Rural Health Crisis Brings Advocates to Washington


Rural Health Crisis Brings Advocates to Washington              

A record number of rural health advocates were on Capitol Hill Feb. 11-13 in response to growing evidence that rural America faces a worsening health crisis, including higher mortality rates and less access to care. Randy Tobler, MD, FACOG, CEO of Scotland County Hospital & Clinics in Memphis, Missouri, was one of those advocates that attended and represented America's heartland. During NRHA's 31st Rural Health Policy Institute - the largest rural advocacy event in the country - more than 500 rural health care providers and advocates converged on Washington DC and asked Congress and the Administration to end the catastrophic rural hospital closure crisis, mitigate the increasing mortality gap between rural and urban America, and improve health care workforce shortages. 

According to the NRHA (National Rural Health Association) there have been more rural hospital closures in 2019 than any of the past 15 years. Dr. Tobler said, "Scotland County Hospital is not immune to the pressures that threaten all small safety net facilities. We provide a broad array of services close to home, but devastating reimbursement cuts, decreasing utilization of services and spiraling regulatory costs provide increasing challenges. We are meeting those challenges with a variety of initiatives involving our community and other partners, working together to sustain the great healthcare they've become accustomed to. A fundamental problem remains however: Remote decision makers who refuse to realize that our older, sicker and poorer communities need unique answers, not one size fits all answers from Washington D.C."

"Now, more than ever, the voice of rural America is being heard," says NRHA CEO Alan Morgan. "Rural America is facing a national health crisis, and it's time that Washington listens." 

Since 2010, 121 rural hospitals have closed, and hundreds more are at risk. Forty-six percent of rural hospitals operate at a financial loss, up from 36 percent five years ago, according to Chartis Group data. The rate of closures has steadily increased since devastating Medicare cuts, a lack of Medicaid expansion in certain states, and a dearth of private plan competition coupled with exorbitant deductibles in ACA exchanges left rural providers without adequate compensation for care. 

When rural hospitals close, they rarely reopen, and rural patients are left without emergency room access. Because rural hospitals are often one of the largest employers in rural communities, when they close approximately 20 percent of the rural economy vanishes. Medical deserts often form where populations are older, poorer, and sicker. According to a January 2017 CDC report, the mortality gap between rural and urban America is widening, with many rural populations' life expectancy rates on a tragic decline. 

At the NRHA's Rural Health Policy Institute, members of Congress spoke to more than 500 rural health stakeholders. Administrators and providers visited congressional offices to relay unique rural stories to their elected officials. Dr. Tobler made these points to legislators, "We're excited about the commitment to telehealth consistently expressed by Missouri's delegation.  However, the basic infrastructure to actually do the work-like emergency C-sections, or life-saving surgery to stop bleeding- must be preserved by lowering costs, making innovation less burdensome, and stopping the flood of lower and lower payments. We rural folks are problem solvers. By restoring the aggregate cuts and lifting silly regulation, rural health can be restored an sustained long into the future!"

NRHA is a nonprofit organization working to improve the health and well-being of rural Americans and providing leadership on rural health issues through advocacy, communications, education, and research. NRHA membership consists of more than 21,000 individuals and organizations. 

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Photo Bi-Line: Drs. Randy & Heliene Tobler are pictured with Senator Tina Smith (D-MN) in Washington DC during the National Rural Health Association Advocacy Institute last month. Senator Smith, a member of the Senate Health Committee, joined an effort to ensure that all expectant mothers get the healthcare services they need both during and after pregnancy by cosponsoring the Healthy Maternal & Obstetric Medicine (Healthy MOM) Act. The bill establishes pregnancy as a qualifying life event and allows expectant mothers to enroll in healthcare services instead of having to wait until the baby is born to change coverage. The bill also guarantees 12 months of continuous Medicaid eligibility for postpartum women, thus removing key barriers that often prevent mothers from getting the care they need after birth.

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