Article is written by Taylor Sisk. Published on www.NationalGeographic.com July 14, 2021. We are sharing snippets and quotes from RHA of TN and National Rural Health Association. Please read full article here.

Hope amidst declining health care

Across the nation, 12 states have not yet adopted Medicaid expansion as allowed for under the Affordable Care Act. None of the eight states with the most rural hospital closures has implemented expansions. (Voters in two of those states, Missouri and Oklahoma, last year approved ballot measures to expand.)

Six of those non-expansion states are in the Appalachian region, Tennessee among them. Tennessee has experienced more hospital closures per capita than any state. “I don't understand how we can continue to pass up those dollars,” says Jacy Warrell, director of the Rural Health Association of Tennessee.

A resolute spirit

“I’m optimistic that rural communities have the potential to solve this problem,” Jacy Warrell, the director of the Rural Health Association of Tennessee, says. “I think what needs to happen is for policymakers and administrators to really listen to the needs of the community and become partners in solving these issues. I think the answers are there.”

“It used to be we were going to provide every single service in our community, and I think people realize we can't do that,” Jim Kaufman, who heads the West Virginia Hospital Association, says. The most essential question now, he contends, is, “How do we get creative?”

Increasingly, more communities will turn to outside entities, as the financial damage inflicted on hospitals by the pandemic is expected to accelerate mergers and acquisitions.

But, says Alan Morgan, CEO of the National Rural Health Association, “I think there is a role for a small, independent hospital that has a strategic alliance with a larger health system.” That role will be to focus on preventative health and chronic care management, Morgan says, and on “empowering the community to take control of their own health, as opposed to just treating them only when they show up in the emergency room.”