Rural hospitals are closing at alarming rates; more than 80 have shut down since 2005, and another 700 are at risk of doing so. The standard policy response is more subsidies and federal aid. But rural healthcare is struggling largely because the system blocks competition, innovation, and new providers. The solution is not more government funding—it is removing the barriers that prevent healthcare providers and emerging technologies from serving rural patients. Rural healthcare can improve if policymakers allow competition and expand provider supply.
Rural communities face healthcare provider shortages. Part of the reason is that doctors tend to practice in urban areas, but outdated regulations also play a role. Many states restrict the ability of advanced practice registered nurses (APRNs) and pharmacists to provide routine care without physician supervision. APRNs have repeatedly shown they are just as capable as physicians of performing annual checkups, and many studies have demonstrated the benefits of allowing local pharmacists to administer vaccines and provide other routine services. These restrictions reduce the supply of providers in areas where physicians are already scarce.
Because these shortages are partly artificial, they have a straightforward fix: remove the restrictions. Expanding the scope of practice for qualified providers would allow APRNs to practice independently within defined scopes and permit pharmacists to perform routine services that often go unattended when patients must drive hours to receive them. More local healthcare providers mean greater access for patients in rural communities that face some of the largest barriers to care.
Justin Leventhal is a Senior Policy Analyst for the American Consumer Institute, a nonprofit education and research organization that advocates for consumers through evidence-based analysis and data. Follow Justin on X @JustinLeventhal.