Earlier this month, Virginia joined other states in applying for a portion of the federal government’s $50 billion allocation for rural health funding. This is especially important in the commonwealth, where approximately 25% of Virginians live in rural areas. In the last eight years, two rural hospitals have closed, and six rural hospitals are at risk of closing or reducing service lines. For residents of Augusta and Rockbridge counties, the timing of this funding is too late as they grapple with last month’s closing of three Augusta Health locations.
The Rural Health Transformation Program aims to improve rural health care access, outcomes and workforce capacity through state-driven transformation plans. Half of the program’s money will be divided equally among all states that apply. The remaining portion will be awarded to states based on their rurality, initiatives and policies that meet the program’s objectives.
A recent Joint Commission on Health Care report highlighted Virginia’s rural health crisis with some disturbing findings — lower life expectancies in rural regions; higher rates of chronic disease, including heart disease and hypertension; and greater prevalence of depression and other mental health conditions. When rural hospitals close or reduce services, residents face not only decreased access to care but also job losses and financial insecurity that reverberate throughout their communities.
According to the Rural Health Information Hub, 1 in 5 rural residents receive care through rural health clinics, federally qualified health centers, and free and charitable clinics — but even those facilities face challenges finding enough primary care providers.
The Virginia Task Force on Primary Care found 45.5% of Virginia’s localities lack a sufficient number of primary care physicians, and the Association of American Medical Colleges is predicting a shortage of up to 86,000 physicians by 2036, including up to 40,400 primary care physicians. When NPs and physician assistants are added to the primary care provider count, the percentage of localities with an insufficient number of providers decreases to 13.7. With the Bureau of Labor Statistics projecting 135,000 new NP jobs by 2033, NPs are uniquely positioned to step up to serve our communities and help address gaps in access to care.
NPs are advanced practice registered nurses who have master’s, and often doctorate, degrees and are nationally board certified to diagnose and manage common and complex medical conditions. In addition, NP preparation and certification is focused on a specific population such as family, gerontology, women’s health, pediatric or mental health. This ensures every NP’s expertise is tailored to the patients they serve.
With the majority of NPs certified in family care, they are well equipped to deliver a comprehensive, high-quality, cost-effective solution to today’s primary care access challenges. In fact, NPs are the fastest growing primary care provider, with nearly 1 billion patient visits annually.
As an NP for nearly 20 years, I’ve provided care across diverse health systems and communities, yet it is within my own rural Isle of Wight County where the gravity of access — and the impact of this work — feel most personal.
Each day, family and neighbors travel long distances, face months-long waits, or forego treatment altogether because of persistent rural health barriers. Unlike many rural areas losing health resources, our community is hopeful as a new Riverside hospital takes shape — a project that symbolizes opportunity, stability and long-overdue health equity. Yet its success will depend on sustained legislative commitment and policies that strengthen rural health systems while retaining and empowering the growing NP workforce to deliver the accessible, high-quality care these communities so urgently need.
Though National Nurse Practitioner Week (Nov. 9-15) ended on Saturday, please join me in thanking the more than 20,000 NPs in Virginia — among the 431,000 NPs nationwide — who are committed to providing solutions to Virginia’s health care access challenges.
Alysia Pack, DNP, FNP-C, PMHNP-BC, of Smithfield is the president of the Virginia Council of Nurse Practitioners.
