AHA 2019 Rural Report

Rural Rheumatology

Hospitals are cornerstones of their communities, serving as principal access points to care for the nearly 20 percent of Americans who live in rural areas. They maintain timely access to services through local, on-site care and connect patients to more distant providers via telehealth or care networks.

In addition, hospitals are the leading employers in rural areas, furnishing critical financial support to the communities they serve. Beyond delivering health care services, they provide employment opportunities and contributions to the local economy, both of which promote community growth and development.

Recommendations for Action

In light of the ongoing challenges confronting rural providers and new challenges ahead, the AHA believes that federal policies must be updated and new investments made in order for rural communities to thrive in the health care system of the 21st century. To this end, the AHA is working to advance policy priorities across several key areas for rural health, including:

  • Fair and adequate reimbursement that updates Medicare and Medicaid payment rates to cover the cost
    of care.
  • New models of care that improve financial predictability and include rural providers in the movement
    toward value-based care.
  • Regulatory relief from antiquated requirements that do not improve patient care.
  • Expanded access to telehealth services and ensuring health information technology costs and
    compliance requirements are addressed to ease the burden on rural hospitals.
  • Workforce programs targeting rural areas that continue to be hard hit by provider shortages.
  • Prescription drug price concerns, including unsustainable high drug costs and attacks on the 340B
    program, which supports vulnerable communities.


Although rural hospitals have long faced unique circumstances that can complicate health improvement efforts, more recent and emergent challenges are exacerbating their financial instability – and by extension, the economic health of their community. Individually, these are complex, multi-faceted challenges.

Taken together, they are immense, requiring policymakers, stakeholders and communities to work together, innovate and embrace value-based approaches to improving health in rural communities. The federal government must play a principal role by updating policies and investing new resources in rural communities.

To see the full Rural Report, visit www.aha.org/ruralhealth

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