Increasing Access: Reaching Out to Rural Veterans

Nearly 40 percent of enrolled Veterans live in rural areas of our country. This includes men and women Veterans of all ages, races and ethnic groups.  Like other individuals living in rural areas, Veterans have difficulty in obtaining access to quality health care. The reasons for this are multiple and varied, but mainly stem from the need to travel long distances to health care facilities, lack of health insurance, and lack of specialty care providers working in rural areas. As a result, rural populations tend to be in poorer health; in fact, a study by the Office of Health and Human Services estimates that half of the adults living in rural areas suffer from a chronic health condition. With regard to rural Veterans, there are the unique health complications associated with combat exposure such as PTSD, depression, and traumatic brain injury.

Over the past decades, VA has transformed itself from an in-patient tertiary care system to an out-patient health care system with an emphasis on prevention and patient-centered care using the electronic health record and patient aligned care teams. The Office of Rural Health was created in March 2007 to  bring this model of care to Veterans in rural and highly rural areas. It’s a model that can provide not only the specialty care that can meet the unique health needs of Veterans, but one that can also provide care to meet the needs associated with chronic illness and aging.

ORH has established six strategic goals and associated initiatives to accomplish their mission of increasing access to quality health care for Veterans living in rural areas. They include improved communications and outreach to rural areas, building and staffing community based outpatient clinics and outreach clinics, enhancing  tele-health capabilities such home-based tele-health and tele-mental health in rural areas, funding transportation systems to VA facilities from rural areas, and collaborating with non-VA clinicians to provide health care for women Veterans. ORH is making great strides on all of our strategic goals. Using VA data sources, ORH can report the following progress:

• From FY08 to FY10, over 217,000 Veterans from rural areas were enrolled through ORH outreach and communication efforts
• Fifty-one VA community-based outpatient clinics were opened in rural areas
• Thirty-seven VA Outreach clinics have been opened in rural areas
• Within a new telehealth-based program that focuses on obesity, the number of services provided to rural Veterans rose 60% in the past year to 13,035.
• The number of rural Veterans receiving mammograms, by both VA and non VA providers, increased 17% (20,447 in FY10)
• The number of rural veteran outpatient primary care visits increased 18% to 5.5 million in FY10

From FY09 to FY10, the number of rural Veteran telemental health encounters increased 23%

Although we are proud with our progress, there is still much to be done to provide rural Veterans with the care they deserve. ORH is committed to fulfilling our mission and will report back here on our progress as well as the impacts our programs and initiatives have made to improve the health and well-being of rural Veterans.

Mary Beth Skupien, P hD, MS, RN, is the Director of the Office of Rural Health for the U.S. Department of Veterans Affairs.

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