By TIM ALEXANDER Illinois Correspondent
DEKALB, Ill. – The mounting health needs of an aging rural population has coupled with an increase in the number of patients unable to pay for medical services to drive the closures of hundreds of rural hospitals. This is according to Alan Morgan, CEO of the National Rural Health Association (NRHA), who told a Farm Foundation-American Farmland Trust webinar audience that the lion’s share of rural hospitals still in operation are losing money every day. The June 25 webinar, “Reviving Rural: Agriculture as the Heartbeat of Healthy Communities,” examined how enhancing agriculture can catalyze the revival of rural health, prosperity and resilience. Restoring a vibrant health community was one of the catalysts of rural revival examined by the webinar’s panelists. “In the last decade, 109 or more rural hospitals have had to close their doors,” said Morgan, who described the NRHA as a broad-based organization that includes small town leaders, educators and researchers. The NRHA represents over 90 percent of the nation’s rural hospitals, health clinics and health centers. “Looking at our data right now I can’t believe I’m saying this, but a little over half of the nation’s rural hospitals are currently operating at a loss,” Morgan added. “This is astounding data.” He said that the common perception that rural health centers and hospitals are closing due to a decline in human life expectancy spurred by the COVID-19 pandemic, along with an ongoing rural healthcare workforce shortage, are false. Rather, trends in rural hospital closures over the past two decades reveal that the majority of closures are not occurring in areas where life expectancy is decreasing. “It’s actually in the areas where you have a clustering of patients with high health needs and the inability to pay,” Morgan, who has over 31 years’ experience in healthcare policy, reported. “That’s why the current national discussion on Medicaid is so important. When you cluster patients with high health needs and the inability to pay, it forces these rural hospitals to pick up the bill, and in many cases they simply aren’t able to do that and keep their doors open.” Morgan said he bristles at the notion that rural Americans are simply not willing or able to fulfill the workforce needs of their healthcare system. “There is nothing wrong with rural America,” he said, “but it’s really important that we continue to grow our own (medical workforce) and employ rural residency training programs. That way we can keep our kids in our rural communities and let them know there is a home for them after they graduate from medical school.” Decreasing access to points of healthcare, combined with a declining workforce, can lead to a decrease in human life expectancy in underserved rural communities, according to Morgan. “Unfortunately, it is not unusual to see 20 years less life expectancy in a rural community than you might see in the suburbs or an urban area. But the story that isn’t being talked about is that because of these challenges, it’s forcing innovation,” he said. These innovations have included the rapid advancement of tele-health, or remote health services, in the rural healthcare system. The tele-health boom is shaping what rural healthcare will look like 20 years from now, noted Morgan, who was named one of the nation’s top 100 most influential people in healthcare by Modern Healthcare Magazine. “You’re going to see healthcare providers working on a community basis to make sure that you have access to high-quality healthcare services,” he said. “In the past we’ve seen technologies and concepts like patient navigators come up, community health workers, and of course, tele-health. The chance for tele-health to bring some of the state’s top specialists into your local community really expands access, and is a force multiplier and tool for addressing workforce shortages.” In addition to advancements in tele-health, an increase in the use of remote patient monitoring is also occurring across rural America. Most notably, the utilization of wearable remote devices that allow patients to monitor their own health status (working in partnership with a primary care physician and, sometimes, a community health worker). “These are innovations that we are now seeing expand into the urban context, as well,” said Morgan, adding that the use of artificial intelligence (AI) also represents a boon to the rural healthcare sector. “One of the greatest time (consumers) that rural providers have is the completion of paperwork. Utilizing AI in documentation is freeing up hours of clinical time that care clinicians can now refocus on their communities.” All these innovations are coming together to deliver greater and more reliable care settings in the rural context than what you might see in an urban setting, according to Morgan. He added that with healthcare being the largest employer in some rural counties, the explosion in healthcare technologies can serve as an economic engine for many communities. “Healthcare, agriculture, small business, education – they all have a role to play together moving ahead. It’s really important to recognize the relevance and the importance of the access of healthcare to be able to keep our seniors in the community, to be able to keep our farmers and ranchers there to do the job that needs done, and also to expand maternity care so that we can attract young families to rural communities and build a future for rural America,” he said. |