Georgia’s Rural Health System Needs Comprehensive Exam

Tim SweeneyGeorgia’s recently appointed Rural Hospital Stabilization Committee will convene Monday, June 9 for the first time and it should seize the opportunity to fix a health care access problem that cries out for a comprehensive solution.

Hospitals are closing in rural Georgia at an alarming rate, including Charlton Memorial, the subject of a recent NPR story.

The committee’s creation coincides with new rules to allow financially struggling rural hospitals to cut costs by scaling back services to become standalone emergency rooms. But the committee should use the opportunity to take a wider look at the deficient health care infrastructure found throughout rural Georgia. It should also examine the role expanded access to health coverage could play to help struggling hospitals.

The name of the committee suggests that it will focus on Georgia’s rural hospitals, but it is also important to examine provider shortages in other areas, including primary care services. After all, rural hospitals are not operating in a vacuum. Patients who lack access to sufficient primary care services could be less able to control chronic conditions and end up in a hospital more often. Replacing full-service hospitals with limited-service facilities could even exacerbate these problems in communities with limited health care providers.

The plan to allow standalone emergency rooms to replace full-service hospitals was put together in haste this year, so it is also important for the committee to examine the idea deliberately to mitigate unintended consequences. Some county emergency medical service providers say to assure reimbursement they typically take emergency patients to hospitals, rather than standalone emergency rooms. The inability of counties to get federal reimbursement for ambulance trips to new rural standalone emergency rooms could create challenges for county emergency services in communities home to these new, limited service facilities.

This committee should also be a prime venue for an in-depth conversation about the root causes of problems facing rural hospitals, including high poverty and uninsured rates, especially in south Georgia. One option to address the high rates of uninsured people in many rural communities is to expand Medicaid eligibility. That action alone could cover half of the nearly 300,000 uninsured adults in Georgia’s rural counties.

States that expanded Medicaid are already demonstrating the dramatic improvement it can provide to hospitals by reducing the numbers of uninsured patients hospitals serve, while increasing patients with health coverage of some kind.

Georgia’s rural health care infrastructure problems have grown in communities across Georgia for a long time. Georgia invests the third lowest amount per-resident in health care, which likely exacerbates problems in rural and other underserved communities. Expanding Medicaid coverage would bring in billions of federal dollars to help stabilize Georgia’s health care system, including its rural hospitals.

Let’s hope the new committee embraces this chance to take a holistic look at ways to nurse the state’s rural health care system back to health.

 

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1 thought on “Georgia’s Rural Health System Needs Comprehensive Exam”

  1. Georgia’s rural hospitals provide much more than emergency care, essential as that is. They offer educational services, wellness programs, and medical monitoring that enable residents with chronic conditions to manage their care with the guidance and support of knowledgeable professionals, thereby PREVENTING many potential emergencies. Fleets of helicopters could provide faster treatment than standalone emergency centers, which would still require transportation to a hospital after stabilization of the patient.

    I believe that treating sick people and accident victims within their communities,where they can maintain contact with family members and friends,is preferable to isolating them in distant hospitals. My husband experienced many hospitalizations for COPD in the last years of his life. Even when we arrived at the ER in the middle of the night, the staff greeted him by name and did all that they could to put him (and me) at ease. I am certain that the TLC he received at our rural hospital extended his life by several years. He never was just a “number”; he was a PERSON who was known and treated with love, which we came to realize was the norm at Habersham Medical Center.

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