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The National Rural Health Association

The National Rural Health Association (NRHA) gives a voice in congress for the 62 million Americans living in rural areas and health care providers who would on their behalf.  The NRHA’s mandate is to help health care providers and patients in rural America overcome the unique and challenging circumstances of working in rural communities and help pass legislation that would fairly compensate doctors, nurses and health care support practitioners by recognizing the differing demographics between rural and urban areas.

The NRHA is a broad-based member organization made up of a variety of health care providers, with representation from private providers, hospitals, different types of clinics, state government representatives, and educators. To manage all of these different groups and interests, the NRHA has a number of constituency groups that reflect the different perspective of its members.

The groups are comprised of like-minded people whose concerns surrounding issues related to rural health have motivated them to go to the highest levels of government to enact positive change. There is an inherent synergy in the NHRA, whose voice carries a lot of weight because it does not represent the perspective of a singular group, rather many groups working for a common cause.

Important initiatives

Kris Sparks is the recently appointed President of the NRHA who seeks to use her position to implement the Affordable Care Act in a way that is positive for rural America. Three key areas of focus for NRHA are workforce, addressing rural health disparities and eliminating payment inequities. “I will feel successful in my year as NRHA President if programs implemented under health reform are sensitive to rural needs and help improve the health of rural America,” she says.

The NRHA is the catalyst for changes on a governmental level that positively address the economic, cultural and social differences of rural America and that have acknowledged the disadvantages of these areas in terms of education and legislatives representation. For instance, although nearly 25 percent of Americans live in rural areas, only about 10 percent of physicians practise in these regions. Statistics like these illustrate a systemic lack of proper health care for a significant portion of the population, and the NHRA works diligently to represent this population.

Health reform legislation will improve accessibility and affordability of health coverage for rural Americans. The NHRA is working to guarantee issue and renewability of coverage and the prohibition of pre-existing condition exclusions to ensure that insurance coverage is available to all Americans, even if they are already sick. It is also working to establish provisions to control insurance companies’ rating practices, prohibit annual or lifetime limits on benefits and place a cap on consumer cost sharing will keep health costs under control for rural Americans. 

Understanding rural concerns

For the NHRA to be effective, statistical information is imperative. A program call “Rural Health Works” analyzes the impact of the health care system in a rural community and uses that data to further its cause.  “Health care is an economic engine in communities and especially in rural communities. If there is a hospital in a rural community it is usually the largest or one of the largest employers. In one of the Rural Health Works recent publications they concluded ‘The economic impact of health services upon the economy of Fulton County is tremendous’,” says Sparks.

“There have been a number of positive changes having a strong voice at the congressional level which is what the NRHA provides and has supported the creation of programs like critical access hospitals, certified rural health clinics, payment programs for providers going to shortage areas, enhanced payment for rural providers. There have been a number of program and policy changes at the federal level to encourage more people to go to areas where they are needed.”

In an effort to take its work to other countries that share the same issues with access to health care, the NRHA has a health exchange; last year, the NHRA worked with Peru and successfully laid the groundwork for future collaboration with that country.  The purpose of the exchange was to develop a baseline understanding of rural healthcare delivery in Peru, exchange ideas among policy leaders of both countries, and identify best practices that work in rural remote areas.

The NHRA meets annually, organizing the largest gathering of rural health experts from across the country. This year’s meeting is to be held May 3 to 6 in Austin, Texas and Sparks is confident it will provide valuable information and tools for communities, providers, policy makers, and others to address issues. The conference will feature a pre-meeting for students interested in rural practice. Says Sparks, “Rural workforce is a major focus of the NRHA, getting students interested in practicing in rural areas is important to building the workforce. Austin will be a great meeting location. After our heads are full of great ideas we can enjoy a warm Texas welcome and all that the city has to offer.”

The NHRA has harnessed  momentum from grassroots up to the highest levels of government. By continuing to advocate on behalf of the millions of Americans in rural communities, access to more and better health care is becoming a reality. 


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