My background is part of why I’m proud to work for a President who has made rural healthcare, and rural health, a priority. President Trump is determined to build a healthcare system that provides affordable, personalized care that puts you in control, provides peace of mind, and treats you like a human being, not a number.
As Prepared for Delivery
Thank you, Tom [Engels], for that kind introduction, and thank you for welcoming me to HRSA today.
I want to begin by thanking everyone here for the great work you’re doing, and I want to thank everyone present here today, whether you’re from HRSA, somewhere else at HHS, or outside of the government, for your dedication to the topic we’re here to discuss today: rural health.
As some of you might know, my interest in rural healthcare goes way back—way, way back. Rural healthcare runs five generations deep for me. My great-great-great grandfather was a doctor in rural Illinois in the late 1800s; he traveled to his patients using everything from a horse and buggy to a rowboat.
And my mom spent her 58-year career working in a rural hospital. Today, that hospital is also a Federally Qualified Health Center, funded by HRSA. It’s called “Community Health”—that’s one way you can gauge how dedicated an entity is to serving patients: very little spent on their marketing and naming budget. It’s a community health center, just call it “Community Health.” What they lack in creative marketing I can assure you they make up for in the quality of care they provide.
Rural health is a true passion of mine, which is why I’m glad to be here today. You know, around this time of year, people start debating about their favorite holiday: Is it Thanksgiving, Christmas, something else? For me, though, you’ve heard my background—you have to throw National Rural Health Day into that debate, too.
My background is part of why I’m proud to work for a President who has made rural healthcare, and rural health, a priority. President Trump is determined to build a healthcare system that provides affordable, personalized care that puts you in control, provides peace of mind, and treats you like a human being, not a number.
This vision doesn’t only apply to densely populated cities; it applies to America’s rural areas too. In many cases, they need this transformation the most.
There are three particular platforms that Secretary Azar has identified for delivering this transformation: first, improving the ways Americans finance their care; second, delivering better value from the care they receive; and third, focusing on particular, impactable health challenges.
Today, I want to mention a few areas where we think we can make an impact on rural health and deliver on the President’s vision in the rural context.
First, I’ll mention preventing disease; second, creating sustainable models for financing; third, utilizing technology and innovation to improve patient access; and fourth, laying the groundwork for a strong rural health workforce.
On preventing disease, we know there are particular health challenges we need to tackle in rural areas. As just one example, HRSA has invested heavily to prevent opioid abuse and provide treatment in rural areas, which have been especially hard hit by our country’s opioid crisis. Another particular health challenge in rural areas, among the many we’re looking at, is maternal health. Just this fall, we saw HRSA launch the Rural Maternity and Obstetric Management Strategy Program, a pilot program to support rural health networks that will share best practices to help improve patient care, and we look forward to thinking more about how to spread best practices for this vital health challenge.
The second issue I wanted to mention is sustainable financing models. We need to think about what rural healthcare may look like in the future, because the right approach—both in terms of financing and care delivery—may not always be the kind of traditional hospital my mom started working at in the 1960s.
Ultimately, a sustainable model will include traditional hospitals, but it may also incorporate other models of care, like community health centers, critical access hospitals, and rural health clinics. We’re interested in looking especially at how these various models can work together, in concert, to meet the needs of a rural area.
The third area I wanted to mention is improving access to care through innovation and technology. Technologies like telehealth can be a game changer for improving healthcare in rural areas, giving many access to care they haven’t had before. However, there are many barriers blocking this technology from reaching its full potential.
We’re trying to change that, for instance, in Medicare by allowing providers to be reimbursed for remote patient monitoring visits and for assessments of electronically transmitted images. We’ve also started paying separately for physicians to consult with their patients remotely. For someone in a city or suburb, that’s convenient; for a patient in a rural area, it could be life-changing. So we’re interested in how we can further expand telehealth, including in HRSA’s community health centers.
Finally, I want to underscore the need to build a strong rural health workforce. One way to do that is allowing providers to practice to the top of their license, which is something this administration has put a major spotlight on. President Trump’s Executive Order on strengthening and protecting Medicare called on us to open up ways for providers like nurses, PAs, and midwives to be compensated based on the work they’re doing, rather than the license they hold.
We also want to look at how to support residency programs in rural areas.
One of the best ways to help expand the rural health workforce is to train a workforce right in the communities we want to help, and HRSA already works with providers on setting up these kinds of residencies like the Teaching Health Center GME and Rural Residency Planning and Development programs.
A number of the topics I’ve just covered have been areas of interest for HHS’s Rural Health Task Force, which the Secretary put together about a year ago. I want to credit HRSA, CMS, AHRQ and the Indian Health Service with really stepping up with new ideas and leaning into the possibilities for transformation in the areas I’ve discussed today. Just last week, every HHS Agency and Office submitted a rural action plan for new activities they’ll be taking in the coming year, so there is a lot of action to come.
All of you will get to play a part in that work. I believe there are lots of reasons for hope about the future of rural healthcare, and one of those reasons is the enthusiasm I know all of you bring to this challenge.
So thank you all again for being here, and I look forward to today’s discussions.
