For the 60 million Americans living in rural communities, access to medical care is fragile. Unfortunately, that access is increasingly under threat. Since 2010, 95 hospitals across rural America have closed, and a new study shows that another 21% are at risk of closing. As access to rural healthcare continues to decline, it is important to understand the effects this will have on one of the groups this impacts the most: women.
Almost 30% of women age 18 or older live in rural communities, and the effects of their declining access to healthcare are continuing to compound. Rural women are at greater risk of poor health and disease, and often have limited access to preventive screenings and mammograms. Pregnant women in rural areas also face incredible difficulty accessing the necessary maternity care, as only 6% of the nation’s OB-GYNs work in rural settings. As less than half of rural women live within a 30-minute drive of the nearest hospital offering obstetric services, and only about 19% of family physicians in rural areas offer these services, pregnant women in these areas are forced to travel long distances for prenatal care.
When women, especially expectant mothers, don’t have adequate access to care, their health outcomes worsen. While the maternal mortality rate in central metropolitan areas is 18.2 for every 100,000 live births, this number jumps to 29.4 in rural areas. The outcomes for black mothers, many living in rural areas, are even worse, with nearly 40 deaths per 100,000 births.
Air medical services play a particularly important role in rural communities and help fill the gap that has been left as a result of decreased rural access to care. These flying ICUs provide life-saving care and transport patients to the nearest facility in the shortest amount of time. In medical emergencies where every second counts, they play a critical role in ensuring women who live far away from the medical facilities receive the critical care they need.
Unfortunately, patient access to air medical services is also under threat. The reimbursement rates for these services haven’t been updated in nearly 20 years, even as costs have increased. This is because more than 70% of air medical patients are either covered by Medicare or Medicaid, or they are uninsured. For the other 30% of patients, some of the private insurance companies that insure them deny coverage for this life-saving service based on “medical necessity” after the fact and refuse to go in-network with air medical providers. This puts the entire system at risk, all while demand continues to increase, especially in rural areas with hospital closures.
As women in rural communities across the country face diminishing access to care, their health outcomes will only continue to worsen. That is why we urge Congress to focus on addressing this crisis by passing legislation to update reimbursement rates for air medical services to reflect the true cost of care, allowing women to access the important obstetric care they need. We also encourage private insurers to do right by those they insure and make sure this important service is covered.
While access to care is particularly urgent for rural women, let’s not forget that shrinking access to care affects every rural American. To improve access to care, lawmakers need to focus on ensuring there is a sufficient network of hospitals and doctors throughout U.S., explore boosting access to alternative care options like telemedicine, and make sure that patients who do go to the doctor are not saddled with surprise bills as a result of insurance not covering their visit.
Every American—whether they’re expectant mothers or receiving vital treatment for other health concerns—deserves quality and timely access to healthcare, no matter their ZIP code.
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