Critical Access Hospitals

Healthcare access and delivery in rural area has been challenging not only within the U.S., but also in many developed countries. Many issues seem to be common to this maldistribution of physicians and other HCPs. According to Weinhold and Gurtner1, ” [c]ommunities have become progressively disempowered by the continuous centralization of services and the dismantling of infrastructure.” Rural populations tend to be at

One area where access to care is a problem is in the rural communities. Healthcare professionals including physicians, nurse practitioners, and nurses all affect the quality and cost of care (Derksen, & Whelan, 2009). Going forward importance needs to be placed on using recourses more efficiently and effectively; these resources include but are not limited to tests, prescriptions,

Transportation is one of the largest barriers to health care access in rural communities. Fortunately, many interventions

Such data suggests that rural areas were actually better off in terms of medical care prior to the enactment of the Affordable Care Act than they are now. Before ACA implementation, the rural population was significantly more likely to be covered by Medicaid (21%) or other public insurance (4%) than the metropolitan population (16% and 3%, respectively). Therefore, while urban individuals on average had more healthcare benefits due to the nature of their insurance provider, since Medicaid made up some of the gap in employer-sponsored coverage in rural areas, the uninsured rate was similar in rural and urbans populations prior to the ACA (Figure 2).

Americans living in rural areas have found out that getting access to quality health care is not only hard to obtain but very expensive. People who live in rural areas have the highest rates diseases that are chronic, poverty is higher, an having no insurance, and there are limitations to having access to primary care physicians to millions of rural Americans. Since the economy is going through a downturn, this has the potential to cause a rise in a number of access and health issues that are already causing problems in communities in rural areas.(HealthReform.Gov., 2012). This is where the new health care tax or the Patient Protection and Affordable Act of 2010 will play one of its greatest roles which is its main goal which is to allow coverage to all residents of the United States and thereby improving the delivery of needed health care to rural parts of America. (Becker & Dunn, 2012).

Another threat is the current state of rural hospitals nationwide. According to the case study, about 25% of Americans live in rural areas and only about 10% of physicians actually practice in rural areas. There is a 15% gap in the ratio of rural citizens to available practicing physicians. This is a threat to ELH’s need to attract and hire more physicians. In relation to rural hospitals, citizens have longer drive times to their medical facilities. This causes them to delay routine visits which subsequently exacerbates

The North Eastern Local Health Integration Network is responsible for integration amongst different health care establishments and providers within towns such as Sudbury, Timmins, North Bay and a few more. These towns are relatively rural communities and an reoccurring issue in rural communities is not having the same opportunities as those living in urban communities or in the city. Living in rural communities, limits the access that residents have to the care they need because of a lack of these care facilities and providers and it also limits the quality of care that these residents can receive because of a lack of resources and specialists. Unlike in Toronto and surrounding towns, many people have access to primary care, specialists, rehabilitation and more. North eastern LHIN and supporting organizations such as Health Science North and Rural Health pub work to implement integration initiatives to help increase the access to quality health care services to residents of rural communities in northeastern Ontario. One of the programs

The “What’s Different about Rural Health Care?” (2010), website identified factors contributing to the disparities in health care, “rural Americans face a unique combination of factors that create disparities in health care not found in urban areas. Economic factors, cultural and social differences, educational shortcomings, lack of recognition by legislators and the sheer isolation of living in remote rural areas all conspire to impede rural Americans in their struggle to lead normal, healthy lives.” These disparities increase the risk of mortality in the rural

Rural health professionals represent a diverse set of individuals seeking to meet the main goals of public health. Their desire to promote health and prevent disease is blocked by many barriers, due to the geographical position of their target population; yet they still persevere to serve their specified communities. Approximately twenty percent of America is rural, and rural counties are more likely to report fair to poor health. This particular population cannot be compared to its urban counterparts due the sheer amount of obstacles health care providers and patients face. Rural Americans are shaped by geography and tradition which creates a combination of factors that create disparities.

