Three notes:
- One study, recently published in the Annals of Surgery, found that 99 million Americans — nearly one-third — live at least an hour’s drive from a hospital that offers high-quality surgical care and face out-of-pocket costs higher than what they can afford. Researchers defined access to high-quality care as living within an hour’s drive of a hospital with at least three stars in CMS’ overall hospital quality star ratings program. Affordability was determined using data from the American Community Survey and the Medical Expenditure Panel Survey. The findings showed that while the number of Americans who lacked access due to being uninsured has declined over the last decade, the number who are underinsured — facing high deductibles or significant out-of-pocket costs — has risen.
- A separate study, published Feb. 12 in JAMA, found that 44% of rural Medicare patients now travel at least 60 minutes for surgery, up from around 37% in 2010. Researchers analyzed data from 16 common surgeries performed between 2010 and 2020. While travel times increased across the board, rural patients faced the steepest rise. For low-risk procedures like hernia repairs, appendectomies and knee replacements, median drive times grew from 43 to 48 minutes. For high-risk operations such as coronary artery bypass and liver resection, median travel times reached 69 minutes.
- Researchers pointed to rural hospital closures as a major driver of worsening surgery access trends. At least 151 rural hospitals have closed since 2010. Another 423 rural hospitals are at risk of closure, according to a recent Chartis report.
