Board of Directors as CEO. Prior to joining Choptank Community Health, Rich was the Associate Director for the National Center for Child Death Review, a program of the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services, and previously a community health consultant with the Michigan Child Death Review Program.
A recording of Rich’s testimony can be accessed at bit.ly/ruralhealthcarehearing.
Choptank Community Health System’smission is to provide access to exceptional, comprehensive, and integrated healthcare for all. Medical services include primary healthcare, women’s health, pediatrics, behavioral health, chronic health management, care navigation, and laboratory services, with new medical and school-based health patients now being accepted. More is at www.choptankhealth.org.