Supporting Rural Hospitals Is The Key To Achieving Health Equity
Timely access to high-quality healthcare can make the difference between life and death. Unfortunately, for the one in five Americans who reside in rural areas, a growing healthcare access crisis has already led to hundreds of “medical deserts” and rural hospital closures. Just since 2010, 151 rural hospitals have closed their doors for good. These closures and the severe challenges surviving rural hospitals face pose significant obstacles in our nation’s fight for greater health equity.
Health equity is a very prevalent problem in rural America. As things stand, rural areas face severe workforce shortages in healthcare and skyrocketing costs, which jeopardize rural healthcare providers. Even though rural areas contain over 15% of the nation’s population, they are served by only 10% of its physicians. On top of this shortage, rural Americans are disproportionately likely to suffer from cancer and heart disease. Furthermore, leading causes of death, such as suicide and drug overdose, affect rural areas at far more significant rates.
Access to critical health services can be sparse in rural communities. Most rural counties lack access to specialties such as maternal care or treating addiction. Rural communities suffer from more health conditions than any other in the country, and still, they experience severe disparities in access to and quality of healthcare. To attain health equity, rural communities should have a “fair and just opportunity to achieve their optimal health.” Our country is falling short of the health equity we seek because of these disproportions of care in rural America.
Hospital systems are a key part of the solution to resolve health disparities in rural areas. They play a vital role by bringing access to around the clock to underserved communities. Rural residents lean on their local hospital systems not just for emergency and critical care, but also for specific services such as mental health and oncology care and treatment that may be available in other types of facilities in major cities.
Not surprisingly, when rural hospitals are forced to close their doors for good, devastating effects follow for the community they serve. Rural hospitals face many problems, including skyrocketing costs, severe workforce shortages and a lack of funding to sustain operations. While recent rising hospital expenses might be more bearable for a hospital system in a large metropolitan area, even the slightest increase in expense can be detrimental to the survival of a rural hospital. Currently, over 1,060 rural hospitals nationwide are at risk of closure, and 1,182 have been forced to cut down on critical services or options for patient care.
If our country aims to address health equity, then we must support rural hospitals. Some in Washington continue to propose sweeping cuts — like so-called “site-neutral” legislation — that would severely reduce rural hospitals’ ability to deliver critical services. In addition, Medicare reimbursement for hospitals is insufficient, as Medicare underpayments led 67% of hospitals to have negative Medicare margins in 2022. One in three adults in rural areas are enrolled in Medicare coverage, meaning these losses are particularly significant for rural hospitals. Consider how much ground we could make towards health equity if rural hospitals simply received their full reimbursement from Medicare.
Considering current challenges in rural health, health equity may seem impossible to achieve. However, with well-considered action, every American can obtain the opportunity to receive optimal healthcare, regardless of their zip code. Lawmakers need to provide our hospitals with support and better programs that allow health equity to exist and thrive in every inch of our nation, especially along our backroads.
