Many rural communities were already facing problems of access to health care and greater rates of health care problems. Add the coronavirus pandemic, and America’s rural areas are hurting even more.
cases, lagging behind many cities that have hit their peak. Rural residents are often older, sicker, and poorer than urban residents and have less access to medical care, making them particularly vulnerable to COVID-19.
“These hospitals are designed for primary care and surgery, not pandemics. Most of the care is outpatient -- people are coming for diagnostic testing, broken bones, and. If they need intensive care, they are transferred to larger facilities,” says Alan Morgan, CEO of the National Rural Health Association in Washington, D.C.
When county hospitals close, there are ripple effects in the community. Patients have to travel farther to get to the nearest hospital, which is a barrier to routine primary care as well as emergency room and inpatient care, says Carrie Henning-Smith, PhD, deputy director of the Rural Health Research Center at the University of Minnesota in Minneapolis.
To save money, more than half of rural hospitals nationally have furloughed or laid off staff, including Margaret Mary Hospital in Batesville, IN; St. James Parish in New Orleans; and Lexington Hospital in Lexington, NE, says Morgan. But hospitals don’t get paid for their services until about 60 days later, says Hernandez. He anticipates the revenue losses will show up in late May and early June. In the meantime, the hospital has put cost-saving measures in place, such as reducing full-time staff hours and asking staff to take leave without pay.
To keep patients safe, the staff ramped up telehealth visits. “We get compensated $95 per telehealth visit compared to $180 for regular visits -- it’s a fraction of the previous provider payment,” says Garcia.The Trump administration is now calling on states to resume elective surgeries, which were largely suspended as health systems sought to boost capacity for an expected surge of COVID-19 patients.
“We are rolling out elective procedures gradually -- I don’t even expect a 75% increase next month -- we may need to request more tests as we go along.”
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