Primary care providers are much less available in rural areas, studies show

A new study backs up findings that access to primary care providers is lower in rural areas than elsewhere in the state.

“Primary care provider” generally means a doctor, nurse practitioner or physician’s assistant who treats people for common medical ailments.

Mary Ford, Primary Care Development Corporation’s director of evaluation and analytics, said the study in PCDC’s 2019 report titled “Rural Access to Primary Care in New York State” backs findings from 2018 that looked at how socioeconomic status impacted access to health care. The study found that rural counties had less primary care access and that that was an indicator of lower socioeconomic status. Ford said the findings were important because a lack of access to health care negatively impacts a community.

“Primary care access is a fundamental component of healthy and thriving communities,” she said.

The 2019 report backs those findings with harder numbers. The rate of primary care providers relative to the population was lowest in rural areas of the state, with 3.4 per 10,000 people. The second lowest was “micropolitan” areas, with 9.7 primary care providers per 10,000 people. Metropolitan areas had the highest with 15 per 10,000 people. (Correction: An earlier version of this article incorrectly gave these rates as being per 1,000 people instead of 10,000.)

The report also built upon what it looked at in 2018 — how to change the access to primary care providers and how to increase their presence throughout rural areas. One method was to introduce a rural designation for health care that would allow for higher rates on reimbursement. Currently there is an upstate New York designation and a lower New York designation, but this isn’t always effective, according to Bob Ross, CEO and president of St. Joseph’s Addiction and Treatment Centers in Saranac Lake.

“That misses a very important third category,” Ross said. He said a new rural classification would be important.

Areas in western New York, the Southern Tier and the Mid-Hudson Valley have rural populations, (clusters with less than 2,500 people), according to the PCDC. These areas could use that higher reimbursement rate than they currently get.

Ross was interviewed within the study. He said he greatly agreed with the recommendations PCDC made and that it could help hospitals and health services in Tupper Lake, Lake Placid and Saranac Lake, including St. Joseph’s.

Some of the issues highlighted were the difficulty to transport people, medicine and supplies to facilities up north, and the difficulty to hire younger, qualified health care workers. Ross agreed with the idea that barriers for people to get to a health care provider need to be removed. Telemedicine could help, he said.

He also said it needs to be cheaper to treat patients and more profitable for employees to work in rural areas. In metropolitan areas, he said, it is far more profitable and thus more attractive for younger people to work there. Low reimbursement rates from insurance providers such as Medicare and Medicaid — which the 2019 study showed that rural primary care providers receive more often than other geographic areas — is bad for rural areas. A higher return on these types of insurance could be more profitable for young employees, Ross said.

Overall, Ross said he applauded the study and said it brought to light issues that affect areas all over the state and the country.

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