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Congress must protect rural access to emergency room care

Congress must protect rural access to emergency room care

By Former U.S. Senator Heidi Heitkamp, One Country Project Founder and Chair

Emergency Departments (EDs) are one of the most important and irreplaceable services hospitals provide, serving as a literal lifeline for the communities they serve. Open 24/7, every day of the year, EDs treat patients in critical condition and serve as the last resort for those in dire need.

When a few minutes can be the difference between life and death for some patients, swift access to EDs is critical. The national average time needed to travel to an emergency room is about 17 minutes or eight miles, but it’s much greater for rural areas.

Already, hundreds of rural hospitals are at risk of closure, leaving the communities they serve hanging by a thread. To stay afloat, many struggling hospitals have to consider cutting services, such as EDs. Despite these existing roadblocks to care for rural communities, Congress is pushing for harmful cuts to hospital reimbursements, which would put even more EDs at risk of closure, especially in rural areas where access to care is already limited.

EDs nationwide are largely underfunded and over-utilized. From 2005 to 2015, 200 hospital-based EDs were forced to close, while at the same time, there was a 28.6% increase in ED visits per year. Further, EDs are at greater risk of closure in communities with a high poverty rate, placing the most underserved Americans at greater risk of losing access.

Full service EDs are critical to communities but unique to hospitals, as outpatient sites and even urgent care are only open during limited hours. The loss of 24/7 immediate emergency care services would result in dire circumstances for many patient communities and further strain the resources of existing EDs.

Access to emergency services directly impacts patient health outcomes, and studies show that mortality rates increase in areas that lose access to emergency services. Meanwhile, waiting times at remaining EDs increase as those points of care take care of more and more patients. In rural areas with widespread closures, this has the net result that patients must travel significantly further to receive care and wait longer.

The stress on hospitals is further compounded by millions of Americans coming off the Medicaid roles following the end of pandemic-era benefits. While some Americans are no longer eligible for the health coverage they had through Medicaid or are working their way back through a complicated process, hospitals continue to provide these uninsured patients with care, often in EDs, without regard for the patient’s ability to pay. This means some hospitals have seen a significant increase in the amount of care they provide without being paid: uncompensated care, which previously comprised 6.4% of hospitals’ total operating revenue pre-policy change, had already risen to 8.7% by July of this year.

All Americans deserve accessible, high-quality care, but with Congress proposing further cuts to hospital reimbursements, communities’ access to emergency care is increasingly at risk.

These misguided cuts from Washington would only exacerbate hospitals’ financial challenges, reduce access to hospital care across the country and increase emergency department closures. And it’s rural communities that are hardest hit.

Now, more than ever, we must protect access to emergency services for rural Americans, and that starts with protecting the rural hospitals that provide this lifesaving care.

Posted on September 29, 2023 in News.
Tags: health
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