Ky rural health works connecting health care and economic development
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KY Rural Health Works: Connecting Health Care and Economic Development. www.ca.uky.edu/krhw. Kentucky Rural Health Works. Partners UK Center for Rural Health KY State Office of Rural Health UK Cooperative Extension Service UK Dept. of Agricultural Economics. Mission Statement.

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Kentucky Rural Health Works Development

Partners

UK Center for Rural Health

KY State Office of Rural Health

UK Cooperative Extension Service

UK Dept. of Agricultural Economics


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Mission Statement Development

  • Increasing Awareness about the Role of Health Care in Economic Development

  • Providing Tools for communities to invest in health care as an engine of economic growth

  • Conducting applied research to create a solid foundation for policy analysis and educational programming


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Awareness Building Development

Economic Impact of Rural Health Care

  • County, regional and State Level

    • What is the economic impact of the hospital or other health care providers?

      • Jobs provided

      • Income paid

      • Local purchases of materials and services


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How? Development

  • Economic Impact Reports

    • Radio Spots

    • News Releases

    • Ad Campaigns

    • Public meetings

  • Feasibility Studies

  • Other applied research and training


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Public Information Development

  • Economic impact Report maybe the starting point for a media campaign….

    • Press Release

    • Radio Spot

    • Roadside Advertising Boards

    • Flyers and brochures

    • Using information in health and nutrition programming


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Providing Tools… Development

  • Feasibility Study Training

    • Assessing the possibility of adding services, networking to meet

      • Health care objectives

      • Economic development objectives

  • Economic Evaluation of:

    • Preventive care programs

    • Health care access programs

  • Performance Based budgeting

    • Using budget planning to achieve health care strategic goals in communities


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Examples…. Development

  • Demand & Feasibility Studies

    • Demand for new Dialysis unit

    • Prospective use for new rural health clinic

    • Financial Feasibility and Location of new Outpatient surgical unit

    • Response to service demands from new county industrial park


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Applied Research… Development

  • Economic Analysis of:

    • EMS (survey)

    • Telehealth

    • Consumer expenditure patterns

  • State and Federal Level

    • Economic role of Medicaid and Medicare on rural community health sectors

    • State health and economic development planning


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Tools for preventive care evaluation… Development

  • Program Evaluation Tools:

    Determine whether your program is making an economic impact on community

    Examples:

    • Cost savings to health care providers

    • Economic benefits of a healthier population

    • Economic benefit of “Cancer screening program”


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Why? Development

  • To add an element to health care decision making in your community

  • To alter thinking about economic development in your community

  • Promote health network development

  • Address consumer / patient out migration


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Where? Development

  • Health Council or health groups in community

  • Industrial Development Authority

  • Chamber of Commerce

  • Fiscal Court

  • Newspapers, Radio….


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NATIONAL HEALTH CARE: Development

THE BIG PICTURE



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Rural Economic Development Development

  • Target

    • Create jobs

  • Tools

    • Attract new industry

    • Invest in workforce education and training

    • Build new health care facilities or develop healthcare networks, preventive care

    • Beautify Downtown, invest in tourism

  • Evaluation

    • ‘Was the Tool effective in reaching the Objective

    • Economic Impact Analysis “IMPLAN”


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Health Care can be used to achieve Econ Dev DevelopmentObjectives

  • Health Care and Health Education are focused on achieving “Health” targets

    • Nutritional goals

    • Quit smoking

  • Health Care may also play a role in achieving economic development targets:

    • Create jobs

    • Diversify businesses in community “don’t put your eggs in one basket”


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Three DevelopmentTools to Rural Economic Development

  • Invest in:

    • Human Capital

    • Physical Capital

    • Amenities (Public Capital)

  • Just Like your stock portfolio

    • What mix of stocks, bonds, cash do you want?

    • What mix of human, physical and public capital do you want your community to invest in?


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Economic Development Development

Human Capital

Attract Migrants for Jobs or Train Current Residents?

Jobs bring workers or workers bring jobs

Private Capital

Physical Capital

Amenities: public capital

Investments to Attract Employers or Workers?

