Rural Western States Work Together to Tackle Physician Shortages

Maryland's health care system is based on three pillars – all-payer rate setting, a global budget, and total cost of care – that, together, have shown positive results both for the patients and for the state's hospitals. Although evidence of success with regard to health care costs is limited, the model of incentiving investment in community health and preventive care has shown success in reducing readmission rates for hospitals across the state.

Health insurance sign-ups made available to all inmates at the San Francisco county jail, partnered with guidance from a clinic once they are on the outside, allows them to receive better care upon release, and may help prevent a return to crime and substance abuse.

Physical illnesses trigger and exacerbate poverty because costs are too high to treat them. The Associação Saúde Criança in Rio de Janeiro counsels helps by assisting families with services such as food, medicine, vocational training, housing, and legal aid, which helps mothers achieve their personal goals.

Health care in the Netherlands relies heavily on the collaboration, cooperation, and shared responsibility between private markets and government regulations to achieve affordable, consistent, and quality care for patients. Although the system is not without its limitations, this process has helped the country avoid preventable deaths while also guaranting nearly all residents insurance.

To counter a growing concern around doctor shortages, California has implemented a series of measures that aim to keep more doctors in the state, especially focusing on rural areas where they are most needed. From loan repayment plans to expansion and creation of new training programs, the state has already begun to see success in doctor recruitment and retention.

Domestic violence victims often suffer in silence and do not have encouragement to find help. San Luis Obispo in California has created a program RISE that trains primary care physicians to identify signs of domestic abuse and collaborates with clinics to treat and rehabilitate victims. The Affordable Care Act provides coverage for domestic violence screenings, offering financial incentives to help get victims the help that they need.

Project ECHO - driven by a single doctor with a cause - pulled together a team of specialists to develop a model that combines technology with collaborative care and careful patient tracking to help cure for diseases spread to patients around the world through community healthcare agents, as opposed to only specialty centers. This kind of "disruptive innovation" is effectively working to demonopolize health care knowledge and access, and lends to a health system capable of meeting today’s soaring demands for care.

Rural hospitals across the country often struggle to stay open in states where Medicaid has not been expanded, but a method known as "swing beds" has helped two critical-access hospitals in Georgia to avoid this fate. This method, which allows hospitals to swing beds from "only patients in need of acute care to those who no longer require the emergency department but still needed more treatment before a nursing home," allowed for the hospitals to pay off debt and expand services.

Switzerland is home to the world's lowest avoidable mortality rate and residents of the country live longer lives and are healthier than those who live in the United States. Health policy experts credit the Swiss health care system for playing a significant role. Despite the high cost and the penalty for not carrying insurance, the system is praised as guarateeing access to quality health-care and "unlike the U.S., people rarely go bankrupt from medical bills."

Public private partnerships are helping hospitals in Nigeria provide more efficient care, especially as it relates to maternal health. In Lagos State, the model – which partners a private healthcare management firm with the hospital – has helped better equip facilities so more laboratory tests can be conducted in one place. Although this solution doesn't necessarily solve all problems faced by those seeking care, it has helped to provide a more sustainable model of healthcare in many cases.