Less staff, longer delays and fewer options: Rural America confronts a health care crisis

More than 40,000 graduating medical students learned Friday where they will spend the next three to seven years of their medical training.

With the United States grappling with a simultaneous shortage of primary care physicians and a rural health care crisis, many of the graduating students are set to enter the front lines of the country’s health care shortage.

At least 136 rural hospitals and health systems closed between 2010 and 2021, and over 40{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of rural hospitals operate with negative profit margins. Despite billions of dollars in investment in health care, hospitals throughout the United States face the possibility of shutting down.

“I would say it is probably the worst time for health care that we ever experienced,” Joanne Conroy, the chief executive officer and president of Dartmouth Health, told ABC News. She noted that increased costs, inflation, limited housing, and workforce shortages have made running rural hospitals more challenging.

Less staff, longer delays and fewer options: Rural America confronts a health care crisis

Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke University School of Medicine

“We know what to do if we face another pandemic,” Conroy said. “The question is whether or not we have the financial resilience in order to survive it.”

Many hospitals that remain open have cut costs to survive, offering fewer services and beds.

In 2020, 47{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of rural community hospitals did not provide obstetric services, with 89 obstetric units closing between 2015 and 2019. Seven million women reside in counties with limited or no access to maternity care, impacting half a million newborns annually.

According to Conroy, patients can already feel the impact of the crisis, noting that some women in New Hampshire need to drive two hours to deliver their babies. Other effects include fewer available beds in emergency rooms, delays for elective surgery and longer wait times for prescriptions or ambulance pickups.

For new medical professionals entering their residency, especially those joining rural systems, the circumstances of the struggling health systems are out of their control.

PHOTO: Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke University School of Medicine

“It is not my job to fix all of the problems for an entire community, that’s impossible. When you feel like that’s your responsibility, burnout is basically inevitable,” said Katie Stevenson, a Tufts medical student. “When you feel like your goal is to do the best you can with the resources you have, you are able to right-size your expectations a bit.”

An increasing number of students are entering medical school programs that focus on rural medicine. In 2019, the Health Resources and Services Administration issued grants to create 32 newly accredited rural residency programs, supplementing the preexisting programs.

This year, Tufts School of Medicine will graduate its tenth class of students from its Maine Track MD program – a partnership with Maine Medical Center that allows students to pursue a community-based curriculum and gain financial incentives to encourage primary-care specialties.

STOCK PHOTO: A teacher gestures as she lectures a class of college students.

A teacher gestures as she lectures a class of college students.

STOCK PHOTO/Getty Images

Graduating roughly 40 students annually, 27{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of Maine Track students have been matched to programs in Maine and 47{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} have been matched into primary care programs, according to Dena Whitesell, an assistant dean for students at Tufts and psychiatrist at Maine Medical Center.

“We know that students and residents who live in an area [and] who train in an area are more likely to practice in that area in the future,” Whitesell said.

Liv Fauver, a Tufts student who matched with a University of Vermont residency program, grew up in rural New Hampshire and said she felt motivated to work in a similar community where she could positively impact the local residents.

“I think for me, my goal is to live and work in the community that I serve,” she said. “So I’m really in a place where I go home or go to the grocery store and see my patients all the time, because that’s the world that I live in and work in.”

While rural hospitals have closed in record numbers, PCPs – medical professionals who patients regularly use for checkups and other routine care – face additional challenges, especially in rural areas, according to experts.

Greg Sawin, a PCP who has practiced in Massachusetts and Maine as well as Duke University School of Medicine professor, said he worries that the goals of primary and long-term preventative care can sometimes be at odds with larger health care systems.

“We get paid to do things to people. We don’t get paid to keep populations healthy,” he said.

Moreover, he believes the costs associated with medical schools – including the high cost, the likelihood of incurring debt and substantially higher pay to pursue competitive specialties like orthopedic surgery or dermatology, for example – disincentivize primary care options like family or internal medicine.

PHOTO: Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke University School of Medicine

“It can be very appealing to want to go into a specialty where you’re guaranteed to make more money and pay that debt off more easily,” Stevenson said.

Owen Foster lives in rural Vermont and has felt the impact of the decreased number of available PCPs, spending six months to book an appointment with a doctor. Living in a rural area, Foster shares his dilemma with millions of Americans in rural areas impacted by the shortage of PCPs.

“You need basic things at certain intervals in your life,” he told ABC News. “If you don’t have a primary care provider, you can’t get that and you can’t get the referrals you need, so it’s really, really difficult.”

What makes Foster’s experience unique is his position as the state of Vermont’s top health care regulator. As chair of Vermont’s Green Mountain Care Board, he oversees the quality and cost of the state’s health care system.

Learning about the shortage of primary-care physicians in Vermont, Foster decided to use the opportunity to find a PCP as a chance to examine the market as a “secret shopper.”

PHOTO: Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke students express joy on Match Day learning where they would spend the next three to seven years for their residency program.