Amenities (Public) Capital


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Human Capital Development

  • People

    • On the Job Training and Formal Education

    • Entrepreneurship and Risk Taking

    • Influenced by:

      • Culture of region

      • Family and friends

    • Nurses, allied health professionals, Doctors, Dentists, nursing home employees


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Physical Capital Development

  • “Things”

    • Machinery, Computers, Equipment, Buildings

  • Combine physical capital with people “human capital” to produce goods / services

  • It’s a lack of “things” that is slowing economic development

  • Hospital, Clinic, Ambulances, health equipment


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Amenities (Public Capital) Development

  • Environment and Geographical Features

    • Rivers, lakes, caves, forests,

  • Public Events

    • Festivals

  • Public services

    • Schools

    • Roads, bridges, water and wastewater, public safety


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Evaluation Development: Connecting Targets and Tools

  • Need to use the right tools to reach your target

    • Need to use the right prescription for the illness

  • Health Care as physical capital

    • Buildings, equipment

    • Health care purchases support local business

  • Health Care as human and social capital

    • Nurses, doctors, dentists, allied health prof.

    • Develop workforce to expand and retain health care employers

  • Health Care as Public Capital

    • Support industry location, household location


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Evaluation Development: Connecting Targets and Tools

  • Financial Measure

    • Hospital spend money in local community

      • Payroll

      • Goods and Services

  • Non-Financial Measures

    • Health care system helps attract new business to region

    • Preventive care helps promote healthy workforce


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Rural Economic Development in Pictures Development

Human Capital

Financial

Target: Create Jobs

Target: Create Jobs

Non-Financial

Physical Capital

Public Capital


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Rural Economic Development in Pictures Development

Financial: new doctor’s staff payroll

Target: Create Jobs

Target: Create Jobs

Human Capital: Investing in a young person’s medical education

Non-Financial: attract new employer to town



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What is Economic Impact Analysis II… Development

  • Is to measure changes in an economy due to a change in one industry

  • A change in one industry e.g. opening or closure can have an impact on jobs and income on other sectors of the economy

  • This impact can be measured using what is know as multipliers.


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What is Economic Impact Analysis I….. Development

  • Economic Impact Analysis

    • Is an evaluation model to determine if the tool is right for the target

      • Looking forward

      • Current snapshot

    • Tells Us Two things…

      • Economic impact of the existing health care sector

      • Economic impact of expanding or contracting the health sector

    • It Does Not tell Us:

      • Which tool to use?


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Economic Impact Analysis Development

Multipliers

  • Industries are linked together by their purchases from each other

  • These linked purchases produce jobs and income to local residents and commuters in the local economy

  • For example, hospitals demand goods and services from suppliers, those suppliers in turn demand other goods and services


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Economic Impact Analysis: Three Types of Multiplier Effects Development

  • Direct effects: changes in industries to which a final demand change was made

  • Indirect effects: changes in other industries as they respond to the new demands of the directly affected industries

  • Induced effects: reflects changes in household spending from changes in income due to the changes in production


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Health Care’s Local Financial Linkages Development

  • Hospitals, nursing homes, doctors offices, etc… spend money locally

    • Local spending creates local jobs and local income

    • Examples include

      • Floral shops

      • Waste management

      • Legal and accounting services

      • Pharmacies

    • Some spending is non-local

      • Medical equipment

      • consulting


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County Hospital Expenditure Pattern Development

Purchases per $m in Nursing home sales


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Nursing Home Expenditure Pattern Development

Purchases per $m in Nursing home sales


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Economic Impact Analysis DevelopmentJefferson County Hospitals


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Economic Impact Analysis DevelopmentEstill County Hospitals


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Policy Implications Development


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Health Care and Econ Dev Targets Development

  • Health Care (acute and Preventive) can…

    • Promote job growth,

    • Produce a healthier and more productive population (higher wages, more competitive firms)


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For Health Care Development

  • Recognizing a different role in community

  • Continuing growth in importance of medical transfer payments to rural areas

  • Subsidy or funding support similar to manufacturing

  • Role relative to closure or expansion of facilities

  • Networking and Telemedicine


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For health care…. Development

  • Different roles in

    • Large rural hospital centers

    • Small rural hospitals

    • No hospital

    • Nursing homes play a different role


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For economic development officials Development

  • Subsidy and funding support for health care (Why or Why not?)

  • Capital access financing

  • Attracting Rural physicians, dentists and professionals to shortage areas can be an econ dev policy

  • Workforce development and education


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For economic development officials Development

  • Local industrial authorities

    • Supporting medical facilities in industrial parks

    • Seeing primary versus secondary importance of industry

    • Support health and nutrition education programs for workforce


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Extension Agents Role Development

  • Coordinating a campaign to support the local health care system

  • Bridging the divide between health care and economic development in your community

  • Providing access to economic impact reports and training


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Next Steps….. Development

  • Request an Economic Impact Report

  • Begin a Dialogue in your community with health care, economic development officials and community leaders

  • A follow-up meeting with Extension Agents at State Conference in January

  • A feasibility study training to follow next year

    www.ca.uky.edu/krhw


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