Decline in Rural Healthcare Services-What Can we do About it?

Roughly 60 million people call small town America their home, and they face unique healthcare challenges. Statistically, rural Americans are more likely to have a chronic illness, have inadequate health insurance, lower access to care, and also a greater risk of poverty-influenced social determinants of health. Add to those factors that rural Americans also have limitations due to distance, lack of medical professionals, or availability of services, and rural healthcare poses both a significant challenge and opportunity.

A recent report highlighted that just over a fifth of all rural hospitals—roughly 430 hospitals—are near insolvency. Not only is this a potential medical disaster in the making, but an economic one as well. Those 430 hospitals account for roughly 150,000 rural American jobs and are significant contributors to local economies. In fact, when a rural hospital closes, per capita income falls 4% and the local unemployment rate rises 1.6%. As hospitals face increasing financial pressures, investment in everything from technology to equipment to resources falters. This often leads to a step back in services offered and expounds the problem of access while adding the additional burden of supporting underused facilities. All of these issues compound to become a storm of higher costs and reduced outcomes that cause a self-replicating downward spiral.

However, there are steps that can be taken to improve the situation. Telehealth promises to shift the disparity in access between urban and rural population centers by removing the distance barrier and stabilizing the financial support burden. Telehealth technologies allow larger hospitals to provide services locally regardless of where the patient lives, in effect expanding both access to professionals and the types and numbers of services offered. Telehealth holds particular promise for use in schools and in the field of behavioral health where rural communities often face a critical shortage of qualified practitioners or the perception of privacy issues in dealing with sensitive and potentially damaging issues.

Another potential option is the expansion of effective community care coordination platforms combined with integrated networks of care. Integrated networks provide for a broader safety net for both patients and providers in ensuring that patients have access to needed services with quality care and that providers remain competitive and can better apply their combined resources. The opportunity to develop strong continuums of care that track and support rural patients across time also promises to do much in improving the individual quality of care and the general population health.

Coordinating care in rural areas continues to be a challenge for high-need individuals. The expansion of telehealth, integrated care networks, and other efforts to deliver person-centered care are an important step in overcoming these challenges. To learn more, check out our white paper “Evolving Delivery Models Demand Community Care Coordination.”


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