This brief summarizes key challenges faced by the rural ambulatory safety net in delivering primary care and behavioral health services since COVID-19 and the policy changes that have been implemented in response to those challenges. It also offers state-level policy recommendations to improve rural-specific primary care and behavioral health care through sustaining and supporting the movement towards telehealth, addressing social needs, and advancing value-based payment and care.
To provide the best possible care to patients and thrive in new payment environments, community health centers (CHCs) and community behavioral health organizations (CBHOs)— two pillars of the safety net—are redesigning their workflows, infrastructure, and partnerships.
Advancing payment and delivery reform in the ambulatory safety net in rural areas presents unique challenges and will require solutions specific to this context, for both primary care and behavioral health.
This case study examines the experience of Southern Prairie, a 12-county collaboration in rural southwestern Minnesota that has facilitated the integration of health care services and community supports through accountable care approaches, which includes a Medicaid accountable care organization (ACO) and a nonprofit center that implements initiatives to address major population health issues.