Healthcare in very rural and frontier communities: Balancing equity, effectiveness and efficiency

The National Center for Frontier Communities in partnership with State Offices of Rural Health have designated close to four percent of the nation's population as remote rural communities or “frontier”. Ten million frontier residents are scattered across 56% percent of the land area of the United States.

Healthcare access and services in very rural and frontier communities are very different from delivery systems in “rural” and urban centers. Residents of very rural and frontier communities are typically older, poorer and more likely to be uninsured. These communities suffer the most severe health care provider shortages in the country. Very rural economies are often based on limited resources or activities and are more at risk of economic downturns and boom-bust cycles--such as farming, ranching, tourism, logging, and mining—and they may be more vulnerable to less desirable sources of business income, such as nuclear waste disposal. These communities often lack any form of public transportation and are located in food deserts.

The National Center for Frontier Communities in partnership with the national Frontier and Rural Expert Panel have examined five evidence-based healthcare models that provide effective and cost-efficient care for frontier and remote rural communities. These programs include: Community Health Worker based care coordination, mental health aides, dental aides, community health aides and Frontier Extended Stay Clinics. Participants will learn about the key program components, education and training requirements, funding/sustainability issues, regulatory factors, and policy issues relating to each of the five models.