Arizona’s Center for Rural Health, located at the UA, was recently awarded a three-year $348,000 grant by Health Resources and Services Administration to support the Arizona Small Rural Hospital Improvement Grant Program

The grant program aims to help rural hospitals facilitate quality improvement, develop and implement programs using shared savings activities and improve financial performance.

“The fiscal challenge rural hospitals face is really because these hospitals provide a lot of uncompensated care,” said Daniel Derksen M.D., AzCRH director. “Patients that come to their emergency department—or are admitted to their hospital—don’t have health insurance, so they end up doing a lot of charity care.”

Last year a hospital in Douglas, Arizona, was forced to close, causing 60 people to lose their jobs and forcing patients to drive farther to receive medical care.

Derksen said last summer he testified in front of the congressional Ways and Means Committee about Medicare and Medicaid payment policies that affect rural hospitals.

“On my way I got a call from the Douglas hospital saying that they would have to close their doors,” Derksen said. “Unfortunately we weren’t able to help them, but I was able to use them as an example while testifying, explaining to Congress that if we don’t pay attention to issues in federal policies such as Medicare and state policies combined [with] federal policies like Medicaid, then we’re making it very hard for these hospitals to stay open.”

The grant, which aims to aid 13 hospitals in rural areas, will help facilitate health system reforms like value-based purchasing programs, accountable care organizations and payment bundling.

All of the hospitals except two are federally designated critical access hospitals, which means they are located more than 35 miles from another hospital and house fewer than 25 beds.

Many states have designated offices for rural health, and have state agencies which help support those rural hospitals. In Arizona, though, there is no designated state agency—instead, the AzCRH operates within the UA’s Mel and Enid Zuckerman College of Public Health.

Bryna Koch, a public health doctoral student and special projects coordinator at the AzCRH said they are currently working to ensure these rural hospitals provide high quality care.

“I think it’s important for the state to help out these rural hospitals if the government has the money for it,” said Diego Garcia, a physiology freshman.

Garcia said healthcare in rural areas is something that not a lot of people think about.

“This program really tries to support rural hospitals so that they can make quality improvements,” Koch said. “They collect quality improvement data and use that data to check their progress and identify areas where they still need to improve.”

A total of 76 rural hospitals across the U.S. have been forced to close their doors, according to the University of North Carolina Rural Health Research Program. Koch said program participants really just want to make sure that people in rural areas have access to equal health care compared to anyone else in the state.

A number of students from the UA who work in public health will be making presentations alongside the AzCRH at the 43rd annual Arizona Rural Health Conference, taking place July 26 to 27.

The conference hopes to engage health care providers, academics, community health professionals, administrators, state and local leaders, CEOs and CFOs in a statewide discussion about rural heath. 

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