As a retired doctor and lifetime rural Kansas resident, I understand well how access to health care can be a matter of life and death for families and communities.

Kansas faces many challenges maintaining services in rural communities. Solutions will require a combination of technology, innovation, risk-taking and political courage.

As a rural practitioner, I championed technology’s power 30 years ago, seeing telemedicine as key to maintaining services for our future and to solving our health care puzzle by mitigating rural workforce shortages and enabling outside specialty services.

Last year, recognizing telemedicine’s potential, the Legislature passed a law ensuring all health insurers cover these services — but maximizing telemedicine’s benefits requires improved broadband capabilities and addressing payment policy.

Telemedicine isn’t the ultimate solution, however. Kansas Health Institute reports that rural areas of Kansas have the highest uninsured rates — the biggest challenge facing rural healthcare systems.

Lack of insurance is a barrier to rural Kansans’ ability to access care, and means our health care providers are less likely to be paid for services, whether delivered in person or by telemedicine.

Instead of receiving routine and preventive care, our uninsured family and friends forego care or end up in emergency rooms. Hospitals and providers experience more uncompensated care, threatening their bottom lines and ability to maintain services.

The problem is dire, with three rural Kansas hospitals closing in recent months. A 2016 iVantage study identified more than 30 other Kansas hospitals risking closure.

To address financial instability from high rural uninsurance rates, Kansas should expand KanCare, its Medicaid program.

Research shows Medicaid expansion significantly reduces uncompensated care costs — stabilizing rural hospitals and helping keep the doors open.

By supporting hospitals in this way, we provide opportunities for rural health leaders to look at new, innovative ways to deliver and finance care.


Robert Cox, M.D., Hays