Though the topics of health equity and social determinants of health are certainly not new, efforts to provide equitable care to every patient are now taking center stage in the discussion of health trends. A 2023 article from the American Hospital Association posits that this year, health equity will no longer be seen as a “side hustle” because we may see “healthcare organizations begin to unlock that value proposition with the development of new care models and ecosystems”.
Value is a critical concept in this discussion. Deloitte points out that “persistent health inequities have a substantial impact on health outcomes and spending”. The firm estimates that inequalities carry a price tag of more than $42 billion in lost revenue alone.
Given the impact on finances, outcomes, and member satisfaction that can be tied to inequalities within the system, health plans, and payers are actively looking for new tools and tactics to improve health equity within their populations. One place to focus: members residing in rural settings.
Disparities in access to healthcare in rural vs. urban communities
Many rural communities have seen their healthcare options shrink over the past decade. According to an American Hospital Association analysis, the closure of rural hospitals exceeded 135 between 2010 and 2021, with 19 in 2020 alone. In fact, a recent Centers for Medicare and Medicaid Services study found that only 12% of physicians practice in rural areas. Given these dynamics, it is not surprising that the majority of areas deemed “health professional shortage areas”—61% —are in rural areas.
Although some communities receive mobile services where clinicians visit periodically, the overall trends are discouraging. Of the highest concern is that the healthcare gap leaves many rural Americans in a precarious position if a health emergency or unfamiliar condition arises. The situation is particularly serious because rural residents are more likely to have multiple health conditions compared with people in other areas, including suffering disproportionately from heart disease, stroke, hypertension, diabetes, and arthritis, as well as accidental injury5.
Closing the health information gap in rural areas: The role of payers in patient education
Fortunately, payers have an opportunity to serve rural communities using online member and patient education programs that can help members better understand and manage their conditions and treatment. This idea is not only practical in terms of utilizing the tools and care management programs many organizations already have in place but also speaks to a direct need identified by members themselves.
Members are eager for more information and look to health professionals to provide it, according to our recent study1 of more than 1,000 people. John Vivoda, Senior Director, Patient Strategy and Product Management at Wolters Kluwer, Health, noted the study revealed: “80% of patients leave their encounter with unmet questions, and almost 40% of rural patients report that they don't routinely receive patient education, compared to 24% of their urban counterparts.” The gap in receipt of educational materials is concerning, given the growing trends around lack of access.
Payers are in a unique position to close this information gap and mitigate negative outcomes by providing credible educational content through multichannel digital solutions. With the right information and engagement resources, they can improve care outcomes and the overall member experience.
Payer opportunities to increase rural healthcare access: Utilizing available data
As we detailed recently, payers already have the capabilities needed to improve the member experience, increase patient engagement, and deliver more and better patient education in rural communities. Healthcare experts at consultancy McKinsey & Company believe payers could have even more impact by segmenting members based on psychographic factors. This would identify and concentrate outreach efforts on members who may be more receptive to care management, particularly those at inflection points in their health journey when new treatments or decisions are considered.
Return on investment in rural communities
Patient education alone will not resolve the rural healthcare access crisis; however, it is one tool in the arsenal of an industry grappling with how to address equity on multiple fronts. Beyond this, the dividends for using care management programs in rural areas are clear. According to the McKinsey analysis, engaging members is key to improving payers’ return on their investment in care management, as well as ensuring a better, healthier experience for members.
Engaging plan members in rural areas with trusted, evidence-based education content delivered through a range of communication channels can help close the health education gap, respond to members’ needs, and support better health outcomes even as the landscape of healthcare in America evolves.
Learn more about how payers can use UpToDate Member Engagement and education solutions to close care gaps.
