In the vast tapestry of American healthcare, rural hospitals stand as unsung heroes, quietly but significantly contributing to the more than 60 million Americans—about one-fifth of the U.S. population—living here. These facilities, nestled in remote regions and small towns, are a lifeline to their local populations, even when local might mean being 30 or more minutes away from the nearest healthcare facility. With limited options for transportation, rural hospital closures are becoming detrimental to these communities, but the effects can be felt throughout the entire healthcare ecosystem.

The Backbone of Healthcare Infrastructure

If we look at the headlines just over the past month, more and more rural facilities are at risk or preparing to close their doors. Not only does this put patients in a difficult spot, literally and figuratively, but they are struggling to reach the next closest hospital for care, and the availability of care dwindling too. 

Currently, the patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas. As hospitals close, pressure increases on those whose doors are still open. Rural physicians are burnt out, with nearly 60% of healthcare workers reporting declining mental health, and new physicians finding it harder and harder to see the benefits of practicing in rural America. 

According to a 2021 Association of American Medical Colleges (AAMC) study, America could see a shortage of between 37,800 and 124,000 physicians by 2034. The study added that if rural residents had the same access to healthcare as their urban counterparts, rural areas would need an additional 180,000 doctors.

Although having access to medical care doesn’t ensure good health outcomes, it remains a crucial factor for the well-being and overall health of a population. The obstacles encountered by rural residents in obtaining healthcare services exacerbate health disparities. 

Extending Reach and Accessibility

Improving access to rural healthcare requires a multifaceted approach that addresses both systemic challenges and community-specific needs. These tangible steps can be taken to address these disparities:

  • Expand non-physician providers’ roles: Empowering nurse practitioners, physician assistants, and other non-physician providers to diagnose, test, prescribe, and refer patients can significantly enhance healthcare access in rural areas. By leveraging their skills and expertise, these providers can offer primary care services and address a wide range of healthcare needs within the community.
  • Enhance access to specialized healthcare: Rural communities often lack access to specialized services such as home care, substance use disorder treatment, reproductive health services, and palliative care. By investing in the establishment of specialized care centers and expanding outreach programs, rural residents can access these essential services closer to home, reducing the need for long-distance travel and the burden on hospitals.
  • Recruit and incentivize providers: Offering financial incentives, loan forgiveness programs, and professional development opportunities can attract providers to rural practices, ensuring that communities have access to a diverse and sustainable healthcare workforce.

Investing in training programs and continuing education opportunities is also essential for maintaining high-quality care standards. By equipping providers with the necessary skills and resources, they can better meet the unique healthcare needs of rural populations and improve health outcomes within their communities.

  • Ensure access to telehealth services: Telehealth is a valuable tool for expanding access to healthcare in rural areas, allowing patients to connect with providers remotely for consultations, diagnosis, and treatment. The COVID pandemic accelerated the adoption of telehealth, but much of rural America still struggles to access it. Investing in telehealth infrastructure and promoting telemedicine initiatives can overcome geographic barriers and improve healthcare access for rural residents. 

The Biden administration’s 2024 budget included nearly $45 million to help expand telehealth services through various measures. These include increasing reimbursement rates for telehealth visits, expanding coverage for telehealth services under Medicare and Medicaid, and investing in telehealth infrastructure to support rural healthcare providers and patients.

  • Home Care: These hospitals not only serve as primary care facilities but also act as hubs for extending medical assistance to even more remote regions. Teams of dedicated healthcare professionals frequently venture into these surrounding rural areas to provide crucial services such as administering medications, collecting blood specimens, distributing vaccines, and delivering antibiotics. Many of these medical interventions necessitate careful handling and storage, especially those requiring cold or frozen storage to maintain efficacy. With committed staff and reliable medical equipment that travels; such as durable medical cases for first aid and other supplies and thermal custom packaging that utilizes phase change materials (PCMs) to maintain temperature sensitive material within a specific range;  rural hospitals ensure that even the most underserved populations receive the care they need.
  • Strengthen the rural healthcare safety net: The Biden administration has also allocated additional funding in 2024 for critical access hospitals, rural health clinics, and other healthcare facilities serving rural communities. These investments aim to strengthen the rural healthcare infrastructure and improve access to essential services. The NRHA emphasizes the importance of these investments in addressing rural healthcare disparities and ensuring that all Americans, regardless of location, have access to quality healthcare services.

By addressing healthcare needs at the grassroots level, rural hospitals play a key role in preventing disease, reducing hospitalizations, and improving overall population health—a ripple effect that reverberates throughout the broader healthcare system.