With 41 percent of enrolled Veterans living in rural areas, the need for improved access to quality health care for rural Veterans has led the VA to transform the way health care is delivered. Rural Veterans face challenges when trying to access to quality health care because of the shortage of health care resources in rural areas, as well as the lack of specialty care providers. The Office of Rural Health (ORH) is working to ensure that rural Veterans have access to the health care they deserve.
VA is working to shift the current health care system from “problem-based disease care” to one that is “patient-centered and healing”. This change is being accomplished by adapting the VA health care system to the changing demographics and needs of our Veterans in rural areas. For example, there is an increasing demand for women’s services for Veterans in rural areas. The number of women Veterans seeking VA health services has doubled, from 150,000 in 2000 to 300,000 in 2010. This demand is being met by increasing specific women focused services such as maternity and menopausal care services and by providing training in women Veterans health care services to rural providers. In addition, most rural Veterans are in the 55 to 74 age group, therefore they need care focused on management of chronic conditions such as hypertension, diabetes and heart disease.
Technology has become an important tool used to increase access to health care. Almost one-third of the entire ORH project portfolio in FY 11 consisted of expanding telehealth capability to rural areas and creating new models of care using telehealth technology. One such project expands access to care nationally for Veterans living in rural areas through the use of care-coordination home technologies (CCHT). This program focuses on patient self-management of chronic conditions such as diabetes via a range of telehealth technologies that include messaging, monitoring, and video devices. Other ORH projects funded in FY11 fall in one of the following areas: Primary/Specialty care, new rural CBOCs, and rural expansion of Home Based Primary Care.
VA is focused on transforming from an inpatient hospital system into a continuum of care health system by expanding home-based primary care, community- based outpatient clinics, telehealth services and online health programs into rural areas. In addition, ORH has initiated a national expansion of outreach services for homeless Veterans living in rural and highly rural areas, by partnering with the VA Office of Mental Health.
Using VA data sources, ORH can report the following progress:
- The number of rural health outpatient mental health visits increased from 3.4 million in FY09 to 3.9 million in FY10
- The number of rural women veterans impacted by ORH projects: 8,636 by the end of FY10
- From FY10 to FY11, the number of new mental health appointments at ORH funded new community-based outpatient clinics increased from 111 to 587.
- From FY10 to FY11Q1, approximately 416,132 rural veterans were impacted by ORH projects.
- From FY10 to FY11Q1, approximately 57,191 unique patients were seen at ORH-funded rural CBOCs
ORH continues to fulfill the VA mission by funding and overseeing sustainable projects that will improve the lives of ruralVeterans. Future progress will be reported here as we continue to support projects, programs and initiatives that help rural Veterans lead healthy lives.
Mary Beth Skupien, PhD, MS, RN, is the Director of the Office of Rural Health for the U.S. Department of Veterans Affairs.