Strategies to Bring Better Healthcare to Rural Communities

Patients living in rural communities in the U.S. have worse health outcomes than those living in more populated areas.

Patients living in rural communities in the U.S. have worse health outcomes than those living in more populated areas, according to new research by health economist Joshua Gottlieb of the University of Chicago Harris School of Public Policy. Because of the lack of financial prowess, these organizations are also in greater danger of closing when compared to their larger counterparts. About 30% of all rural hospitals in the country are at risk of closing, according to the Center for Healthcare Quality and Payment Reform, due to losses on patient services and low financial reserves.

To discover how rural providers can offer their communities better quality healthcare, Gottlieb and his colleagues analyzed the relative effects of certain policy solutions on inequities in healthcare quality between urban and rural areas. They found that making greater investments in things like urban centers and transportation can have a profound impact on the quality of care provided to rural communities.

But healthcare providers alone can’t shoulder the costs of such projects on their own, while they can make contributions, it is up to policymakers to help get people in rural communities the high-quality care they need, according to the research. Additionally, the research also found that policymakers are stuck with a trade-off between concentrating medical care production in larger regions where they are more efficient at producing services, and promoting healthcare access in rural communities.

Investments in production and travel subsidies can boost healthcare quality and access, but will have different impacts on patients and providers, as well as neighboring regions, the research says.

"Healthcare produced in large regions is higher quality. Policies to reallocate care to smaller regions may impact patients’ access to healthcare in unexpected ways," the research says. "Traditional production subsidies in small, underserved areas help healthcare producers (e.g., doctors) more than patients in those areas.  Patient travel also plays a meaningful role in enabling access to higher-quality, more experienced, and specialized care. Policymakers should consider travel subsidies rather than only production subsidies to increase access to care for underserved patients."