Population health solution: Combine emergency and primary care services at rural hospitals

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Combining emergency and primary care provision could improve population health in rural areas.

The critical lack of adequate primary care options in rural areas has led to a decline in population health. A new proposal suggests supplementing emergency medical facilities could help solve the problem.

Margaret Greenwood-Ericksen

Both rural communities and the Centers for Medicare & Medicaid Services have had to either get creative or allocate increased funding to ensure rural populations continue to receive appropriate healthcare. Margaret Greenwood-Ericksen, M.D., of the Department of Emergency Medicine at the University of Michigan in Ann Arbor, says it's time for a new model of care provision.

“The traditional urban model of healthcare has been ineffective at improving rural health,” she said. In an article published in the Annals of Emergency Medicine, Greenwood-Ericksen, along with University of Michigan colleagues Renuka Tipirneni, M.D., and Mahsid Abir, M.D., suggests emergency care hospitals can bridge the gap.

Since emergency departments become de facto care centers for populations that lack primary care resources, the article suggests those facilities work to augment existing primary care networks to supplement their work.

At Carolinas HealthCare System Anson in Wadesboro, North Carolina, leaders reinvented the struggling rural facility, redesigning it to combine both emergency and primary care spaces. The authors’ model proposed a general partnership that aims to move patients from a cycle where they receive periodic emergency care to more of a pipeline, where the emergency department treats the patient, and then encourages them to move to a patient-centered medical home.

Benefits of such collaborations would stem from improvements in both acute and emergency care provision and improved behavioral and population health for a population currently underserved, according to the article. The authors also suggest such a partnership would improve the financial stability of rural hospitals currently acting as safety-net facilities, the loss of which can have truly devastating effects on surrounding communities.