February 11, 2020


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When it comes to predicting the general health and wellbeing of a population, a crystal ball isn’t necessary – just the zip code will do. According to the Rural Health Information Hub, Americans who live in rural areas experience significantly worse health outcomes compared to their urban counterparts. 

Health disparities are the difference in health status when compared to the overall population, often characterized by higher incidence of disease and/or disability, increased mortality rates, lower life expectancies, and higher rates of pain and suffering. [1] 

A recent study from the Centers for Disease Control and Prevention (CDC), has demonstrated that Americans who live in rural areas are more likely to die from five leading causes than Americans who live in urban areas. The data points to a striking gap in health between rural and urban Americans and concludes that rural Americans are at an increased risk of early death. [2] 

To compound the concern, rural-based Americans with behavioral health illnesses are more likely to face a scarcity of treatment options. According to the World Health Organization, in the United States more than 90 million individuals live in Mental Health Professional Shortage Areas (MHPSA). Most MHPSAs have rural zip codes. Mental health conditions are prevalent in rural America – nearly 20% of all rural residents have a mental condition. Rural residents are more likely than urban residents to experience a serious mental illness. [3] 


5 Reasons Why Zip Codes Matter to Patient Health 

  1. Rural Americans are at an increased risk of early death. 
  2. Rural residents are less likely to have employer-provided health insurance coverage, and if they are poor, often are not covered by Medicaid. 
  3. Unintentional injury deaths are approximately 50 percent higher in rural areas than in urban areas, partly due to greater risk of death from motor vehicle crashes and opioid overdoses. 
  4. Due to the distance between healthcare facilities and trauma centers, rapid access to specialized care can be more challenging for people injured in rural areas. 
  5. Reread #1. 

There is a marked difference in rural versus urban life expectancy and mortality that has emerged in the past few years. Rural Americans tend to have higher rates of poverty, less access to health care, and are less likely to have health insurance. Providers who serve rural areas are often faced with the additional challenges of limited capital, lack of specialists, and high ED use, to name a few. CMS has yet to create an option for rural providers to stay viable in Medicare Shared Savings Program ACOs – providers who already face daunting obstacles. 

Caravan Health understands the challenges rural providers face and from day one, we have made it our mission to hep rural hospitals succeed in the ACO program. Our results demonstrate that when implemented right, ACOs position rural providers with the support, resources, and infrastructure to improve health care costs and deliver better coordinated patient care. Time and time again our ACOs have performed better than the benchmark. In fact, we helped rural providers in the ACO Investment Model drive more than $250 million in savings to Medicare.  

Now, we’re ready to do it again with our risk-free rural ACO solution. Recent reports show that 50 percent of rural ACO participants will leave the Shared Savings Program rather than be forced into downside risk. We’re not ok with that which is why Caravan is willing take 100% responsibility for rural providers who join a Caravan-supported ACO. This means that rural hospitals and clinics can participate in CMS’ ‘Pathways to Success’ program with no chance of writing a check to CMS for ACO performance. Perhaps the playing field will never be level when comparing rural health disparities to urban, however there are now options to help rural providers improve the health outcomes for millions of Americans. 

Learn More about our Rural Risk-Free Solution

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