When healthcare quality management expert Donna Kurek made the switch to a more rural hospital system, she realized that there exists a whole different set of social determinants to consider in Appalachia, especially in the context of bundled payments. This reimbursement system can impact more complex patients negatively, especially in the presence of comorbidities such as diabetes and obesity, both of which disproportionately impact rural populations. In today’s podcast she discusses Appalachian health disparities, the contrast between urban and rural environments, and reflects on how the bundled payment system has made the role of the coordinated care team even more crucial. She shares insights into the role health literacy plays in improving health decisions and outcomes, and she explores valid concerns from advocates that some patients may be excluded from elective surgery in ways that could be considered inequitable. With podcast host Eileen Body.