Premera grants $5.7M over three years for rural care
Programs financed by a grant from Alaska’s largest private individual health insurer are turning their eyes toward rural communities, where health outcomes tend to be the worst.
Premera Blue Cross Blue Shield, the Washington-based health insurer, announced a $5.7 million investment in the state Oct. 29, spread over three years and split among a handful of recipients.
The overall intention of the grant is to improve rural health care access in a state that comprises about one-fifth of the land mass of the United States but where nearly half the state’s population lives in one urban area and the much of the rest is scattered across a largely roadless, largely undeveloped landscape.
The majority of the investment — $3 million — will serve as seed money for a new Rural Health Care Fund, from which grants will be issued to address “equity, availability and access to quality health care in rural areas,” according to a press release from Premera. The fund will be managed by the Rasmuson Foundation and housed by the Alaska Community Foundation.
In addition to three $100,000 grants to Norton Sound Health Corp., Yukon-Kuskokwim Health Corp. and the Tanana Chiefs Conference to support community health aide/practitioner programs, the University of Alaska Anchorage will receive $1.77 million to expand its College of Nursing programs at four campuses, three of which are rural.
The funds will also be used to increase recruitment efforts among Alaska Natives in rural areas. Another $700,000 will go to the Alaska Native Tribal Health Consortium, supporting the construction of its Anchorage-based Education and Development Center. The center provides Alaska Native-centered education for aspiring health care workers, particularly in rural areas, said Andy Teuber, chairman and president of ANTHC, in the press release.
ANTHC has an Anchorage-based education center. However, the dental health aide, behavioral health aide and community health aide programs are in separate facilities at the moment; the grant funds will help build out the interior of the education center to bring all three programs under one roof, according to Shirley Young, ANTHC’s public relations and marketing manager.
“Instead of housing the training programs in a variety of costly locations, which is how we have been operating, the students will benefit from offering co-location with inter-professional education on the Alaska Native Health Campus,” she wrote in an email. “Accessibility to quality education at a sustainable cost point is critical, especially considering Alaska’s current financial situation.”
Young said having all the programs on the Anchorage campus will help provide students with culturally relevant training before going out to pursue jobs, many of which are in rural communities across Alaska. Increasing the number of qualified providers in rural areas remains a priority for ANTHC’s board of directors, she wrote.
Health care disparities between rural and urban areas are well established, both in health outcomes and service availability. People living in the rural areas of the state tend to be poorer, are more likely to be uninsured and have less access to primary care. In 2016, more than two-thirds of the primary care providers in the state were located in the Anchorage or Mat-Su areas, according to a study from the Alaska Department of Health and Social Services. There were only 17 licensed primary care physicians in the Northern region and 37 in the Southwest region in 2016.
Training more physicians is only part of the solution, according to the DHSS study; competition for clinicians is significant and training does not reduce unequal distribution of providers. The community health aide/practitioner program provides health professionals in many rural locations, but they are not licensed physicians of the same clinical level as a primary care physician.
Improving access to nurses and physicians in rural areas of the state is the primary purpose of the grant, said Premera president and CEO Jeff Roe in a statement.
“Many of Alaska’s communities are hundreds of miles from a regional medical center, and in most rural communities there is not an adequate number of physicians, primary and mental health care providers and sufficient facilities,” he said. “It is critical to invest in effective, long-term solutions to close the growing gap between urban and rural health care access.”
UAA is placing the funding into recruitment and program expansion at its Bethel, Dillingham and Ketchikan campuses. Those three campuses have capacity for growth and community support, said Jeff Jessee, the dean of the College of Nursing and vice provost for University of Alaska health programs. UAA is partnering with the University of Alaska Fairbanks and the University of Alaska Southeast for the programs, as the Ketchikan program is located on the UAS campus and the Bethel and Dillingham programs are on UAF campuses, he said.
“All of our state universities understand there’s an enormous need for nurses across Alaska, and our long-term vision is to expand our nursing programs on other campuses as well,” he said.
The University of Alaska system is under financial pressure due to state budget cuts, but UAA intends to design the program to be financially sustainable, Jessee said. The Premera funds will be used for startup and expansion costs, with between 40 to 50 new nursing students by the fifth year of the grant, he said. Tuition is the major source of revenue, and is intended to cover ongoing costs for the program.
“The School of Nursing also has important community partners who have pledged consistent funding for our nursing programs in the state, and growing our nursing workforce remains a priority for the University of Alaska as a whole,” he said. We expect support to continue, because there’s widespread recognition of how essential nurses is to the future of our state.”
Elizabeth Earl can be reached at [email protected].