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Roadmap to Strong Rural Health Care

Rural Health Care is at Risk

In rural communities across the U.S., hospitals and health systems are cornerstones for the health and well-being of the patients and communities they serve. Rural hospitals and health systems provide much needed access to affordable, quality health care for patients close to home, and operate as economic anchors in their local communities, supporting good paying jobs and infusing the local economy with spending on goods and services. In 2020, rural hospitals supported one in every 12 rural jobs nationwide, as well as $220 billion in economic activity.
Rural hospitals make up about 35% of all hospitals nationally, but over 68% of Nebraska hospitals.  Nearly half of rural hospitals have 25 or fewer beds, with just 16% having more than 100 beds. Given that rural hospitals tend to be much smaller, patients with higher acuity often travel or are referred to larger hospitals nearby.  
Rural hospitals face significant staffing shortages versus urban areas. Only 10% of physicians in the United States practice in rural areas despite rural populations accounting for 14% of the population. Nearly 70% of the primary care Health Professional Shortage Areas (HPSAs) are located in rural or partially rural areas.
Given their unique constraints, rural hospitals and health systems often need to be resourceful in pursuing opportunities that improve both financial stability and viability.  Access to capital is important to stabilizing a vulnerable hospital or advancing an innovative one. For some rural hospitals, partnerships, collaborations, mergers or affiliations also can be a good option. Many rural hospitals were already in precarious financial positions even before the COVID-19 pandemic, and the pandemic has exacerbated the challenges that many rural hospitals were already experiencing, including workforce shortages, limited access to critical supplies and an aging infrastructure.

About the Roadmap

Sustaining Rural Hospitals and Clinics

  • Provider Rate Increase 
  • Rural Health Clinics
  • 340B
  • Rural Emergency Hospital Model (REH)
  • Medicare Advantage 
  • Prior Authorization Fixes
  • Telehealth Parity 
  • White Bagging Policies

Growing Our Rural Health Care Workforce

  • Current Workforce
  • Future Workforce
  • Education Pipeline

Improving Access to Post-Acute Hospital Care in Rural Nebraska

  • Long-term Services and Support for Seniors 
  • Difficult to Transfer Patients

Improving Rural Well-Being

  • Rural Mental Health
  • Maternal Health

Preserving Life Saving Services

  • Emergency Medical Services