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AHA's Advocate for Rural Health Names Top Concerns

John Commins, for HealthLeaders Media, January 29, 2014

The new head of the AHA's governing council representing small or rural hospitals discusses his most pressing challenges: addressing the shortage of health professionals, advancing population health, and preserving the critical access hospital designation.


Paul Bengtson

Paul R. Bengtson,
CEO, Northeastern VT
Regional Hospital

Healthcare providers across the country will face a challenging environment in the coming year as ground-changing reforms take effect. For any number of reasons, however, meeting those challenges will be even harder for providers serving rural areas.

  1. The patients they serve tend to be older, sicker, less educated, and poorer.
  2. Access issues are far more challenging in rural areas, where the closest hospital or physician's office is more often miles away.
  3. Every rural provider trying to recruit a physician, a nurse practitioner or any of a number of specialists understands the intense competition for clinicians.
  4. Smaller and remote hospitals and other providers often cannot easily access the capital or the expertise for technology upgrades and interoperability mandates that can create economies of scale, improve care and reduce costs.
  5. Many rural hospitals, through no fault of their own, over-rely on Medicare, Medicaid, and other government payers with lower reimbursements than private payers, which also makes it more difficult to offset the costs of charity care

I could go on, but you catch the drift.

Despite all of the challenges, Paul R. Bengtson, CEO of Northeastern Vermont Regional Hospital, a critical access hospital in St. Johnsbury, is upbeat about the work that rural providers accomplish.

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