Site-Neutral Cuts Will Harm Access to Senior Care
By The One Country Project Team
America has a looming geriatric health crisis, and rural areas are getting hit the hardest. Seniors in rural America face additional challenges in accessing care as they experience more health problems and are less equipped to travel long distances. As rural hospitals continue to face extreme financial pressures and some are forced to close, these challenges will only worsen.
Congress must enact policies that help improve access to quality health care for older Americans, not push ahead with proposed “site-neutral” cuts that would harm rural hospitals and, in turn, seniors.
During the first half of the 21st century, there will be a 350% increase in those aged 85 and older, and by 2034, there will be more people 65 and older than those under 18. A disproportionate share of Americans aged 65 and older live in rural areas, and that percentage is increasing much faster than in urban areas. According to the National Rural Health Association, 25% of seniors live in rural areas, and this figure will only increase as the Baby Boomer generation ages.
Hospitals already face increased demand for senior services, but workforce shortages make meeting this need increasingly difficult. Couple this with existing financial challenges, inflation, and other cost of care factors, and hospitals are having a hard time staying afloat. Adding to these factors, Medicare only pays hospitals 84 cents for every dollar they spend on patient care, creating a constant financial deficit and forcing hospitals to find other sources of revenue or cut services to stay open.
Beyond the many challenges hospitals face in providing high-quality health care for rural patients, traveling to access care is often difficult for rural seniors compared with their urban and suburban counterparts. A lack of adequate public transportation in rural areas makes driving essential, but unsuitable roads and increased risks associated with senior drivers present additional barriers to access. Hospital closures or service line cuts would force these senior patients to travel even further to access the care they need.
The problems associated with aging often mean seniors need additional health services and more intensive care, but access continues to dwindle as many hospitals operate at a loss. This has profound implications for rural communities, as in lieu of adequate care access, friends and adult children are often forced to stay home to provide that care themselves. In 2015, approximately 34.2 million people provided unpaid care to an adult 50 years or older. The direct care workforce already accounts for nearly 4.8 million people, but projections estimate that number will need to nearly double by 2031 to meet the needs of America’s aging population.
At a time when this crisis is more evident than ever, Congress has proposed harmful cuts to hospital funding that will shrink already-dwindling access even further. These cuts ignore the unique value hospitals provide communities, including specialized health services and 24/7 care. Should hospitals be hit with further cuts to their funding, many that are already struggling could be forced to close or reduce the types of services they offer—especially in rural and underserved areas. As America’s population ages, access to these vital care lifelines will only become more important for rural America’s older adults.
Instead of pursuing harmful site-neutral cuts that put seniors’ care at risk, our elected leaders must work together to protect our rural hospitals and equip these vital points of care with the resources they need to meet these challenges head-on.