Access to healthcare in rural communities is a known issue. More than 136 rural hospitals closed in the last 10 years. Currently, an additional 600 are at risk of closing.

Rural Americans experience higher mortality rates than urban Americans in many conditions, notably in cancer, heart disease, and chronic respiratory conditions.

Between June 2023 and January 2024, Intermountain conducted three focus groups with Board members of rural hospitals in Intermountain’s footprint. The Board members recognized rural access issues as a health equity issue. Also, across all focus groups, participants expressed that mental health was the most concerning health equity issue to their communities.

“We approach this work with humility,” says Lisa Nichols, VP of Community Health. “When we conduct our Community Health Needs Assessments, we recognize that the only people who really understand the rural needs and disparities in different communities are the people who live there.”

The needs identified by rural communities include:

• Access to care
• Affordable care
• Addressing the social determinants of health, specifically housing
• Behavioral health

Intermountain’s Community Health team works across our rural communities to address care. One example comes from Granite County, Montana, where there were no mental health services in 2018. Thanks to the Telehealth Network Grant Program, funded by the Health Resources Services Administration (HRSA), Intermountain and the local network of volunteers and professionals have served more than 15% of the population in the past two and a half years.

“We used this grant to stand up tele crisis evaluations with Intermountain’s licensed clinical social workers doing the evaluations via telehealth in five rural, critical access hospitals’ emergency departments,” says Project Director Kayla Sanders. “We have also set up resource coordination, created community-driven mental health discussions and resources and most impressively, used this grant to set up in-person counseling and medication management services utilizing providers in our community.”

Another example is from Cassia Regional Hospital in Cassia County, Idaho, with an HRSA Rural Health Care Services Outreach grant that is funding Project REACH (Remote Expanded Access to Community Health). The patient-centric program allows rural providers to monitor chronic disease and prevent worsening outcomes. Patients are given tools like blood pressure cuffs, coached on medications and appropriate interventions using the Teach-Back method, and assisted with post-discharge care plans during routine home-based check-ins.

“Relying on virtual care, patient self-monitoring, and at-home visits with our Community Health Worker for cardiac or pulmonary patients, these tools are a lifeline during the critical time directly after discharge from the hospital,” says James Watkins, program development manager. “We’ve seen our patients become more informed about their health, more empowered to manage their chronic disease themselves, and far less likely to need emergency services or in-patient facilities at Cassia Regional Hospital.”

The Community Health team continues to collaborate with our Strategy Office to find creative ways to sustain healthcare in rural communities.

About the grants:

The Telehealth Network Grant Program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,125,836 with 100% funded by HRSA/HHS and $0 and 0% funded by nongovernment sources.

The Project REACH grant is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1 million with 100% funded by HRSA/HHS and $0 and 0% funded by nongovernment sources.