A new report includes several recommendations to improve healthcare in rural Tennessee communities, which center on workforce development, access to care, and social drivers of health (SDOH).
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Gov. Bill Lee established the Tennessee Rural Health Care Task Force in 2019 to improve health access and outcomes for rural Tennesseeans. The task force included 34 public and private stakeholders representing the Lee administration, the Tennessee General Assembly, rural healthcare leaders, and community members across the state.
The task force met from May 2022 through June to develop evidence-based recommendations to improve rural communities’ access to preventive and comprehensive healthcare services, improve rural health outcomes, and promote equitable and efficient healthcare delivery in those areas.
The report found that Tennessee’s rural communities face unique healthcare challenges that impact both physical and behavioral health.
“Rural Tennesseans often experience diminished access to care, in part due to limited availability of healthcare facilities, long travel times to receive care, workforce shortages for high-demand healthcare professions, and a high cost of healthcare. Rural community members also experience distinct social and environmental obstacles which can contribute to poor health outcomes, including mental health challenges, obesity, and substance misuse.”
— Tennessee Rural Health Care Task Force report
The state recently prioritized programs and resources to improve rural healthcare, including the Health Care Modernization Task Force, Healthy Smiles Initiative, Tennessee Rural Hospital Transformation Act of 2018, Tennessee Broadband Accessibility Act, and the Small and Rural Hospital Readiness Grant Program. Tennessee also expanded access to dental services for all adults receiving TennCare (Medicaid) benefits and extended postpartum benefit coverage to 12 months following the end of a pregnancy.
Lee wanted to build on these initiatives, and formed the task force to develop a set of recommendations, including innovative programs, policy and funding opportunities, and legislative agenda considerations.
While the task force recognized numerous challenges impacting rural communities, members used recent rural healthcare trends to identify three priority areas that have downstream impacts on all rural Tennessee communities—access to care, workforce development, and SDOH. The task force formed three workgroups to align with these priority areas, and assigned members to them based on their respective areas of expertise.
The access to care workgroup recommended the following initiatives:
- Utilizing more than $5 million to establish a center of excellence for rural communities and providers (from hospitals, outpatient and long-term care facilities, and dental and behavioral health centers) to provide or coordinate operational and strategic technical assistance, background implementation research, and advocacy efforts to expand service line delivery, evaluate alternative payment models, or transition services to better meet rural community needs.
- Utilizing $7 million to establish Planning and Implementation Grant funding for the center of excellence to disburse to rural communities and providers to supplement technical assistance services provided through the center.
- Utilizing more than $5 million to increase access to specialty care in rural communities through a provider consultation program and the Tennessee Department of Health’s Project Access Specialty Incentive Pilot Program.
The workforce development workgroup recommended the following initiatives:
- Utilizing $67.7 million to expand current healthcare, behavioral health, and dental health pathway programs by increasing early exposure to healthcare careers, increasing transition opportunities into health science education and healthcare careers, and improving healthcare career advancement programs.
- Utilizing almost $39.5 million to bolster and expand existing rural health and behavioral health registered apprenticeship programs, enhance non-state apprenticeship programs, and identify opportunities to develop new “apprenticeship-like” programs for high-demand healthcare professions.
- Utilizing almost $22.5 million to provide longitudinal, recurring state funding to expand or develop rural healthcare preceptorship and rotation programs, rural training tracks, accelerated medical training opportunities and fellowships, rural residency programs that prioritize placement in rural communities, and continuing medical education courses.
The SDOH workgroup recommended the following initiatives:
- Utilizing $33 million to support county health councils to improve food security, transportation, and substance misuse/mental health condition prevention through the establishment of Rural County Planning Grants, the expansion of Collaborative Action for Resilience and Equity Grants, and the implementation of private partner development support.
- Utilizing $9.6 million to support rural providers in addressing their patients’ SDOH experiences, including assisting them with preparing for and implementing TennCare’s Closed Loop Referral System.