Rep. Daniel Pae, R-Lawton, and Rep. Arturo Alonso-Sandoval, D-Oklahoma City, hosted an interim study on healthcare challenges facing rural Oklahomans before the House Public Health Committee on Thursday, Oct. 10. 

"A strong healthcare system is the backbone of a healthy economy, but when we fail to invest in rural healthcare, we fail our fellow Oklahomans," Pae said. "Without providing the right resources today, rural hospitals will continue to close their doors. These difficulties won't just go away if we ignore the problem or resolve themselves unless we take targeted investment and action." 

"This interim study shed light on our current healthcare challenges and the immediate steps we can take to make a significant difference next session," Alonso-Sandoval said. "As a representative of an urban district, I've seen how parts of our cities face healthcare access issues similar to our rural communities. It's clear that addressing the lack of healthcare resources is crucial for all Oklahomans, no matter where they live. This study emphasized the importance in providing comprehensive solutions that ensure quality healthcare is accessible to every Oklahoman."

According to the Oklahoma Hospital Association (OHA), in 2023, Oklahoma's healthcare spending per capita was $9,444, whereas the U.S. healthcare spending per capita was $10,191. 

When speaking on operational challenges hospitals face, Rich Rasmussen, president and CEO of OHA, said total expenses were $2 billion higher in 2023 than pre-pandemic. He attributed this increase to rising labor costs, including contract labor expenses, as well as growing prices of utilities, drugs and supplies. 

"The majority of hospitals dipped into their reserves to be able to cover operating costs," Rasmussen said. 

Sean McAvoy, executive director of Primary Care Services for Comanche County Hospital Authority, said there are several reasons why providers may choose not to go to rural areas. 

McAvoy said many rural areas lack facilities that meet healthcare standards, requiring new construction of healthcare facilities, as well as having a smaller workforce to recruit from, leading many healthcare providers to recruit new hires, which can be costly. Additionally, McAvoy said, rural areas with fewer employees mean fewer people with employer-sponsored healthcare, which typically pays better rates to healthcare providers. 

McAvoy said transportation presents a challenge in rural areas, especially for older adults, but telemedicine is an increasingly valuable tool to address certain healthcare concerns. He also pointed to mobile clinics as a good option to expand care in rural areas quickly, although he said they typically have high operational costs. 

Melissa Alvillar, the chief nursing officer at Comanche County Memorial Hospital, said Oklahoma is ranked 49th nationally in healthcare outcomes. 

"Hospitals such as ours are willing to grow and willing to add beds to facilitate the care that the rural environment needs, but we need the financial help to support that," Alvillar said. She said healthcare providers need support from lawmakers to deliver the care Oklahomans deserve. 

"We have the ability to be higher in healthcare than 49th," Alvillar said. 

She told attendees it's hard to get people to join or stay in the healthcare workforce given the increase in physical assaults and threats against healthcare providers and, as a result, the cost of staff pay and benefits to retain employees is "through the roof," further stressing hospitals' and clinics' budgets. 

Dr. Mark Woodring, vice chair of the Board of Rural Health Association of Oklahoma, highlighted the recent groundbreaking of a new rural hospital in Tillman County. Since the 2016 closure of Memorial Hospital and Physician Group in Frederick, residents have driven between 30 minutes to an hour to receive hospital-level care. The new hospital is funded in part by the Legislature's appropriation of federal American Rescue Plan Act (ARPA) funds. 

According to the most recent data, Woodring said, "Most of Oklahoma is a health professional shortage area." One suggestion he offered to improve rural health outcomes was creating a healthcare rural opportunity zone pilot program or offering state income tax exemptions or credits to providers who relocate. 

"It's creating maybe an additional incentive not to go into a specialty that's going to pay them more," Woodring said. "They know that certainly primary care, while competitive is not paying as much as a maybe a cardiologist or an orthopedic surgeon."