The Health of Missouri’s Rural Residents and Hospitals
November 20 marks National Rural Health Day. The designation was formed by the National Association of State Offices of Rural Health to call attention to the unique health care needs of rural Americans. People who live in rural areas often face additional challenges in accessing health care that is close to home. On average, rural residents also are older, more likely to suffer from multiple chronic conditions and less likely to have health insurance coverage.
Hospitals are significant economic engines in rural communities. They also face increasing pressure to remain financially viable in the current health care policy landscape of increasing rates of uncompensated care, declining reimbursement from payers, disproportionate share funding cuts and the continued reluctance of the Missouri General Assembly to reform and expand Medicaid coverage for low-income, working Missourians.
Rural Missourians account for a disproportionate share of residents who would benefit from expanded health insurance coverage through Medicaid. According to the latest health insurance coverage data from the U.S. Census Bureau, residents under the age of 65 from rural counties account for one out of every four Missourians, yet they account for nearly one in three uninsured residents with income below 138% of the federal poverty level — the income threshold for Medicaid in states choosing to expand the program.
Eighty-one counties and 41 census tracts are classified as rural areas in Missouri. With a population of 1.8 million rural residents in 2014, nearly one out of every three Missourians lives in a rural area. Similarly, rural patients accounted for nearly one in three hospital visits in Missouri during the most recent 12-month period for which data are available.