Will Small Health Make the News Long Enough to Matter?

It is about time that Small Health Care received some attention as the small hospitals and small practices, but will this continue. Off and on over past decades, primary care has received much attention, but the attention has not resulted in changes in payment policy. In fact the increased cost of delivering care has made matters worse. 
Small Health Care is at least half made up of primary care and much of the remaining local care is basic services - services lowest paid by design. Small health does not have multiple lines of revenue with the top reimbursement in each line as seen in large health care. 

 It is an impressive run of articles with some content regarding small health care, often negative but a few positive

The AMA says changes are needed in health information technology - but our nation plunges on with far less efficient HIT. The software still takes far too much time and effort.

CMS moves on recklessly with Meaningful Use regulations in 2015 even though experts in HIT and those representing rural health care (National Rural Health Association) have encouraged more caution.

AAFP experts also agree that the Meaningful Use regulations are ridiculously complex.

 9/11/14 Commonwealth - All Health Care Is Local

9/10/14 Headlines - Small Hospital Closures Accelerate, Finances Weaker for Stand Alones

9/9/14 Commonwealth Do Health Care Costs Fuel Economic Inequality in the United States?



 Changes have not come
  • Primary care pay remains low and especially low compared to non-primary care specialized services
  • Disproportionate share funding is going away and across the board cuts have continued to reduce revenue.
  • Graduate medical education has not been reformed despite legislation and nearly a decade to observe the legislation going for naught.
  • Continued funding for Medicaid to remain at higher rates of pay has not passed. 
  • The government has not eased up on penalties that more commonly go to sites where small health is found.
  • The state governments have not reformed Medicaid criteria, eligibility, payment barriers, or low pay.

 Can rural and small practice urban sites rally together to get more than just discussion?

 Will federal facilities and funding supports contribute to care or undermine what remains of private small health care?

 What will turn clinicians around to primary care and small health care when payment so obviously rewards specialized care and sites with concentrations of clinicians?

Open Season Upon Small Health Care

Continue on to Open Season on Small Health By Big Media

Summary of Small Health Complexities

Reference Links

Recent Works

Starting to Solve Societal Inequities - Support for a SMART Start from the Very Beginning of Life

Best Beginnings for Health Access Clinicians - Shared Origins and Optimal Health Access Focus During Trainings

Family Medicine Needs a New Beginning - Current Preparation, Admission, and Medical School Plus Health Policy Interact To Prevent Family Medicine Choice - and Health Access Result

Too Many and the Wrong Clinicians for graphic - Additional consequences result from designs not specific to primary care or care where needed.   

And the Next Victims of Cost Cutting: Dual Eligibles - Those Most Vulnerable and Least Able to Defend Themselves Are Next

ALS Disease Focus Is Not a Top Priority - Have fun, but Minor Incidence Diseases Are Below the Major Diseases, and Far Below Health Care Caused Disease, and Causes of Early Death, and the top 10 priorities for most Americans - and America as a Nation  

Hotspotting Has Many Spots To Consider - Simple Interpretations Are Inaccurate, Many Different Characteristics Shape the Outcomes, Not Just Geographic Location

Retail Clinic Recoil - Many Side Effects Can Be Anticipated, And More to Come

Global Fails Local But Local Focus Succeeds Globally

What Veterans Need Is Family Practice - No Other Type of Clinician Comes Close to the Location or the Scope

Domino Decline By Design - as ERs Close, Those Nearby Face Challenges, as Small or Rural Hospitals Close or Practices Where Needed...

Declines in Health Care Delivery Despite Increases in Health Spending - If We Keep Accelerating Non-Delivery Costs, We Can Continue to Remain Behind Health Care Demand

Health Care Delivery Is No Laughing Matter - Political Cartoons are Nice, but...



Blogs indicate that primary care can be recovered and should be recovered.

Dr. Bowman is the North American Co-Editor of Rural and Remote Health. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association and the long term chair of the STFM Group on Rural Health.

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