Duke University School of Medicine

“What I found was I was completely incapable of getting a doctor,” he said. “I called eight places and the best I got was on an indefinite wait list, which never came to fruition.”

Rural areas comprise about two-thirds of the primary care health professional shortage areas nationwide, even though only 20{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of Americans live in rural areas.

The problem is also likely to worsen over time. Projections indicate that the United States will likely suffer a shortage of between 17,800 and 48,000 PCPs by 2034.

Moreover, health care professionals believe that the shortage of PCPs can make other elements of health care more expensive and worsen overall patient outcomes. Sawin gave the example of a person getting strep throat. Without a PCP, the person might go to a local hospital emergency room, which is significantly more expensive than other treatment options.

“In terms of mismatch of resources, you know, a kid with strep throat showing up in the ER is like cutting butter with a chainsaw,” Sawin said.

Foster added that primary care providers are “critical to controlling the costs of a health care system” due to their role in the early identification of issues, their ability to diagnose mental health issues, and their approach to preventative medicine.

According to Foster, PCPs in rural areas, however, struggle to find and retain staff, negotiate with insurance companies and prevent burnout. The shortage of PCPs, combined with the increased health care needs of the older population in rural areas, creates a concerning combination.

STOCK PHOTO: A group of medical students discussing some work while huddled around a whiteboard at the lab together.

A group of medical students discussing some work while huddled around a whiteboard at the lab together.

STOCK PHOTO/Getty Images

Despite these issues, Foster said he was optimistic about some approaches to make primary care more financially feasible, including adding a floor for PCP spending within health plans and government involvement in rate setting.

A new generation of students graduating from rural track programs also has the potential to reverse the tide of the PCP shortage in rural areas, with 571 additional primary care matches this year. Stevenson, for example, matched with the Swedish Cherry Hill rural program in Washington state.

“I think we have an opportunity in this country to do a much better job of taking care of our patients if we do a better job of funding primary care and preventative care and creating healthy environments,” Stevenson said.

Breast cancer recovery options could be affected by a health insurance coding change

When Rita Davis located a small nodule on her appropriate breast, the middle college teacher and her husband, Britt, experienced no strategy that discovery would convert into a lot more than a yearlong battle versus intense most cancers that included medical professionals eliminating her suitable breast and offering her chemotherapy and radiation. Davis misplaced her hair, eyebrows, nails and her perception of self.

“Anything is so uncontrollable to you as the client,” she claimed.

So when medical practitioners requested if Davis needed breast reconstruction surgical procedure, she agreed.

“At the very least you get some type of a preference,” she claimed. “You get to have sort of a say of what is actually occurring to you and your overall body at that position.”

Most girls who bear breast reconstruction get implants, which are built of silicone and loaded with a silicone gel or saline alternative. But they have hazards of further surgical procedures, ache, rupture and even related immune procedure most cancers.

Davis understood from her own exploration that there was another selection: something known as diep flap medical procedures where pores and skin, tissue and blood vessels are eradicated from a woman’s abdomen — primarily a tummy tuck — to develop a new breast with the woman’s tissues. Breast reconstruction surgical procedure rose 62{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} from 2009 to 2014, stats from the Company for Health care Study and Top quality clearly show.

But Davis’ circumstance highlights an issue some breast most cancers survivors who want reconstructive surgical treatment are coping with: variations in the way the governing administration codes the technique, which will make some kinds of surgical treatment more challenging to get, prompting some insurance policies companies to fall reimbursements appreciably, which usually means having to pay out of pocket is the only solution for some.

Though Davis preferred the idea of making use of her own pores and skin for the course of action, the few surgeons she could uncover in San Antonio who provided diep flap surgical procedure did not choose her insurance policies. 

Their income price? All-around $50,000.

“I never imagine which is reasonable, primarily right after combating this form of a journey, this sort of fight, to be explained to, ‘Because you never have the money, you never have the selection to do everything diverse,'” she stated.

Dr. Elisabeth Potter, who specializes in diep flap surgeries, suggests section of the issue is that the operation is longer and necessitates advanced microsurgical expertise, this means numerous plastic surgeons you should not offer you it. In addition, some medical doctors cost a lot increased charges — and is not going to acknowledge insurance plan.

Potter does settle for insurance plan, but now, she states, a alter in the way the governing administration codes the course of action is about to make the medical procedures even more challenging to get. That has prompted insurance policies providers to start off sending out letters declaring reimbursements will drop, some as much as 80{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}. 

But all those who are unable to manage the medical procedures may perhaps be out of luck.

“Make no slip-up, women who want this surgical procedure and have money will constantly have entry to it,” Potter mentioned. “The only folks that this coding change has an effect on and hurts are women who need to have access through insurance plan.”

The Facilities for Medicare and Medicaid companies, the government agency that oversees the coding, suggests the coding improve arrived about after the American Healthcare Association and plastic surgeons asked for them. But medical practitioners groups explained to CBS Information the insurance policies organizations are to blame for determining to lessen their reimbursements.

