A rejuvenated program at Washington State University highlights a continuing problem with the American health care system — a lack of services in rural areas. The problem extends from general practitioners to hospitals to pharmacies, and it impacts rural residents throughout the country.
Now, WSU’s College of Pharmacy and Pharmaceutical Sciences is bolstering efforts to train pharmacists to work in more rustic areas. An anonymous $2.2 million donation last year has helped kick-start the Rural Health Initiative at the university’s Spokane and Yakima campuses.
The (Spokane) Spokesman-Review reports: “Along with regular coursework, the curriculum emphasizes rural health topics, hands-on experiences in rural clinics and a capstone project focused on improving an aspect of rural health care.”
The issue speaks to broader issues in rural health care, signaling a decline in general care. As one pharmacist in Eastern Washington said: “The pharmacist is the most accessible health care provider in America, because you can walk into pretty much any pharmacy and talk to a pharmacist in less than a minute.”
While much consternation has been focused on diminishing hospital care or a lack of nurses, pharmacists often provide the most direct contact with those in need of care. And a study by the University of Washington has found that 450,000 adults in our state live in what is a considered a pharmacy desert, without easily accessible service.
That shortage is spreading to other aspects of health care. A recent study by the nonprofit Center for Healthcare Quality and Payment Reform found that nearly 30 percent of rural hospitals nationally are at risk of closure. Experts cite persistent financial losses and low financial reserves as the reasons.
Last month, the federal government rolled out a new assistance plan for rural hospitals, but the facilities must agree to changes in inpatient services. The new model would continue Medicare payments if rural hospitals convert to a stand-alone emergency room and outpatient service center.
The Washington Post reports: “Hospital administrators say the unusual condition has them stuck between a rock and a hard place — balancing community needs for inpatient care against their facility’s long-term viability. The National Rural Health Association supported the model because of the need to maintain emergency services in rural areas, but acknowledges it doesn’t solve all the financial challenges facing rural hospitals.”
Congress created the new rural hospital designation in a funding bill passed in December 2020.
All of this represents continuing pressure on rural hospitals. As Vox.com explains: “Revenue is based almost entirely on the volume of medical services a hospital provides and, by their very nature, hospitals serving rural or otherwise remote communities do not see as many patients. That has put many of them in poor financial condition.”
In the past decade, more than 130 rural hospitals have closed, and the COVID-19 pandemic has upended the financial model for hospitals large and small.
Hospitals serve as the mountaintop of American health care, but pharmacies form the base. Troubles there reflect shortcomings that will spread to urban areas and throughout the system.
Washington State University’s attention to the needs of rural communities is a laudable step. But Congress and the Legislature also must pay attention to a growing health care crisis in rural communities.