By Jonathan Nelson
Last week, Adrian Billings, MD, PhD, traveled from his home in Alpine, Texas, to Austin to testify on behalf of TAFP and the Texas Medical Association at a hearing of the House of Representatives Public Health Committee. The hearing focused on assessing the challenges rural Texans face when trying to access health care.
“I stand before you today privileged to advocate on behalf of rural patients and communities. I do not want to fail these incredibly resilient rural human beings,” Billings said.
Statistically, rural Texans are older, sicker, and poorer than their urban counterparts. Billings told the committee that rural Texans often have more complex medical needs, such as multiple chronic conditions, and they also need community resources like assistance obtaining healthy foods or transportation to medical appointments.
“Yet these resources also are few and far between in rural areas. A patient’s rural ZIP code can and does represent a risk factor to their health.”
In recent legislative sessions, lawmakers have invested resources to stabilize the rural health system, including new dollars to support rural hospitals. Lawmakers also enacted legislation to expand use of telemedicine, even before the COVID-19 pandemic necessitated its swift adoption.
“However, Texas has not implemented a cohesive, enduring, long-term rural health enhancement plan to address the myriad needs of the rural health care system – workforce, infrastructure, emergency medical care, and population health.”
Billings laid out eight recommendations for the committee to consider in advance of the 88th Texas Legislature, set to begin in January 2023.
- Redouble Texas’ efforts to make comprehensive, affordable health insurance available to all.
- Promote adoption of value-based payment initiatives to improve health outcomes and access for rural Medicaid enrollees, including initiatives focused on improving rural maternal and mental health services.
- Replenish funding for the state Physician Education Loan Repayment Program to encourage physicians to practice in rural areas.
- Fund the Professional Nursing Shortage Reduction Program to increase rural nurse recruitment and retention.
- Allocate $20 million to boost the Family Medicine Residency Program.
- Increase physician supply by sustaining Texas’ investments in graduate medical education.
- Activate the state Rural Training Track grant program, established by the Legislature in 2019, by allocating $1 million to fund the creation of rural training tracks in the state.
- Support telemedicine payment parity to ensure rural physicians who want to offer the service to their patients can do so.
“In the coming weeks, our organizations will be collaborating with rural hospitals, academic health centers, community clinics, nurses, and others, to assess a potential model for this approach in addition to formulating a more robust package of potential reforms,” Billings said. “In the meantime, we encourage the committee to strongly support investing in proven initiatives to accomplish our shared goals to sustain a vibrant, effective, and efficient rural health care system.”