Hoosiers living in rural areas could soon have better access to healthcare through a new state program. But experts say it won’t fully address cuts to healthcare.
In December, Governor Mike Braun announced the state received nearly $207 million in grant money from the federal government’s Rural Health Transformation Program, created in the “One Big Beautiful Bill” to fund the state’s Growing Rural Opportunities for Well-being program. It aims to expand rural health programs and improve access.
That same bill also made over $1 trillion in cuts to the Affordable Care Act and Medicaid and put more restrictions on qualifying for Medicaid. It also limits medical student loans and Medicare eligibility.
In Indiana, 64 of 92 counties are considered rural. According to Lindsay Weaver, state health commissioner at the Indiana Department of Health, 13 counties don’t have an emergency department, and a few don’t even have a primary care provider.
Of those 92 counties, 24 percent of them are considered “maternity deserts,” including Greene County, whose hospital recently ended its obstetric services.
Grant money will be split among eight regions; Greene County’s region is projected to receive $15 million annually for the next five years. That money will be shared among the seven counties in the region. Leaders from each region will have to agree on how to spend the money.
There are restrictions in place on what regions can spend their allocated money on. For example, the money cannot be used for new construction or building expansions, but can be used for minor renovations, such as modifications to existing rooms or repurposing a room.
Brenda Reetz, chief executive officer at Greene County Hospital, said she was hoping to use the money to be on the same electronic health record system as other providers. That would make transferring patient information easier, but it’s not allowed by the grant’s rules. She also can’t use the money for major infrastructure projects.
“These are 30-year projects that are necessary to maintain our buildings, necessary to make sure that our buildings meet all the regulations that we have to meet and make sure they're safe for our patients,” she said. “But, you know, a boiler replacement is $10-15 million and it's once in 30 years. And so we were hoping some of the funding could be used for things like that.”
Even if she can’t change what electronic health record system the hospital uses, Reetz said she still hopes to use some of the grant money to streamline sharing patient information in other ways. She also wants to increase access to care through expanded telehealth programs. That’s something the state is investing in, Weaver said. Recruiting more physicians is also another priority.
“We will have funding specifically to recruit physicians to rural communities and provide a stipend for them to commit to working in that community for five years,” Weaver said. “We know that a high percentage of physicians who have that type of commitment end up staying there, you know, 10 years out. So that's going to help build out that workforce.”
Reetz said she doesn’t plan to invest that money in OB services but would like to strengthen the existing departments to make sure they’re ready when needed.
“It's been part of our OB discontinuation plan of making sure our ER is ready to receive those patients, if need be, and also working with our EMS to make sure that our EMS has all of the tools and equipment they need to be able to potentially transfer neonates and pregnant moms,” she said.
Reetz said she is looking forward to a new project funded through the program that will allow patients to get their medications before leaving the hospital.
“It's a really good thing that I think is going to be very helpful for our patients, and it's going to help compliance for our patients when they leave the hospital,” she said. “Anytime you improve compliance, you're reducing the chance of readmissions and things like that.”
While federal money will help a bit, Reetz said there needs to be more investment in rural communities. She already has to do more with less.
“We're cut what we're paid, nothing is getting cheaper. Everyone wants to be paid more. Supplies continue to cost more. Regulations continue to increase. With every regulation, there comes more cost,” she said. “And so while everything we do continues to cost more, it is expected for us to do more with less, and there's going to eventually be a point where that is no longer sustainable in healthcare, and I think we are very, very close to that point, and thinking that these Rural Health Transformation funds is going to help any of that is an unrealistic expectation.”
Weaver said people can expect to see some of these changes within the next year.
