Estimated Yearly Expenditures for Rural Health
10/94 last revised
Estimates are a minimum. Actual figures may be 30 - 50% higher.
I. UNMC Expenditures
Preparation and training of medical students 1 million
WAMI study notes 12% of UNMC graduates are consistently in rural areas
Graduate medical education costs 1 million
40% of our FP graduates x Family practice
GME costs of 1.5 million plus additional
funds for special programs.
Rural physician and community support provided 1 million
Research by fp dept 100000
Wellness programs for rural 74000
CME 200000
Consults planning and recruitment 50000
Rural research center 150000+
Rural partnerships for pediatrics 100000
Synapse, midas 200000
Resident and faculty temporary services 500000
to rural communities and physicians
Resident rural clinic services 1 million
40,000 visits and rising
Clinical support, backup unknown
probably the largest single figure
II. Costs incurred by rural communities 800000
Support of student education 600000
for housing, travel, meals, more
GME Costs paid by rural communities, 200000
hospitals,doctors
Benefits to rural communities
10 FTE of workforce at $360000 per for 3.6 million in economic impact in rural Nebraska each year during CORE rotation and RTT sites in rural areas
Benefits from ARTP fellows to their faculty and communities
Benefits from graduates locating in rural areas
50 + % of 16 grads a year for many years at $2 Million in impact each year
III. Costs incurred by the state
John Navis salary, benefit, travel
ORH and health dept
data
other - best estimated by state
The last year in rural health - focus on R & R
Data from Statmaster national database
Search by counties of less than 10000 and still a hospital reveals 28 counties in NE, Texas has 47, KS has 41, CO 12, MT 22, ND 17, OK 15, SD 22, ID 10, all others less than ten. NE is a nice mix of multiple sizes of rural health systems with a good N value for the smallest systems.
State support for Clarkson, Creighton and UNMC have assisted the state with its best FP match ever. All programs matched except Creighton and they matched 4 for 7 and actually Creighton will have 9 first year residents this year. This highlights the investment that the state has made, but it also illustrates the challenge the state will have to retain current docs for these upcoming physicians as well as influencing them to choose rural and underserved practices. The next two to three years will be the best opportunity for the state in years in the areas of recruitment and retention.
NeRHA moving along
rural health policy group formed at UNL and UNMC
UNMC
RHEN coordinator hired and active
major increases in UNMC outreach
collaboration with state regarding database
Rural Program director position in Dept fp created/filled by Robert Bowman
much increase in recruit and retention cooperation at UNMC and other FP programs - recruitment of fp residents targeted, brochure to all rural docs, hospitals, community recruitment groups
more rural visits
original research on recruitment and retention
assistance with locums development
doing locums in some rural communities
obtaining names of faculty and graduates to do locums
major effort to update current rural providers
rural fellowship developing and increased rural rotations to provide increased rural health services (through NHSC and UNMC funds)
increased effort to recruit students and residents to come to Nebraska and do rural practice through local efforts, Academy sponsor a student efforts, student advisor program of NAFP, efforts at AAFP Student Resident Annual meeting
plans to combine NeRHA meeting and FP resident recruitment Sept 7-8
Nationwide database collected on rural faculty and rural family practice programs
Leadership of national group (Society of Teachers of Family Medicine Group on Rural Health) that prepared databases and rural curriculum
Rural legislation update
RWJ Practice Sights
Already impact - Nearly every major hospital visiting these early networks to court them for the future