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Rural Healthcare Crisis

Rural populations experience unique challenges to accessing healthcare. Long-distance travel to the nearest hospital may be the most apparent concern for regular healthcare and time-sensitive emergencies. Still, the issues facing rural populations run far deeper than that alone. Over the last five years, rural communities have been experiencing a crisis as healthcare availability declines. Rural communities struggle with limited access to primary care doctors and specialists, and they are uniquely affected by how fixed costs and revenue cause hospitals to shut down certain services or close altogether. 


A few ratios quickly highlight the disparity between rural and urban healthcare access. The number of physicians per 10,000 rural populations is 13.1, while for urban populations it is 31.2. Rural communities having less than half the number of available physicians than urban communities is already an apparent discrepancy, yet that alone doesn’t do the issue justice. When it comes to specialized medicine, people living in rural communities face a significant challenge in accessing care. The number of specialists per 100,000 people in a rural population is 30. In urban populations, it’s 263. There is an incredible difference between 3,333 potential patients per specialist in rural areas and 380 potential patients per specialist in urban areas. On top of that, rural patients, on average, travel more than twice the distance (17.8 miles) as urban patients (8.1 miles) for medical care.


Rural healthcare is also disproportionately damaged by the unique way fixed costs and revenue affect offered care. For example, more than 100 rural hospitals have stopped delivering babies or announced that they will cease during 2025. Why is there such a dramatic decrease in offered maternal care? One-third of all rural hospitals in the country are at risk of closing because of severe financial problems. The primary reason is that at-risk hospitals have higher fixed costs (cost of staffing and supplying the hospital) than revenue from patient visits due to a smaller population. For these hospitals, private insurance, Medicare, Medicaid, and uninsured patients do not pay enough to offset what it costs to deliver services to patients, with private insurance causing the highest losses. 


“More than 700 rural hospitals – one-third of all rural hospitals in the country – are at risk of closing because of the serious financial problems they are experiencing. Over 300 of these rural hospitals are at immediate risk of closing because of the severity of their financial problems.”

- Center for Healthcare Quality and Payment Reform



When hospitals struggle to stay open, they look to cut services, causing the most financial losses. Because maternal care and labor and delivery services are very specialized, keeping maternity care teams on staff is expensive. Additionally, in smaller communities, there are fewer births at the hospitals. The fixed cost of providing maternity care is high, and the payment per birth at many rural hospitals does not cover the cost. This means that maternal care and labor and delivery services are often the first services to be cut when a hospital is struggling financially.


“Less than half (42%) of U.S. rural hospitals still offer labor and delivery services; in 11 states, less than one-third do.” 

- Center for Healthcare Quality and Payment Reform



Rural healthcare is experiencing a crisis in the availability of care. It is essential for all of us, urban and rural alike, to pay attention to these signs and do what we can to advocate for policy action to support the health of rural populations and access to care for all Americans.


References:


Learn More about Rural Healthcare:

https://ruralorganizing.substack.com/s/daily-news-clips (Check under the HEALTH CARE, PHARMACIES AND RURAL HEALTH section of their Daily News Clips)


Thank you for reading,

Ashby Glover



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