Poll finds big gaps in rural health care

Most rural Georgia residents in a new survey say they have experienced problems with the affordability of health insurance and the cost of health care.

Healthcare Cost

When asked the biggest problem facing local health care, 68 percent named cost, with quality of care and access to care trailing far behind, according to the survey of 491 people. It was conducted by Opinion Savvy and commissioned by Healthcare Georgia Foundation.

The poll may be the first to focus entirely on rural health care issues in Georgia. It comes in the wake of four rural hospital closings in the state since the beginning of 2013.

Those hospitals closed due to financial problems, and the economic and medical effects of their loss have drawn the attention of Georgia’s political leadership.

Across America, rural residents generally lag far behind people in other areas when it comes to health and quality of medical care. 

Rural regions have higher death rates due to heart disease, stroke and cancer. They also have higher rates or smoking, diabetes, and low birth-weight babies, and higher rates of uninsured people. And rural areas have chronic shortages of primary care physicians.

An estimated 2 million Georgians live in rural areas of the state.

Asked what their community needed most in terms of health care, about half of those surveyed in the poll indicated it was a clinic. And 77 percent said there is either a moderate, severe or extreme shortage of medical providers in their community.

Stewart Webster Hospital
Stewart Webster Hospital is one of four rural Georgia hospitals to close since January 2013.

More than half said that local, state or federal government have the responsibility to ensure local access to quality care, while 27.3 percent said the private sector had that responsibility.

About 40 percent surveyed in rural Georgia said they had experience with being uninsured.

Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in the state, said Tuesday that  “we’re seeing a phenomenal migration [of patients] to uninsured, underinsured and self-pay.”

He noted that fewer people have employer-based coverage, and that many have such high deductibles that it makes them underinsured.

“Cost is a killer in rural areas,’’ Lewis said. “Many are retired or on fixed incomes. That’s why they want clinics.”

Georgia’s rural hospitals, unlike those in some other states, are not getting a revenue boost from Medicaid expansion under the Affordable Care Act. Expansion would extend Medicaid coverage to more low-income patients, meaning the hospitals that treat them would get more revenue. But Georgia is among the states that have rejected Medicaid expansion, saying it’s too costly.

Gov. Nathan Deal has backed a pilot program that is using telemedicine to facilitate remote diagnoses of patients in rural areas.

Gary Nelson
Gary Nelson

Gary Nelson, president of Healthcare Georgia Foundation, said this week that his organization has met with legislators, representatives of rural hospitals and other stakeholders about strategies to improve rural health care in Georgia.

Nelson said he hopes the foundation’s rural Georgia work will help drive “sustainable and effective’’ investment in those areas. “It’s long overdue,’’ he said.