Senate Finance Committee Addresses Issues in Rural Health Care Access

During a Senate Finance Committee hearing held May 16, members gathered to discuss multiple subject areas within rural health care, including access to telehealth and obstetrics, as well as workforce decreases. The hearing featured health care experts that serve rural communities who addressed the unanimous notion that “without rural health care, you can’t have rural life.”¹

Committee members discussed the need for better health care resources among rural communities in the US. | image credit: jonbilous / stock.adobe.com

What’s the Issue?

With the goal of addressing the decrease in access to necessary rural health care resources, Senator Ron Wyden (D, OR) introduced the hearing by detailing the issues within rural health care, specifically telehealth access, maternity deserts, and the lack of skilled health care workers in rural communities.

To discuss the pressing issues within rural health care, the hearing featured a panel of rural health care experts. Those individuals included Michael Topchik, executive director of Chartis Center for Rural Health in Chicago, Illinois; Jeremy P. Davis, MHA, president and CEO of Grande Ronde Hospital in La Grande, Oregon; Lori Rodefeld, MS, director of GME Development Wisconsin Collaborative for Rural Graduate Medical Education in Sauk City, Wisconsin; and Keith J. Mueller, PhD, Gerhard Hartman professor of health management and policy and director of the Rural Policy Research Institute in Iowa City, Iowa.

The panel gathered to address the issue of maternity deserts and presented the case of St. Alphonsus in Baker City, Oregon, as an example. “In 1897, St. Elizabeth Hospital opened in Baker City and began to deliver babies. After being acquired by Trinity Health, the sixth largest hospital chain in the country, they closed their labor and delivery unit with less than 60 days’ notice. Trinity basically said delivering babies at St. Alphonsus was just a money-loser,” said Senator Wyden.²

He then touched on telehealth in rural communities, addressing the bureaucratic blockades that prohibit interstate health care. He mentioned multiple examples of how providers in one state must jump through hoops and acquire pricey licenses to provide care for patients outside of their state, and patients who may have no other choice but to seek telehealth services outside of their own state.¹

Finally, Wyden explained the struggling rural health care workforce. If young Americans are not encouraged to enter health care sectors in rural areas, those communities will suffer from workforce shortages and an inability to retain skilled nurses, practitioners, and other health care providers.

Why It Matters

• In the case of St. Alphonsus, delivering babies was just not profitable for the St. Elizabeth Hospital system. After the announcement of St. Alphonsus’ delivery room shutting down, the community was outraged. To make up for this detrimental shutdown, the hospital offered the community $240,000 in relief, amounting to under $2000 for every year the hospital has served the community. Indeed, St. Alphonsus is just one example of the recent, and extreme, lack of obstetric services in rural communities. “Between 2011 and 2021, 1 out of every 4 rural hospitals in America stopped providing obstetrics services. That’s 267 communities across the country where giving birth locally is no longer an option,” according to Wyden’s statement ahead of the hearing.¹
• Wyden introduced telehealth as a “gamechanger” for seniors in need of convenient health care services, as well as an avenue to lessen the burden on those taking care of seniors. “It’s past time for these artificial barriers preventing Americans from receiving telehealth across state lines to be knocked down, and I’ll be battling for commonsense improvements like this in Congress’ upcoming work related to telehealth,” said Wyden.¹
• “Health care jobs often represent an important economic engine for rural life. But it’s becoming more and more difficult to attract qualified health care workers to rural communities, in part due to the risk of closures that I’ve been discussing. It’s going to take an all-hands-on-deck approach to get this fixed,” continued Wyden’s statement. He explained that an update of the Graduate Medical Education program is the first step to improving the rural health care workforce. Furthermore, it starts with using funds to reach high schools and encourage young people in these areas to consider health care professions.¹

READ MORE: Local Pharmacy Access in the United States Significantly Lower in Rural Areas

Expert Commentary

• “Rural hospitals make up about 35% of all hospitals in the US. Nearly half of rural hospitals have 25 or fewer beds, with just 16% having more than 100 beds. Given that rural hospitals tend to be much smaller, patients with higher acuity often travel or are referred to larger hospitals nearby. As a result, in rural hospitals, the acute care occupancy rate (37%) is less than two-thirds of their urban counterparts (62%),” wrote the American Hospital Association ahead of the hearing.³
• “I know every single member of this committee is passionate about improving health care in the rural and underserved areas of the country they represent, both Democrats and Republicans. Making a difference for these communities is going to require listening to the needs of rural areas so this committee can support these communities and focus on innovative and pioneering approaches that make the most of the federal dollars this committee is responsible for,” concluded Wyden.¹

In Depth Insights

• About 50% of all rural hospitals in the US “operate in the red,” according to Wyden.² The main goal of this Senate Finance Committee hearing was to address and put a spotlight on the issues of rural health care. With greater disparities in rural health care access compared with urban and suburban communities, the committee and panel experts agree that focus and funds need to be redirected to health care in rural communities.
• While several government and community entities across the country are in agreement about rural health disparities, little has been done to address the issue. “More than 46 million people in the US (15% of the population) live in rural areas. There are more older adults, people with disabilities, and veterans living in rural areas. Rural areas tend to have higher rates of people who do not have health insurance and who have limited access to health care services because many medical centers in rural areas are closing,” wrote the FDA.⁴

Extra Reading

• Healthcare Access in Rural Communities (Rural Health Information Hub)

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.

References

1. Wyden hearing statement on rural health care. US Senate Committee on Finance. May 16, 2024. Accessed May 21, 2024. https://www.finance.senate.gov/chairmans-news/wyden-hearing-statement-on-rural-health-care

2. Rural health care: supporting lives and improving communities. US Senate Committee on Finance. May 16, 2024. Accessed May 22, 2024. https://www.finance.senate.gov/hearings/rural-health-care-supporting-lives-and-improving-communities

3. AHA statement for senate finance committee hearing on rural health care. May 16, 2024. Accessed May 22, 2024. https://www.aha.org/testimony/2024-05-16-aha-statement-senate-finance-committee-hearing-rural-health-care

4. Rural Health. FDA. June 22, 2021. Accessed May 22, 2024. https://www.fda.gov/consumers/minority-health-and-health-equity-resources/rural-health