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Oklahoma State University Center for Rural Health. Where does Oklahoma rank nationally for its health status (1 st is best and 50 th is worst)?. 33 rd 43 rd 46 th 49th. 1 United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”.

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Oklahoma State University Center for Rural Health

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Oklahoma State University

Center for Rural Health


Where does Oklahoma rank nationally for its health status (1st is best and 50th is worst)?

  • 33rd

  • 43rd

  • 46th

  • 49th

1United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”


Where does Oklahoma rank nationally for its ratio of primary care physicians to total population?1

  • 5th

  • 23rd

  • 39th

  • 49th

1United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”


  • 25% of the state’s population smokes (improving)

  • 32% of the state’s population is considered obese (increasing)

  • 16% of Oklahomans do not have health insurance (was improving)

  • Dead last for the percent of the population that has had a recent dental visit

  • Dead last for the percent of the population that meets its recommended intake of fruits and vegetables

The Health Status of Oklahomans1

1United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”


What About Rural Oklahoma?


How many more people are there per primary care physician in rural Oklahoma compared to urban Oklahoma?

  • 25% more

  • 50% more

  • 75% more

  • 100% more


Mission

Our mission is to support the Oklahoma State University Center for Health Sciences and its College of Osteopathic Medicine by seeking to improve healthcare in rural Oklahoma through:

  • Student education,

  • Residency training,

  • Research,

  • Program applications,

  • Advocacy, and

  • Alliances with others who share our goals.


Presentation Overview

Center for Rural Health Departments and Program Areas

  • Medical Education

  • Clinical Services

  • Grants and Research

  • Advocacy


Rural Medical Education


On average, approximately what % of all graduates from OSU-COM have entered primary care following graduation?

  • 45%

  • 55%

  • 65%

  • 75%


Approximately what % of graduates from OSU-COM have entered primary care following graduation since 2006?

  • 40%

  • 50%

  • 60%

  • 70%


Community Clinic Rotation Sites2010


Rural Clinic Rotation Sites2010


Community Hospital Rotation Sites2010


E.R. Rotation Sites2010


Medical Education

  • Pre-Doctoral Training in Primary Care Grant

    • Medical School

      • Earlier exposure to rural practice

      • Expanded rural rotations

      • Expanded rural didactics

      • Increased experiences with simulators

    • Residency

      • Rural residency programs


Clinical Services


Clinical Services

  • Enid Clinic

    • Primarily Medicare, Medicaid, and SoonerCare


Grants and Research


Grant Funded Activities

  • Annual Grants

    • State Office of Rural Health

    • Area Health Education Center

  • Project Grants

    • Health Information Technology


Grant Funded Activities - Annual

  • State Office of Rural Health

    • State Office of Rural Health (SORH)

    • Small Hospital Improvement Program (SHIP)

    • Medicare Rural Hospital Flexibility Program (FLEX)


Grant Funded Activities - Annual

Small Hospital Improvement Program (SHIP)

  • Eligibility

    • Small (49 beds or less)

    • Rural (outside of an MSA)

  • Authorized Expenditures

    • Prospective payment systems (PPS);

    • Value-based purchasing programs (VBP);

    • Accountable care organizations (ACO); and

    • Payment Bundling.


Grant Funded Activities - Annual

  • Flex Program

    • Conversion to Critical Access Hospital (CAH) status

    • Support for Quality Improvement

    • Support for Operational and Financial Improvement

    • Support for Health System Development and Community Engagement


At most, how many beds may a Critical Access Hospital have?

  • 10

  • 25

  • 50

  • 100


May a Critical Access Hospital have an average length of stay of more than 96 hours?

  • Yes

  • No


How much more money annually does a typical Oklahoma hospital make by converting to critical access status?

  • $ 42,071.00

  • $ 186,106.00

  • $ 227,449.00

  • $ 291,470.00


Impact of CAH Conversion

RN Lawler, GA Doeksen, and V Schott. Impact of Conversion to Critical Access Hospital Status for Oklahoma’s Rural Hospitals. The Journal of Rural Health. 2003.


Critical Access Hospitals

Flex Monitoring Team. Statewide Financial Performance of CAHs – Oklahoma, www.flexmonitoringteam.org/documents/BriefingPaper7_FinancialIndicators.pdf


Critical Access Hospitals

Flex Monitoring Team. Statewide Financial Performance of CAHs – Oklahoma, www.flexmonitoringteam.org/documents/BriefingPaper7_FinancialIndicators.pdf


Critical Access Hospitals

Flex Monitoring Team. Statewide Financial Performance of CAHs – Oklahoma, www.flexmonitoringteam.org/documents/BriefingPaper7_FinancialIndicators.pdf


Grant Funded Activities - Annual

  • Area Health Education Center (AHEC)

    • Model AHEC Program

    • State Matching Funds???????

    • Geriatric Education Center Program


OSU Center for Rural Health’s Services and Activities

February 2010


Grant Funded Activities - Project

  • Health Information Technology

    • USDA Distance Learning and Telemedicine Grant

    • Tobacco Tax Funding for Telemedicine


Research


Research

  • State

    • Effectiveness of rural medical training programs at OSU

    • State of the State’s Rural Health

  • National

    • Gender and generational issues related to physician recruitment and retention

    • The efficacy of telemedicine in the provision of mental health in rural areas


Advocacy


Advocacy Efforts

  • Collaborative Response

    • State

      • OOA

    • National

      • AOA

      • NRHA

  • Propose legislation

  • React to proposed legislation

  • Connect legislators and rural providers


Advocacy Agenda

  • State

    • Medicaid reimbursement for telemedicine

    • Reinstate funding for OkAHEC

  • National

    • Retain increased reimbursement for primary care physicians

    • Interest-free loans for starting residency programs in rural, underserved areas


Why should you consider a rural practice?


After adjusting for cost of living, who earns a higher income?

  • Rural Physicians

  • Urban Physicians


Physician Incomes in Urban and Rural Areas

Reschovsky JD, Staiti A. Physician Incomes in Rural and Urban America. Center for Studying Health System Change. 2005.


Who is more likely to be satisfied with being a primary care physician?

  • Urban Physician

  • Rural Physician


Physician Satisfaction in Urban and Rural Areas

Luman K, Zweifler J, and Grumbach K. Physician Perceptions of Practice Environment and Professional Satisfaction in California: From Urban to Rural. The Journal of Rural Health. Summer 2007.


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