What Should Rural Healthcare Look Like After Reform?

For large portions of rural areas today, Mueller says, there is only one health insurance company actively selling health insurance packages.

3. It should guarantee that patients should have access to a healthcare delivery system that is local and offers choice. "A health plan that is based on use of provider networks must contract with local providers," he says.

The latest health reform proposal, H.R. 3962, addresses "standards for network adequacy," but is not specific and leaves the details up to a "Health Choices Commissioner," he says.

4. It remedies the declining health practitioner workforce in rural communities through subsidies, loan forgiveness programs, and incentives to encourage younger providers into rural areas.

The report, funded in part by the Robert Wood Johnson Foundation, says that without health reform policy change, "rates of employer sponsored health insurance coverage in rural areas will continue to decline."

It recommends, "because a greater percentage of rural residents are self-employed, some form of subsidy (e.g., tax credits for individual insurance purchase) should be part of an effective solution."