Arizona health leaders discuss challenges to accessing care in rural areas


Hannah Saunders


Healthcare leaders discussed challenges to accessing care in rural and border communities at the 2024 Arizona State of Reform Health Policy Conference last week.

Douglas sits about two miles away from the Mexico border, and is home to Chiricahua Community Health Centers, Inc., (CCHCI). CCHCI CEO Jonathan Melk said about 35 employees live in Mexico.

“The first time they closed that border during COVID, we learned that one of them had the only key to the medication room,” Melk said. “That’s a real barrier to care and I want to emphasize: there are people going across the border; thousands of people every single day, legally. They’re going back and forth for work, school, (and) shopping.”

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The greatest health-related challenge in the area is identifying health conditions, Melk said. 

“All of our stats are just that much worse than our urban counterparts,” Melk said. “Everyone, in general, has less family income, and the opportunities aren’t there across the country. So that’s what drives our strategies and how we address things.”

Sarah Darragh, Medicaid director at Arizona Complete Health, said the most pressing challenge she sees is access to care in rural areas. Medicaid members in urban areas have higher health scores than members in rural areas, indicating that they are healthier than their rural counterparts. 

“In rural areas, clinics and hospitals are further away, so we see higher rates of chronic illness,” Darragh said. 

Arizona Complete Health is excited about the Arizona Health Care Cost Containment System (AHCCCS) opening the community health worker designation for Medicaid, Darragh said. AHCCCS recently announced that organizations that employ certified community health workers will be able to register as AHCCCS providers and be reimbursed for providing Medicaid services. 

“Historically through community reinvestment funds, we were able to do that on a smaller scale, but this really broadens and expands access to care and the ability to engage with members in a unique way,” Darragh said. 

Arizona Complete Health recently established a health equity committee that is inclusive of providers and systems partners, Darragh said. The committee aims to understand community needs and discover ways to deliver related services to members. She said there is currently low utilization of prenatal care, and outreach work has shown year-over-year performance improvements. Contracting and working closely with providers for direct wellness visits have also been useful, Darragh said. 

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