Florida Rep. Debbie Wasserman Schultz, a breast cancer survivor, is element of a bipartisan effort and hard work to reverse the coding change.

“You know, to start with you face down irrespective of whether you might be heading to survive breast most cancers, but psychologically, so a lot of the aftermath as you go through the course of action of currently being a survivor turns on your psychological wellbeing and how you feel as a human and as a girl,” she claimed. “And this impediment was place in the way of breast most cancers survivors.”

In the meantime, Davis linked with Potter, who agreed to do her surgery for whatsoever total Davis’ insurance policies will pay — even though it won’t protect all her fees.

Leveraging consumer brands to bring healthy lifestyle options to seniors

At one time, the business of healthcare might have seemed impenetrable to outsiders. If an organization wasn’t directly connected to medicine, research, pharmaceuticals, health insurance and the like, there was no place for it. However, as stakeholders have recognized the assets those outside of the field can contribute, there has been a surge of collaborations and integrations that strengthen healthcare delivery, quality and outcomes.

For example, while physicians have long touted the benefits of physical activity, health plans also understand the value of including gym memberships or fitness programs as a benefit. Today, senior fitness programs are a popular benefit for Medicare Advantage enrollees and plans, offering members a cost-effective way to improve and maintain their health. SilverSneakers®, the leading fitness program for older adults, promotes greater health engagement and accountability through regular exercise and social opportunities, and has been proven to improve overall health and lower healthcare costs.

Leveraging consumer brands

In recent years, recognizable, consumer-facing brands have entered the fold as both consumers and healthcare experts have recognized a need for opportunities for healthcare services to be more integrated in typical consumer experiences. Today, meal delivery services, ride-sharing services, retailers and tech brands are seeking new ways to reach consumers with solutions to improve their health and well-being. It’s no secret that many consumers use fitness and healthcare apps, but it may be surprising that leading technology companies are also recognizing the potential to support the senior population through virtual and mobile solutions.

SilverSneakers understands the potential to leverage technology and recognizable consumer brands to enhance its own offerings. SilverSneakers recently announced that, starting in 2023, members in participating health plans are eligible for an Apple Fitness+ subscription at no additional cost. With a Fitness+ subscription, these SilverSneakers members will have access to 3,000-plus workouts and meditations, which will join SilverSneakers’ virtual suite of live and on-demand fitness and holistic health offerings, interest-based social connection opportunities, mental enrichment, personalized member content and a network of up to 22,000 fitness locations. The result is more opportunities for more members to experience the mental and physical benefits of exercise and meditation.

Apple Fitness+ enables SilverSneakers members to move how they want, where they want, using familiar technology. They can choose from workouts and meditations ranging from 5 to 45 minutes across 11 workout types, including dance, Pilates, strength and yoga, along with video and audio guided meditations to support cognitive health and stress relief. There are also workout programs with custom content, including Workouts for Older Adults, which helps users stay active at any age with a focus on strength, flexibility, balance, coordination and mobility.

The power of collaboration

So, as SilverSneakers becomes a more comprehensive program through its latest offering of Apple Fitness+, a brand that people know and love, it becomes even more enticing to health plans and their members, with greater potential to improve senior health. But what’s the benefit for Apple Fitness+? SilverSneakers has 18 million eligible members nationwide. With 10,000 people turning 65 every day, today’s seniors expect tech-enabled health options for everything from doctors’ appointments to wellness. Apple Fitness+ is committed to being the world’s most inclusive fitness subscription service, recognizing that today’s older adults are active and connected.

Fitness+ is designed to be welcoming and inclusive to all and to help users live a healthier day – no matter where they are on their fitness journey. The workouts and meditations are led by a diverse team of trainers, curated for a range of abilities, skill levels, ages and interests. Every Fitness+ studio workout includes modifications to accommodate all fitness levels, along with options for closed captioning and subtitles in six languages.

SilverSneakers has been a leader in the senior wellness space for 30 years and understands the unique needs and fitness preferences of older adults. Through this new offering, it is furthering its commitment to accessible fitness for seniors. SilverSneakers is the only senior fitness program that will offer Fitness+ in January through select Medicare Advantage plans.

While the exclusivity of healthcare may have served it well at one time, today, harnessing the strengths of disparate entities has the power for transformation. In this case, by linking two brands that are respected in their categories and have a shared vision, fitness can be a more approachable, accessible and fun pursuit for seniors. And when seniors embrace opportunities to be more physically and mentally well, everyone wins.

To learn more about SilverSneakers, visit www.tivityhealth.com/brands/silversneakers/.


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Leveraging consumer brands to bring healthy lifestyle options to seniors
At Tivity Health, we help adults improve their health and support them on life’s journey by providing access to in-person and virtual physical activity, social, and mental enrichment programs. Our suite of services supports health plans nationwide as they seek to reduce costs and improve health outcomes. At Tivity Health, we deliver the resources members need to live healthier, happier, more connected lives. Learn more at www.tivityhealth.com.