Healthcare Economics Ashe County Case Discussion

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Read A Case Study of Rural Health Care in the Economic Downturn and reflect upon the issues identified in Ashe County. How do socioeconomic factors such as those presented in the case affect the ability to deliver healthcare? How do you think healthcare organizations can provide care to rural communities? Research solutions that have been implemented in the past and try to develop new, creative solutions based on what you have learned.

In your response posts, critique your peers’ solutions for providing healthcare to rural communities. Which issue(s) are your peers’ solutions addressing, and which obstacles would make their solutions difficult to implement?

To complete this assignment, review the Discussion Rubric document.



I think the biggest problems for Ashe County are number one the poverty level and number two the lack of primary care providers. I think Ashe County would benefit from utilizing advanced practice nurses in a clinic setting to offer more primary care options for some of these patients. The ability to obtain managed care for chronic conditions is imperative because this will help cut down on the number of ER visits that these people that can’t afford them have to make. Also, if they might look into partnering with a Medical school close by to open a free clinic for the population that does not have healthcare coverage. this would be a win/win because the med students would be getting the experience they need and the population would be getting the care they need. My current facility has a clinic that was created by our med students and ran by our med students and offers free care to the community and they receive grant money and donations to cover administrative cost. It has been a very successful program since 2004. Here is the link if you would like to review it:

About the Clinic


One socioeconomic factor in this case study is the aging population of rural areas. Elderly people have higher healthcare needs, so the demand and the price of care is higher in rural areas. There is no economy of scale like that found in denser population areas, and there is not a good balance of the young and healthy with the old and sick. Medicare also doesn’t pay as much as private insurance.

According to the case study, another problem in Ash county is access to health insurance. Our healthcare system is based on buying insurance through your employer and that creates problems. Many small companies just cannot offer benefits for their employees, and unfortunately rural areas have more small businesses than metro areas. 81% of Ashe county employers had less than 10 employees. If they offer insurance at all, it will most likely have high deductibles and copays that patients cannot afford to pay. Also, if you lose your job you often lose your insurance. In Ashe county there are high rates of uninsured, underinsured, and people on Medicare and Medicaid, which pay less than private insurance. If most patients at a hospital or office are covered by these services the provider may not make a profit, and may even lose money, and have to close.

I believe we need a national health care system, or at least a beefing up of the ACA. This would solve the massive problem of losing insurance due to illness or unemployment, especially now with Covid 19 causing unemployment. Barring that for now, telemedicine is helping to bridge the gap between rural and metro areas. According to Hicken and colleagues “Federal efforts such as the Recovery Act Broadband Initiatives Program are increasing the penetration of high-speed Internet into rural areas, which will support further dissemination of telehealth to these areas.” Telemedicine is taking off during this pandemic (at least in NJ) because the demand has increased dramatically. Risk of infection while going to the office was not a big driver on the supply or demand sides previous to the pandemic. Telemedicine may really be helpful for specialty medicine, where a rural area may not have a specialist. For instance, in pulmonary care, management of chronic diseases like asthma and COPD can be performed by nurses and respiratory therapists after an initial diagnosis and physical exam by a pulmonologist in a bigger city.


Lee, R. (2019). Economics for healthcare managers. (4th ed.) Chicago, IL: Health Administration Press.Retrieved from

Hicken, B. L., Smith, D., Luptak, M., & Hill, R. D. (2014). Health and aging in rural America. In J. C. Warren & K. B. Smalley (Eds.), Rural public health: Best practices and preventive models. (pp. 241–254). Springer Publishing Co.…

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