How to Combat the Challenges Facing Rural Healthcare

Date: 2020-11-06

Rural residents, which account for one-fifth of all Americans, face more barriers to accessing healthcare than residents of urban areas. For one thing, rural communities contain fewer people; for providers, this means greater risk and higher cost to deliver care in these areas, which translates to fewer options for residents.

However, the challenges facing residents of rural areas don’t stop at merely having fewer providers from which to choose. They also tend to be older and have higher rates of chronic illness. Other factors like poverty, food insecurity, poor education, and inadequate employment tend to afflict rural communities, too. These rural social determinants of health affect the overall health and wellness of populations in indirect but powerful ways.

Couple all of these increased risks with the fact that proper care is hard to come by, and you’ll find that rural residents are more likely to delay care — which can lead to more complex, serious, and costly health conditions down the line. 

Access to Specialists Plays a Key Role in Treatment Outcomes

With fewer overall providers, rural areas also tend to have fewer specialists

In rural settings, family physicians are frequently trained to provide an entire spectrum of care: From pediatrics to OB/GYN, they’re often the one-stop shop for healthcare. Providers in more populated areas, on the other hand, are more likely and able to refer members to specialists when they need more specialized care.

One 2019 study examined the rural-urban disparities in health by surveying Medicare beneficiaries with at least one chronic condition in both rural and metropolitan residencies. Researchers found that rates of preventable hospitalizations and mortality were 40% and 23% higher among rural residents, respectively. 

However, the rates of preventable hospitalizations and mortality were approximately 16% and 17% lower, respectively, among members who had visited specialists at least once the previous year. Such findings suggest that care involving both specialists and primary care physicians can lead to better outcomes — but that approach is oftentimes out of reach for individuals in rural communities.

The Importance of Improving Access to Healthcare in Rural Communities

In addition to heart failure and diabetes, when conditions and symptoms such as hypertension, hyperlipidemia, elevated blood sugar levels, and obesity go untreated, they necessitate more costly care — such as dialysis, cardiac surgery, and other hospitalizations.

Regularly engaging in preventive care can help members better manage their conditions and avoid costly interventions — it can even help them maintain their health. But without access to care, members of the population who are at risk of developing chronic conditions won’t be able to see their healthcare providers frequently enough to prevent their onset.

Better treatment outcomes hinge on making care more accessible to rural residents and more affordable for both rural members and providers. How can it be done? Here are a few places to start:

  • A significant hurdle to care for rural members is a lack of reliable transportation, especially considering that rural areas tend to be more spread out. Telephonic resources, such as Envolve’s 24/7 Nurse Advice Line, are one way to offer help. Along with assisting rural members in securing transportation, nurses can also coordinate medication needs or suggest further care options via phone call.
  • When members can’t make it to frequent in-person appointments, digital monitoring tools can be another valuable resource. Providers, caregivers, and health plans can stay in the know about a member’s health — no matter where they are. 
  • Rural members often see their pharmacists more than their primary care providers, which means pharmacists also play an important role in improving rural health. They can help members with common issues or suggest further resources for care. Envolve offers pharmacy benefit management services that help keep pharmacists, members, and providers connected for a well-rounded approach to care.

Ultimately, improving access to rural healthcare starts with understanding the hurdles to accessible care in underserved populations and continuing the conversation about how to overcome them. For more strategies to bolster initiatives in rural communities, read the Top Issues in Rural Healthcare Access and Primary Care Delivery Whitepaper (PDF).