Confronting the Rural Health Care Crisis in America

For 57 million people living in rural areas, access to quality health care has waned sharply in the past few decades. Is Telehealth the answer?

Image for post
Image for post
UPMC Susquehanna closed the former Sunbury Community Hospital emergency department on January 31, 2020–about six weeks before the COVID-19 pandemic reached the area. (photo: Paul Weaver)

Small town hospitals have been disappearing from the landscape for decades; but long before many finally did, patients in such hospitals had already noticed a marked decrease in the treatments and procedures available at their local facility.

Today, a colon cancer patient living in a small Kansas town might have to travel two or even three hours to receive the care they require. Patients dealing with long-term health problems and serious health issues might even be encouraged to relocate.

Relocation is, of course, a luxury beyond the means of many working-class people in rural middle-America.

15-years ago, such a patient would have had to travel less than an hour. 25-years ago, that patient would have received most of the care and treatment they required from their local hospital ten minutes away.

Those needing medical care and treatment in rural areas face a different set of difficulties than people living in larger cities. Low-income patients in large cities may struggle with lack of insurance, under-insurance and the high cost of prescription medications.

People struggling in economically-depressed rural areas face those same challenges, plus lack of access to adequate medical facilities. Patients living in rural areas have worse health outcomes overall than those living in large cities and higher rates of preventable disease.

It is difficult for small communities to attract doctors and other healthcare professionals who tend to prefer larger areas. Retaining healthcare workers presents another challenge for small communities.

One the things COVID-19 has changed about the landscape of medical care in America has been expanded access to Telehealth services. Hospitals and medical facilities attempting to reduce traffic during the pandemic have worked hard to rapidly develop the necessary infrastructure, internal systems and technology to deliver Telehealth services to patients remotely.

Now that the ability to provide expanded Telehealth services has been established, medical administrators and professionals have more incentive to continue offering such services than to return to the office-visit based treatment model of pre-pandemic care.

This is good news for uninsured and under-insured people in the U.S. It is especially good news for those in rural areas.

One of the major roadblocks to universal healthcare in the U.S. or expanded Medicare for everyone is the sudden need such a program would create for trained medical staff, nurses and doctors who do not exist.

This cap created by a limited number of health professionals may be mitigated by Telehealth services.

Many patients have experienced the annoyance of having to schedule a routine doctor’s office visit, perhaps to refill a prescription, only to spend less than five minutes with a doctor.

With Telehealth services, medical professionals can expand the number of patients they are able to see. What’s more, patients will benefit from easier and more readily available access to their healthcare providers without the added burden of a physical office visit.

Certainly, having to take time out of your work day, or away from caring for children is an annoyance. For those with limited mobility or limited financial resources, the obstacle of the in-person office visit is often daunting to the point that people avoid the very routine medical care which would keep them healthy.

For those living in far-flung rural areas, the added burden of having to travel three or four hours to receive medical treatment can be an insurmountable obstacle. The expansion of Telehealth services offers a solution that can be extended into rural communities right away.

This week, the U.S. Department of Health and Human Services unveiled the Community Health Access and Rural Transformation (CHART) Model. This outgrowth from recent executive orders by President Trump will improve rural healthcare and Telehealth access through funding and HHS initiatives.

In addition to expanding access to healthcare for rural Americans, the CHART model also aims to lower costs for patients.

“The CHART Model represents our next opportunity to make investments that will transform the rural health care system, allowing us to use every lever to support all Americans getting access to high-quality care where they live.” — Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma

Is this program the answer for which rural communities have been hoping?

The next few months will prove the efficacy or otherwise of such a program. With incumbent President Trump heading into a tough election fight against former Vice President Joe Biden and Sen. Kamala Harris, Trump will no doubt need all the help he can get.

This move to extend healthcare into rural areas long neglected by previous presidential administrations may be a politically savvy one. Whether or not rural voters reward Trump with their vote on Election Day, expanded Telehealth services is likely to benefit U.S. patients in the months and years ahead.

(contributing writer, Brooke Bell)

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store