Recently, the U.S. Senate’s Health, Education, Labor and Pensions (HELP) and Finance committees held separate hearings to examine issues related to hospitals and health care providers that disproportionately impact America’s rural counties.

Since 2010, more than 80 rural hospitals have closed their doors, with an additional 673 facilities currently at risk of closing. According to the National Rural Health Association (NRHA), rural hospitals closed at a rate six times higher in 2015 than in 2010.  These closures have created workforce shortages in rural America, with 77 percent of rural counties designated as Primary Care Health Professional Shortage Areas and nine percent of counties lack any physician services.

On May 22, the Senate’s HELP Committee discussed initiatives to develop a health care workforce pipeline for rural communities. The committee also discussed the current graduate medical education system, which according to experts contributes to poor distribution of providers across the country and a shortage of providers in rural communities.  

Later in the week, on May 24, the Senate Finance Committee examined the underlying causes of rural hospital closures. Legislators discussed the need for reform around reimbursement payment models for rural hospitals and health care providers. Measures such as these would require legislative action by Congress.

Both hearings highlighted the importance of Congressional action to ensure an adequate workforce and delivery system that meet the needs of rural counties. For instance, residents of rural counties generally tend to face more chronic illnesses than their urban counterparts. Inadequate access to emergency departments, due to hospital and facility closures, has resulted in disproportionate occurrences of trauma deaths in rural counties.

Hospital closures in rural counties also have a pronounced impact on local economies. Experts have estimated that if the 673 at-risk rural hospitals close, some 99,000 direct health care jobs and another 137,000 community jobs will be extinguished, resulting in a loss of $277 billion in GDP over 10 years. Hospitals and health systems in rural counties—many of which are county-supported—are often one of the largest employers and key to retaining and attracting local businesses.   

As Congress continues to examine health care facility and workforce issues facing rural counties, NACo will continue to monitor developments while advocating to ensure that our rural counties are able to provide for the health and safety of their residents.