Georgia House Study Committee on Cancer Care Access visits Albany to learn about rural cancer care

ALBANY – A Georgia House Study Committee on Cancer Care Access making its way across the state landed in Albany to hear about rural access on Tuesday.

At a session hosted by Phoebe Putney Memorial Hospital, the committee listened to concerns surrounding rural care – hospital closures, transportation, high uninsured resident rates – and emphasis on the importance of early cancer screening. Chairman Lee Hawkins, R-Gainesville, said the goal was to hear the needs and hopefully create action at the state level to meet them.

Spence Mullis, a cancer survivor and Dublin banker, told the committee it had the opportunity to shape policies that save lives like his. He detailed how having access to primary care and an oncologist in his rural hometown of Dublin allowed him to beat a rare form of cancer.

“The survival of a rural Georgian shouldn’t hinge on their zip code or how far they live from an academic medical center,” he said Tuesday. “It should depend on the quality and the proximity of the care that they can reach.”

Robert Smith, the senior vice president of Early Cancer Detection Science at the American Cancer Society, stressed the importance of early cancer screening. Not only does it lead to higher survival rates, Smith said, but it’s cost beneficial at both a state and local level. 

Smith shared data showing employers report cancer as the top driver of health care costs. Additionally, two-thirds of individuals with cancer and survivors say they’ve missed more than four weeks of work, and more than a third report missing more than three months. He also noted that cancer is the leading cause of medical debt. 

“The loss of economics to the community, we have a hard time measuring that, but just imagine the average number of years of life lost to death and cancer,” Smith said. “That’s many years of somebody no longer being in the community, making an economic contribution.”

However, Smith said early cancer screening rates are “not optimal” across the country. He attributed this to a number of factors, including a disorganized health system that puts the burden on overstressed primary care providers to track cancer screenings. He pointed to Europe, specifically Sweden, which has more specialized screening systems as a model to follow. 

Smith urged state lawmakers to emphasize the importance of early screening, creating a “spirit of achieving better health” to Georgians.

Early screening challenges become exacerbated in rural areas, which make up 120 out of Georgia’s 159 counties. 

Nita Ham, the executive director of the State Office of Rural Health, said health data paint a “pretty bleak picture of rural life.” Ham noted that rural areas see higher prevalence of chronic disease, obesity and tobacco use. Poor nutrition is common, as many areas deal with food deserts. 

Rural Georgians struggle to access primary care coverage close by and many lack transportation to travel for health care.

“Unfortunately, what we see a lot of times in rural areas is these transportation challenges result in patients terminating their care early, and unfortunately, that drives up all of our poor outcomes,” Ham said. 

The State Office of Rural Health also manages the state’s Rural Hospital Stabilization Grant program, which is an effort to prevent rural hospital closures. The state has had 11 rural hospital closures since 2001. 

Ham said health care costs continue to rise, and insurance reimbursement continues to dwindle, and the cost of providing services is too costly for most rural hospitals to sustain. Caylee Noggle, the president and CEO of the Georgia Hospital Association, said cancer costs hospitals a significant amount, with hospitals losing tens of millions of dollars on uncompensated cancer care statewide. 

Ham said many hospitals try to focus their service lines on the most critical needs in their communities, partnering with neighboring hospitals to avoid offering the same services, creating a close-by “network” where rural Georgians can access different types of care. 

Finding primary care providers to move to rural areas also can be a challenge especially, as Smith said, many medical students choose more specialized practices because of better pay.

“Every day we are concerned that we may have another closure,” Ham said. “We certainly are concerned that there may be one or two more in the near future.”

Some presenters mentioned unease about continued Federal funding. Megan Andrews, the assistant commissioner for policy at the state Department of Public Health, talked about the DPH’s breast and cervical cancer program, among others, which she said stands “in the gap for the insured or underinsured population.”

“We are in a wait-and-see approach,” Andrews said. “More than 50% of our agency’s entire budget is federal funds. We haven’t heard any rumors or rumblings that it’s (federal grant) going to be eliminated, but we are waiting and seeing.”