Price High for Lack of Rural Healthcare

For the one-in-five New Mexicans who live in rural areas, accessing healthcare is a challenge with sometimes deadly consequences. Many New Mexicans struggle to get medical care, but travel distances, lack of providers, high poverty, and limited hospital services mean rural residents face higher mortality rates, high rates of chronic disease, poor outcomes for pregnant women and newborns, and more substance abuse.

New Mexico needs a holistic, statewide strategy if it wants to improve the healthcare of New Mexicans. It needs a coordinated system that connects urban, rural, and frontier healthcare services to ensure general and specialized care is available in all parts of the state. It needs to create a healthcare environment that welcomes caregivers to New Mexico and encourages them to stay here. It needs a professional development pipeline that encourages high school students to pursue careers in healthcare and nurtures them through their degrees.

The healthcare provider shortage in the state—all but a few areas of the state are federally designated healthcare shortage areas—means competition for doctors, nurses, physician assistants, nurse practitioners, and other providers is fierce. Rural hospitals and medical centers, already facing financial hurdles, simply do not have the resources to attract practitioners away from urban centers.

To improve the supply of providers, the Legislature earlier this year significantly upped the rates paid to those who serve Medicaid-covered patients. Half of state residents are in the Medicaid program, and higher rates should trickle through the system, improving pay for most providers. Lawmakers should also consider adopting a formula that provides additional compensation to rural providers to encourage doctors and nurses to serve and live in small communities and the creation of other incentives for locating in a rural area, such as housing.

Work also needs to continue on the state’s troubling medical malpractice environment, addressed but not resolved during the last legislative session, and on the state’s approach for reimbursing hospitals for care provided to those who cannot pay because they lack insurance, are not in the Medicaid program, and do not have the personal resources. This uncompensated can be particularly taxing on small hospitals in poor areas.

The Legislature needs to also consider expanding school-based health centers. Which provide early detection of health issues, good nutrition, exercise, and mental health strategies, and early referrals to family doctors and specialists. Absences drop when a school has a health center., New Mexico has more than 50 schoolbased centers serving 16 thousand students, but an effort should be made to get health clinics into more schools.

Similarly, communitybased treatment for substance abuse, especially that involving alcohol, also needs to be a priority. New Mexico has invested heavily in treatment but still consistently has the highest alcohol-related death rate in the country and ranks sixth nationally for drug overdose deaths. Many recovery centers have waiting lists, a hurdle that often waylays efforts to get help.

It will take many approaches to fix what ails New Mexico’s healthcare system. The key will be coordination, communication, and a unified strategy for all parts of New Mexico.

Senator Campos, a Democrat from Las Vegas who holds a doctorate in educational leadership and a master’s in guidance and counseling, has been a member of the Senate since 1991 and a member of the Senate Finance Committee since 1997. Campos is also a member of the Legislative Finance, Revenue Stabilization and Tax Policy, and Water and Natural Resources committees. He has served as the senator from District 8 in northern New Mexico since 1991 and has served as president of Luna Community College, superintendent of the Las Vegas City Schools, and mayor of Santa Rosa.