March 8, 2013:
A research team at the University of Southern Maine School of Public Service has published findings from its SHARE-funded research in The Journal of Rural Health.
Under the lead authorship of Jean Talbot, PhD, the article examines rural issues surrounding network adequacy standards and offers recommendation for crafting standards that are strong enough to provide “real protections” for beneficiaries while incorporating a degree of flexibility that is sufficient to accommodate rural delivery system constraints and ensure the willingness of Qualified Health Plans to serve rural areas. The authors suggest several strategies for achieving this flexibility, including: adjusting standards to account for the degree of rurality in a given area and for rural utilization norms; allowing midlevel clinicians (e.g., physician assistants, nurse practitioners, etc.) to be counted toward fulfillment of patient-provider ratios; and incorporating delivery system innovations such as telehealth.
Link to the article abstract: “Rural Considerations in Establishing Network Adequacy Standards for Qualified Health Plans in State and Regional Health Insurance Exchanges.”
Learn more about the project that generated these findings: “Expanding Coverage and Ensuring Access: The Challenges and Opportunities of Implementing Health Reform in Rural America.”