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Member of the National Rural Health Association (NRHA)

The National Rural Health Association (NRHA) is a national nonprofit membership organization with more than 20,000 members. The NRHAassociation’s mission is to provide leadership on rural health issues.  NRHA membership consists of a diverse collection of individuals and organizations, all of whom share the common bond of an interest in rural health.

The obstacles faced by health care providers and patients in rural areas are vastly different than those in urban areas. Rural Americans face a unique combination of factors that create disparities in health care not found in urban areas. Economic factors, cultural and social differences, educational shortcomings, lack of recognition by legislators and the sheer isolation of living in remote rural areas all conspire to impede rural Americans in their struggle to lead a normal, healthy life. Some of these factors, and their effects, are listed below.

  • Only about ten percent of physicians practice in rural America despite the fact that nearly one-fourth of the population lives in these areas. **
  • Rural residents are less likely to have employer-provided health care coverage or prescription drug coverage, and the rural poor are less likely to be covered by Medicaid benefits than their urban counterparts.
  • Although only one-third of all motor vehicle accidents occur in rural areas, two-thirds of the deaths attributed to these accidents occur on rural roads.**
  • Rural residents are nearly twice as likely to die from unintentional injuries other than motor vehical accidents than are urban residents. Rural residents are also at a significantly higher risk of death by gunshot than urban residents.
  • Rural residents tend to be poorer. On the average, per capita income is $7,417 lower than in urban areas, and rural Americans are more likely to live below the poverty level. The disparity in incomes is even greater for minorities living in rural areas. Nearly 24% of rural children live in poverty.
  • People who live in rural America rely more heavily on the federal Food Stamp Program, according to The Carsey Institute at the University of New Hampshire. The Institute’s analysis found that while 22 percent of Americans lived in rural areas in 2001, a full 31 percent of the nation’s food stamp beneficiaries lived there. In all, 4.6 million rural residents received food stamp benefits in 2001, the analysis found.
  • There are 2,157 Health Professional Shortage Areas (HPSA’s) in rural and frontier areas of all states and US territories compared to 910 in urban areas.**
  • Abuse of alcohol and use of smokeless tobacco is a significant problem among rural youth. The rate of DUI arrests is significantly greater in non-urban counties. Forty percent of rural 12th graders reported using alcohol while driving compared to 25% of their urban counterparts. Rural eighth graders are twice as likely to smoke cigarettes (26.1% versus 12.7% in large metro areas.) **
  • Anywhere from 57 to 90 percent of first responders in rural areas are volunteers. **
  • There are 60 dentists per 100,000 population in urban areas versus 40 per 100,000 in rural areas**
  • Cerebrovascular disease was reportedly 1.45 higher in non-Metropolitan Statistical Areas (MSAs) than in MSAs.**
  • Hypertension was also higher in rural than urban areas (101.3 per 1,000 individuals in MSAs and 128.8 per 1,000 individuals in non-MSAs.)**
  • Twenty percent of nonmetropolitan counties lack mental health services versus five percent of metropolitan counties. In 1999, 87 percent of the 1,669 Mental Health Professional Shortage Areas in theUnited States were in non-metropolitan counties and home to over 30 million people **
  • The suicide rate among rural men is significantly higher than in urban areas,particularly among adult men and children. The suicide rate among rural women is escalating rapidly and is approaching that of men.**
  • Medicare payments to rural hospitals and physicians are dramatically less than those to their urban counterparts for equivalent services. This correlates closely with the fact that more than 470 rural hospitals have closed in the past 25 years.
  • Medicare patients with acute myocardial infarction (AMI) who were treated in rural hospitals were less likely than those treated in urban hospitals to receive recommended treatments and had significantly higher adjusted 30-day post AMI death rates from all causes than those in urban hospitals. ***
  • Rural residents have greater transportation difficulties reaching health care providers, often travelling great distances to reach a doctor or hospital.
  • Death and serious injury accidents account for 60 percent of total rural accidents versus only 48 percent of urban. One reason for this increased rate of morbidity and mortality is that in rural areas, prolonged delays can occur between a crash, the call for EMS, and the arrival of an EMS provider. Many of these delays are related to increased travel distances in rural areas and personnel distribution across the response area. National average response times from motor vehicle accident to EMS arrival in rural areas was 18 minutes, or eight minutes greater than in urban areas.**

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About Bryan Brothers

Bryan Brothers is a healthcare consultant with over ten years’ experience in the healthcare and insurance industries.

With a start in IT business and retail network development, the transition to electronic medical records and meaningful use consulting services was a natural fit.

Bryan is a member of AHIMA, HIMMS, and the NRHA.

He served on the advisory board of Jefferson Technical College’s HIT program. As member of the staff of the University of Kentucky’s Regional Extension Center, worked as a policy and implementation advisor as well as a security consultant. Bryan has served major clients such as lead advisor to Norton Healthcare, and Twin Lakes Medical Foundation and worked with many prominent groups in central KY such as Nephrology Associates of Kentuckiana.

As the former REC Administrator for University Health Care, Bryan brings experience and knowledge to the table as a trusted advisor and privacy and security expert. In 2012 Bryan was commissioned as a Kentucky Colonel by Governor Steven Beshear, the award being the highest honor awarded by the Commonwealth of Kentucky.

Bryan has worked with over 1100 providers, assisting with the achievement of meaningful use, and completion of the HIPAA privacy and security risk assessment.

When Bryan performs a HIPAA Security Risk Assessment, he includes the following:

HIPAA Security Risk Assessment
Security Risk Analysis based on HITECH requirements for MU
Includes review of Administrative, Technical & Physical safeguards
Remediation plan and timeline to eliminate or mitigate identified gaps
HIPAA compliant sample policies provided
Performed by AHIMA Certified HIPAA Privacy & Security professionals

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