Tackling Healthcare Deserts

As we honor our Georgian of the Year John Haupert, it’s worth looking at healthcare deserts in Georgia and how affordable treatment remains an obstacle in many zip codes throughout the state. Kudos to Grady Memorial Hospital for building its freestanding emergency department in Union City, filling a void that emerged on Atlanta’s southside following the closing of Atlanta Medical Center and Atlanta Medical Center South in 2022.

Hospital certificate of need changes, signed into law last year through House Bill 1339, provide eligibility for exemptions for outpatient birthing centers, psychiatric and substance abuse inpatient programs, hospital perinatal services in rural counties and new acute care hospitals, provided they achieve status as a teaching hospital or trauma center designation within three years.

Healthcare deserts are a symptom of a larger problem – a decline in primary care physicians.

Some say leaders should have held out for full Medicaid expansion under the Affordable Care Act coverage in Georgia or abandon CON altogether. But specifics in HB 1339 will at least make it easier to target our healthcare deserts, which are loosely defined as places where residents must drive an hour or more for healthcare. Many are rural. Nearly 66% of counties in Georgia have no obstetric hospital or birth centers, and 43% lack obstetric providers. Maternity deserts identified in a 2022 report from the March of Dimes noted Effingham, Liberty, Tattnall and Jasper counties have low access to birthing facilities, and Candler, Appling, Jeff Davis, Screven, Montgomery, McIntosh and Evans counties are maternity care deserts. St. Mary’s hospital in Lavonia has cut labor and delivery services as a result of President Donald Trump’s “One Big Beautiful Bill,” also known as H.R. 1.

Recently closed rural hospitals seeking to reopen are now exempt from CON if a replacement hospital hasn’t already opened in the same county. The law makes it easier to purchase diagnostic imaging equipment and allows hospitals to relocate within a five-mile radius. It removes the cap for capital expenditures and eases the approval of additional beds.

A few months before H.B. 1 dramatically decreased healthcare funding, Sen. Jon Ossoff announced $11.8 million in federal funding to help reopen Randolph County’s Southwest Georgia Regional Medical Center as a critical access hospital. It had closed due to financial struggles during the pandemic.

Allowing for more resources such as birthing centers and psychiatric care will help complement the growth of urgent care facilities that divert patients from expensive ER visits. Urgent care centers aren’t for everyone; unlike emergency rooms, they can turn away patients with no insurance and some might not accept Medicaid. But they do save money, and some insurance companies like Kaiser Permanente have built their own clinics.

Healthcare deserts are a symptom of a larger problem – a decline in primary care physicians. A national shortage of up to 86,000 physicians is expected in the next decade, the Association of American Medical Colleges reported in 2024. State and federal agencies have designated at least a portion of 149 of the state’s 159 counties as a Primary Care Health Professional Shortage Area. The state will need 2,100 more primary care physicians by 2030 to maintain its current doctor to patient ratio, particularly in rural and low-income areas. The disparities are stark: Clarke County needs 16 new physicians; Clayton County needs 40.

The University of Georgia will launch a new School of Medicine this year, building on its partnership with Augusta University. In its inaugural year, it plans to enroll 60 students per class, eventually doubling its capacity to 120 students per class. According to Tripp Umbach, a healthcare, higher education and economic development consulting firm, each physician that provides primary care in underserved areas would save the state $3.6 million annually for care that would have been provided in an emergency room, and the projected shortage of 1,500 PCPs in underserved areas would cost the state $5.4 billion in delayed healthcare costs.

In 2016, lawmakers enacted the Georgia HEART Program, which allows donors to help rural hospitals in exchange for tax credits. Since its inception it has raised nearly a half billion dollars.

There are many barriers to escaping poverty that have locked people in with no way out for too long. Quality healthcare is a critical piece. Expanding healthcare coverage to all Georgians would immediately lower the number of uninsured people in the state but would not in itself solve all our challenges. Strategic interventions in healthcare deserts are still possible and necessary, and Grady Hospital’s courage is a light in the tunnel. 

Ben Young is Editor-in-Chief and Publisher of Georgia Trend. |  byoung@georgiatrend.com