19 challenges to rural healthcare access

The opioid epidemic and medical surge capacity are among emerging issues that threaten rural hospitals' ability to maintain access to healthcare services in the communities they serve, according to a report released Feb. 4 by the American Hospital Association.

The report outlines challenges affecting rural communities as well as the association's recommendations to ensure these communities flourish.

The emerging challenges, based on the association's report:

  • Opioid epidemic
  • Violence in communities
  • Medical surge capacity
  • Cyber threats

Recent challenges:

  • Care delivery shifts
  • Behavioral health
  • Economic and demographic shifts
  • High cost of drugs
  • Regulatory burden
  • Insurance coverage
  • Medicaid expansion
  • Health plan design

Persistent challenges:

  • Low patient volume
  • Payer mix
  • Patient mix
  • Geographic isolation
  • Workforce shortage
  • Aging infrastructure
  • Limited access

Given these challenges, the association recommends updating Medicare and Medicaid payment rates to cover care costs; updating regulatory requirements; expanding access to telehealth services; and focusing workforce programs on rural areas facing provider shortages.

"Although rural hospitals have long faced unique circumstances that can complicate health improvement efforts, more recent and emergent challenges are exacerbating their financial instability — and by extension, the economic health of their community," the report concluded. "Individually, these are complex, multifaceted challenges. Taken together, they are immense, requiring policymakers, stakeholders and communities to work together, innovate and embrace value-based approaches to improving health in rural communities. The federal government must play a principal role by updating policies and investing new resources in rural communities."


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