On June 5th, 2024, the Nashville Health Care Council hosted its inaugural virtual Crucial Conversations Series, bringing together healthcare leaders to discuss rural health and access to care. Sponsored by Blue Cross Blue Shield of Tennessee, the event highlighted the challenges and potential solutions for rural healthcare. Andrea Willis, Chief Medical Officer for Blue Cross Blue Shield of Tennessee, began the event by emphasizing the importance of fostering meaningful conversations and building connections to solve community health issues. 

Dr. Willis underscored Blue Cross Blue Shield’s commitment to using data to address social drivers of health and raise awareness through annual health equity reports. She highlighted the unique role of Blue Cross in public health and its dedication to supporting healthcare leaders and communities through data-driven insights. 

Rural Health: Setting the Stage for Improved Access 

Moderator Pamela Gentry, Deputy Director of the CMS Office of Minority Health, provided a comprehensive overview of the ongoing efforts and challenges in rural health and access to care. She detailed CMS's work to enhance equitable care in rural, tribal, and geographically isolated (RTGI) communities, which account for approximately 67 million Americans. 

Gentry outlined CMS's role in providing healthcare insurance to over 150 million individuals, focusing on underserved populations, including racial minorities, LGBTQ+ individuals, persons with disabilities, and those in isolated areas. Her perspective brought attention to CMS's comprehensive care framework and priorities, addressing healthcare barriers from optimizing medical technology to expanding healthcare coverage. 

Understanding the Root Causes and Solutions of Rural Health Challenges 

Addressing Workforce Challenges 

William Haugh, President of Lifepoint Health’s Central Division, discussed the broader healthcare workforce challenges, particularly in rural communities, where attracting and retaining medical staff remains an ongoing battle. He emphasized the significance of policies such as the Rural Health Clinic (RHC) designation and telemedicine in bridging gaps in care. Haugh called for legislative improvements, particularly in the J-1 Visa Program and Medicaid expansion, to support rural healthcare providers. Lifepoint’s strategies include employing telemedicine solutions and participating in community coalitions to enhance rural healthcare services. He highlighted the need for flexible, innovative approaches to ensure continuous access to vital healthcare services. 

Haugh noted, "Our biggest challenge is getting the workforce... If you’re serving a county of three or four thousand [countries] and there’s only four or five individuals that can, for instance, do an echocardiogram, the ability to provide that service is going to be a challenge.” 

He continued, “Equally important is ensuring that we provide the essential services needed in rural communities, such as maternity health and OBGYN care. The state of Tennessee, and really the entire country, is facing a maternity desert crisis, and one of my top priorities is to prevent that. We are committed to finding innovative solutions to continue offering these critical services.” 

Haugh punctuated the need to evolve, underscoring that the traditional approach of providers living in the communities they serve is no longer sustainable or sufficient.  

Interested in learning more about maternal health in rural communities?  

Innovative Solutions for Workforce Challenges 

Benson Sloan, CEO and Founder of Rural Healthcare Group, emphasized the importance of technology to enhance healthcare access and quality in underserved communities, such as AI and digital workers, to optimize clinical workflows and support healthcare providers. He highlighted the use of advanced EMR systems and investments in technological solutions as pivotal to the group's strategy. 

Sloan underscored the significance of optimizing clinics and investing in technology to make healthcare delivery more efficient. He said, "We want to create an environment for our providers and the teams within our clinics so that they can show up in a more meaningful way every day and ultimately have a better engagement with a patient." 

Sloan further explained, "We try to take advantage of all of the opportunities available for grants... To be able to recruit and retain providers as it relates to supplementing their student debt." 

Collaboration and Community Engagement 

Natalie Cooper, President and CEO of WellPoint, shared insights aimed to address social determinants of health and improve healthcare literacy among Tennessee’s most vulnerable populations. Cooper emphasized the importance of building trust and working closely with community anchors to provide personalized, community-informed healthcare solutions. 

Cooper stated, "We need to meet people where they are," underscoring the organization's comprehensive approach to Whole Person Health. She also emphasized, "What a lot of us don't have is trust with a lot of these members, and we have to build that. There are times that members will not tell their providers what's truly going on, but someone they trust in the community, that's who they will talk to."  

Leveraging Data for Better Outcomes 

Panelists discussed the crucial role of data in driving decisions for rural healthcare. Cooper emphasized using data to identify member needs and connect them with appropriate resources, stating, "We use data to drive all of our decision making with our members. We use data to also not only identify those members but also to identify the programs in which those members would actually thrive." 

Sloan added, "We've taken all of our patient data from our EMR and created our own risk segmentation analysis... We use that to take a proactive approach with our patients and our communities." 

Sloan continued, "[The United States] spends about a third as much on primary care as other countries do. Pair that with the understanding and knowledge that primary care is the foundation of our healthcare system and is a huge driver in outcomes for patients, thus the need for more access to primary care." 

He also noted, "We use that [data] to take a proactive approach with our patients and our communities and reach out to them in a number of ways, whether that's portals, text messages, phone calls, emails, in office, and so the data that we have is really driving how we start to create those longitudinal care plans for our patients." 

Haugh emphasized, "We look at, why do patients have to leave our community? Another data point we have is ongoing meetings with providers and constituents, to say, what services do you need? What is going on? We take feedback from them to say, if we had this dialysis service, we would not have to send that patient an hour and a half away." 

Collaborative Solutions to Improve Access to Care in Rural Communities 

Participants then moved into breakout sessions, fostering rich discussions on healthcare challenges and innovative solutions. Leslie Meehan, Deputy Commissioner, Tennessee Department of Health shared insights on new investments in rural healthcare to enhance workforce and telemedicine access. George Hampton, Nashville Health Care Council Board Member, President & CEO, Currax Pharmaceuticals emphasized the importance of partnering with universities for data insights, while Wisterya Thompson, Director, Clinical Care and Quality Improvement, Blue Cross Blue Shield of Tennessee highlighted the necessity of educating patients and providers on telemedicine. 

Lindsay Perry, VP, Operations, Psychiatric Medical Care addressed the significant impact of stigma on healthcare delivery in rural communities. She stressed the importance of educating communities and spreading awareness about behavioral health, chronic disease management, and obesity treatment to overcome stigmas and improve patient care. 

The event concluded with a productive Q&A session with the panelists, reinforcing the collective goal of improving rural healthcare. Apryl Childs-Potter, President, Nashville Health Care Council wrapped up the discussion by stressing the importance of focusing on solutions rather than merely outlining problems. 

Join the Conversation 

Stay engaged with upcoming events for those interested in furthering the conversation on healthcare challenges and solutions. Join our next Crucial Conversation on Data and AI on August 1st from 4:00 – 6:00 pm. Secure your spot here. 

Resources  

Access additional resources and insights shared during the Nashville Health Care Council’s Crucial Conversations Series to deepen your understanding of rural healthcare challenges and solutions.  

BlueCross BlueShield of Tennessee's Health Equity report shares what they know about how race and other social factors affect health outcomes. Download the report.