Since 2010, the National Organization of State Office of Rural Health has set aside the third Thursday of every November as National Rural Health Day – a chance to “Celebrate the Power of Rural,” which is home to an estimated 57 million people. While rural living has its benefits – a slower pace, deep community ties, rich agriculture – it is not without its challenges, especially when it comes to health care.
According to the CDC, those living in rural America are “more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.” And yet, access to care in rural areas is dwindling: Since 2005, 181 rural hospitals have closed across the U.S., leaving some with reduced access to health care services and others without in-patient care nearby. While the situation may seem dim, recent telehealth flexibilities – especially amidst the COVID-19 pandemic – have benefitted rural communities, minimizing the need to travel for services or take time off for care.
While rural populations are shrinking and the need for inpatient hospital beds declines, the need for access to care remains. Recognizing this, Congress created the Rural Emergency Hospital (REH) program last December. Under the program, communities would be allowed to transform inpatient hospitals into emergency and outpatient care facilities. REHs would also receive a “facility payment” for spending toward extra medical and support services including behavioral health, oral health care services and other patient support. Regulators are working to flesh out details of the program. BPC looks forward to helping inform the development of this critical new rural hospital model into the coming months.
The problems facing rural America’s access to healthcare are getting noticed:
- Several Sens. recently wrote a letter to HHS and HRSA urging them to make sure that funds allocated for rural health providers under the American Rescue Plan Act are, in fact, given to rural providers.
- There are two pieces of legislation being considered in Congress: S.1512, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021 and H.R.708, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act.
- In South Dakota, leaders from Avera and Sanford Health, two of the state health systems, met to discuss the growing rural health care needs.
- In Kentucky, the Pikeville Medical Center received a nearly $100,00 grant to “improve health and mental outcomes” of children living in rural Kentucky as part of the HRSA Rural Health Network Development Planning Program
- The University of Alabama at Birmingham was recently awarded up to $5 million in grant funds through the CMS Innovation Center’s Community Health Access and Rural Transformation (CHART) Model, another rural hospital transformation model to help address access to quality care in rural areas. (The CHART Community Transformation Track was awarded to four entities – learn more here)
In the weeks and months ahead, BPC will continue looking at the issues impacting rural communities and health care with reports on the impact of digital/telehealth services, bettering public health, and Medicare-Medicaid integration, all of which impact rural communities.
A Letter to the Centers for Medicare & Medicaid Services on the Rural Emergency Hospital program
Streamlining and Simplifying State HCBS Authorities
Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration
Policy Considerations for Fixed Wireless Broadband Tech
Our health project is also building on the federal policy recommendations released in two previous reports regarding access to telehealth services and is requesting public comment on these services. Please consider sharing your responses on our website by Friday, December 10th.
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