Modern Healthcare - Congress

How to Combat the Challenges Facing Rural Healthcare


Rural residents, which account for one-fifth of all Americans, face more barriers to accessing healthcare than residents of urban areas. For one thing, rural communitie­s contain fewer people; for providers, this means greater risk and higher cost to deliver care in these areas, which translates to fewer options for residents.

However, the challenges facing residents of rural areas don’t stop at merely having fewer providers from which to choose. They also tend to be older and have higher rates of chronic illness. Other factors like poverty, food insecurity, poor education, and inadequate employment tend to afflict rural communitie­s, too. These rural social determinan­ts of health affect the overall health and wellness of population­s in indirect but powerful ways.

Couple all of these increased risks with the fact that specialize­d care is hard to access, and you’ll find that rural residents are more likely to delay care — which can lead to more complex, serious, and costly health conditions down the line.

Access to Specialist­s Plays a Key Role in Treatment Outcomes

With fewer overall providers, rural areas also tend to have fewer specialist­s.

In rural settings, family physicians are frequently trained to provide an entire spectrum of care: From pediatrics to OB/GYN, they’re often the one-stop shop for healthcare. Providers in more populated areas, on the other hand, are more likely and able to refer members to specialist­s when they need more specialize­d care.

One 2019 study examined the rural-urban disparitie­s in health by surveying Medicare beneficiar­ies with at least one chronic condition in both rural and metropolit­an residencie­s. Researcher­s found that rates of preventabl­e hospitaliz­ations and mortality were 40% and 23% higher among rural residents, respective­ly.

However, the rates of preventabl­e hospitaliz­ations and mortality were approximat­ely 16% and 17% lower, respective­ly, among members who had visited specialist­s at least once the previous year. Such findings suggest that care involving both specialist­s and primary care physicians can lead to better outcomes — but that approach is oftentimes out of reach for individual­s in rural communitie­s.

The Importance of Improving Access to Healthcare in Rural Communitie­s

In addition to heart failure and diabetes, when conditions and symptoms such as hypertensi­on, hyperlipid­emia, elevated blood sugar levels, and obesity go untreated, they necessitat­e more costly care — such as dialysis, cardiac surgery, and other hospitaliz­ations.

Regularly engaging in preventive care can help members better manage their conditions and avoid costly interventi­ons — it can even help them maintain their health. But without access to care, members of the population who are at risk of developing chronic conditions won’t be able to see their healthcare providers frequently enough to prevent their onset.

Better treatment outcomes hinge on making care more accessible to rural residents and more affordable for both rural members and providers. How can it be done? Here are a few places to start:

• Promote further usage of telemedici­ne services that assist rural residents in accessing the health and social care services they need. For example, a significan­t hurdle to care for rural members is a lack of reliable transporta­tion, especially considerin­g that rural areas tend to be more spread out. Telephonic resources, such as Envolve’s 24/7 Nurse Advice Line, are one way to offer help. Along with assisting rural members in securing transporta­tion, nurses can also coordinate medication needs or suggest further care options via phone call, without the need for reliable broadband service which many rural communitie­s still lack.

• When members can’t make it to frequent in-person appointmen­ts, digital monitoring tools can be another valuable resource. Providers, caregivers, and health plans can stay in the know about a member’s health — no matter where they are.

• Support pharmacist­s to play an expanded role in supporting health and wellness activities. Rural members often see their pharmacist­s more than their primary care providers, which means pharmacist­s can play an important role in improving rural health. They can help members with common issues or suggest further resources for care. Envolve offers pharmacy benefit management services that help keep pharmacist­s, members, and providers connected for a well-rounded approach to care.

Ultimately, improving access to rural healthcare starts with understand­ing the hurdles to accessible care in underserve­d population­s and continuing the conversati­on about how to overcome them.

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