On its latest version of the Our American States podcast, the National Conference of State Legislatures (NCSL) spotlights the effect of the COVID-19 crisis on healthcare in rural america.
The first guest, Alana Knudson, co-director of the Walsh Center for Rural Health Analysis at the University of Chicago gave a national overview of rural health care and its challenges. She describes that rural communities are experiencing similar problems to more urban areas. Knudson says that many rural communities are dealing with hospital closures and says there are at least 128 in the United States. According to Knudson, about 48 percent of rural hospitals had negative margins before the crisis began.
Knudson explains the additional challenges imposed by the crisis and says that because people are social distancing, they are not using primary care and outpatient services. This is hurting hospitals bottom lines as these services are crucial to their financial viability. Rural communities typically have a higher percentage of older residents. Knudson says expanded telehealth is becoming increasingly useful during the crisis to adhere to social distancing and still deliver some healthcare services to residents who are avoiding in person visits.
Dr. James Hotz, primary care physician in Georgia described his viewpoint as a rural practitioner on the frontline of the crisis. He says that because of the digital divide or financial limitations, many rural residents are not able to utilize what insurance companies classify as telehealth. They can still spend time on the phone with their doctor, and according to Dr. Hotz, many receive the same level of care whether it is on a phone call or through video chat. However, calls between doctors and patients are reimbursed by medicare and medicaid at a significantly lower rate. He says state legislators should consider making reimbursements for calls the same as telehealth to incentivize better contact with rural residents that do not have access to telehealth.