Trump administration makes health care in rural areas a priority | Opinion One in five Americans who live in rural areas frequently face health care issues that differ from those who live in cities or towns.

Seema Verma | Guest columnist

Show Caption Hide Caption Why Tennessee's rural hospitals are struggling to stay open As many as 15 hospitals in rural Tennessee are at risk of closing based on financial records from the last three years.

Seema Verma is the administrator of the Centers for Medicare and Medicaid Services.

I recently heard from a mother living in rural Iowa who had a high-risk pregnancy that required her to drive 90 miles to a hospital in South Dakota for her 13 prenatal care visits and delivery. Fortunately, the hospital could manage her condition, and she safely gave birth to a healthy baby.

It’s patients like her that illustrate that one in five Americans who live in rural areas frequently face health care issues that differ from those who live in cities or towns. Rural Americans often have fewer options for local doctors and may have to travel farther to obtain health care, leading to delays in care. Many rural hospitals are facing financial crises. According to one study, approximately 46% of rural hospitals are operating with negative margins. And when a rural hospital closes, as more than 100 nationwide have since 2010, what happens to the community? Rural residents lose access to important services like emergency or maternal care. The community loses a workforce of doctors and nurses, hospitals administrators, technicians and therapists. Ambulance services are often voluntary and are stretched thin having to transport rural patients longer distances to get care. And these serious challenges disproportionately burden vulnerable populations, like seniors, people with disabilities and pregnant women.

The Rural Health Strategy

The Trump administration has placed an unprecedented priority on improving the health of Americans living in rural areas. Last year, the Centers for Medicare & Medicaid Services announced their Rural Health Strategy, which focuses on applying a rural lens to the vision and work of CMS, to strengthen the rural health care system and avoid unintended consequences from government regulations.

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The Trump administration put this strategy into action by announcing changes to improve how Medicare pays hospitals. This policy, which started in October, increases payments to certain hospitals in low-wage areas, including many rural hospitals. On average, rural hospitals in Tennessee are seeing a 3.6% increase in Medicare payments as a result of these changes. By implementing this change in Medicare payments coupled with changes we made to make it easier for certain rural hospitals to train medical residents, rural hospitals will be better equipped to maintain their health care labor force and ensure that patients have access to high-quality, affordable health care.

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A worried nurse

Based on the thousands of comments we received on these proposals, there was widespread recognition of the challenges faced by rural hospitals and agreement that Medicare payments should be modernized to support hospitals in low-wage areas. Hospitals with some of lowest payment rates in the country were concerned that poor payment was contributing to hospital closures in their areas. A 41-year veteran nurse who worked in a rural hospital was worried who would take her place in caring for patients. For far too long, rural hospitals have been left behind, and we must do better.

The Trump administration is delivering on our commitment to ensure all Americans have access to a system that delivers high-quality, affordable and accessible health care. Our beneficiaries living in rural areas deserve nothing less.

Seema Verma is the administrator of the Centers for Medicare and Medicaid Services.