Rural Americans face an exclusive combination of issues that create disparities in health care that are not found in urban areas. Many complications met by healthcare providers and patients in rural arears are massively different than those located in urban areas. Financial factors, cultural and social variances, educational deficiencies, lack of acknowledgement by delegates and the absolute isolation of living in remote rural areas all combined to hinder rural Americans in their struggle to lead a normal, healthy life. Rural hospitals located in rural areas faces many disadvantages, such as; minimum resources, shortcoming or unprepared professionals, and financial disparities. Although many of these challenges could be solved

Quality healthcare in the more rural areas of the United States is not only getting more difficult to obtain, but difficult to afford. American citizens living in rural areas have the highest rates of chronic disease, higher poverty populations, less health insurance, and there is less access to primary care physicians. When the economy is at its lowest point it causes an increase in a number of access and health issues that have already had prior problems in communities and in rural areas, therefore the main goal of the national health care tax of 2010 was to allow coverage to all residents of the United States, and also by transferring necessary health care to places that were farther away, such as the

There are two principal conditions leading to physician shortages in rural communities according to Wright and colleagues. They are “demand-deficient”, meaning they have insufficient populations and resources to support a physician practice, they are “ambiance-challenged,” meaning they are isolated, lack quality services and amenities, and/or are in geographically unattractive settings, or a combination of the two sets of conditions. Inner-city physician shortages are a more recently recognized issue. They are affected by the same conditions, though the specifics are different (Wright, Andrilla, and Hart 2001).

Geographic maldistribution has creates barriers of care to people living in rural areas. Although there is an oversupply of physician specialists in many of the urban healthcare areas around the world, while the inner cities and rural community are struggling to attract healthcare physician professional to provide high quality care to the local population. “The supply of specialties has increased more than 100% over the last 20 years, while supply of generalists has increased only 18%” (Niles,2014). Any shortage of health workers can prevent good access to health services and is a barrier to universal coverage. The issue of the matter is that maldistribution of health workers between urban and rural is consider to be virtual concern around

A challenge that many rural communities are dealing with is the lack of primary care physicians, specialist, understaffed hospitals, and transportation. “Only about ten percent of physicians practice in rural America despite the fact that nearly one-fourth of the population lives in these areas” (National Rural Health Association [NHRA], n.d., para. 2). Although, there are programs designed to improve patients access to hospitals and physicians in rural areas, provider access for these patients remains a barrier. Technology can bridge some of the gaps of care for these patients and it can be beneficial in many ways. With enhanced technology, primary care physicians and patients will be able to have support, access to quality care, improvement in self-management skills, which ultimately, will improve a patient’s health. To assist physicians with delivery of optimal care and for patients to be able to go to scheduled wellness visits with physicians, a new approach to solving rural health barriers are needed.

Critical Access Hospitals are considered as rural hospitals and they have no more than 25 beds within the hospital and are located within 35 miles from any other hospital. Critical Access Hospitals are reimbursed differently by the CMA compared to traditional acute care hospitals, their compensations reveal their operating expenses instead of their volumes. Even through there are large amount of rural hospitals, a lot of them are at jeopardy with being shut down. The United States healthcare expenditures have escalated to 5.3 percent in 2014 to an overall amount of $ 3 trillion, as stated by the CMS Office to the Actuary. The recompenses a hospital gets for the services that were rendered differs and it’s established on the payer. Government payers which entail Medicare and Medicaid, set their rates, and almost all hospitals agree to accept them so they can have access and provide services to these individuals. The commercial payers allow the hospitals to negotiate the rates that are centered around the expected volume and additional factors; but a lot of commercial rates are determined based on the percentage of Medicare and certain formulas that utilizes Medicare rates in the role of baseline figures. For those reasons, reductions in Medicare rates could possibly have a greater effect on hospital funds compared to the Medicare patients (Marshall, 2016).