Top Reads Overview

In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: clinical quality and risk, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.

The Buzz This Week

The election is capturing much of our nation’s attention this week, but while we wait on final results, there are continuing health disparities to address that must not lose our focus. The COVID-19 pandemic continues to grow and break daily new case records. While the cases were more concentrated in urban areas during the first few months of the pandemic, in recent weeks rural areas have been hardest hit. North Dakota, South Dakota, and Montana saw the highest per capita case volumes in the country in the last two weeks. The struggle in rural areas comes at a difficult time. Many are fatigued from months of isolating and stressed from the national political divide. Additionally, job loss has impacted the entire country, and rural areas are no different. Unemployment in many cases means insurance loss, and for those living in states without Medicaid expansion, there may be no affordable alternative. States that did not expand Medicaid have larger proportions of their population living in rural communities— 31 percent of residents in states that did not expand Medicaid live in rural areas, versus 23 percent of residents in states that did expand Medicaid. Rural communities are now facing the combination of exponential COVID-19 growth, dire hospital financial positions, and an overwhelmed population less likely to have insurance coverage than they were a year ago.

Why It Matters

Initial election results display the divide our country is facing and feeling, much of that along urban/rural lines. Urban and rural communities also face differences in demographics and resources, which may impact their ability to respond to COVID-19 outbreaks. Even prior to the pandemic, rural hospitals were stretched financially and vulnerable to closure. At the beginning of the pandemic, they experienced steep revenue declines as hospitals sat empty. Due to financial constraints, many already operated with minimum staff. Now these same hospitals are likely to be pushed to the brink to care for patients who are older, may have avoided necessary care in the last eight months, and have more pre-existing conditions than their urban counterparts. Medicaid expansion in additional states may be one option to keep a large portion of the rural population insured and able to receive affordable care. From 2013 to 2018, Medicaid expansion states saw a decline in patients avoiding care due to cost. Additional federal relief will also be needed, with a focus at the state and local level. Without significant support and relief, rural communities will likely struggle to keep strained hospitals afloat and protect the health of their citizens, regardless of who is sworn in come January.