内容摘要：GLP-1 receptor agonists are injections used to treat diabetes, and some are also approved to treat obesity. They work by mimicking hormones in the gut and the brain to regulate appetite and feelings of fullness. They

GLP-1 receptor agonists are injections used to treat diabetes, and some are also approved to treat obesity. They work by mimicking hormones in the gut and the brain to regulate appetite and feelings of fullness. They

More than one-third of the nation’s rural hospitals — about 700 — are at risk of closing because of “serious financial problems,” according to a July analysis from the Center for Healthcare Quality and Payment Reform. Harold Miller, the center’s president and CEO, said one hospital closure can ripple through a rural community.“If the hospital didn’t exist, there wouldn’t be any physicians there,” Miller said. “There is no place to go and get a lab test except for that hospital. There may be no nursing home or place to get rehab or long-term care other than these hospitals.”

When a hospital does stay open in a large rural area where few people live, the facility may not see the number of patients it would need to see to be profitable, said Arrianna Planey, who researches health policy and management at the University of North Carolina.Leaders in Brownsville tried to find a buyer for the hospital. The county eventually purchased it. Braden Health, a privately held company, then took over the hospital with two conditions from the county supervisors: It must be a full-service hospital with a 24-hour emergency room and staff had to be hired as quickly as possible. Local officials say the hospital is breaking even.Tennessee is one of 10 states — many of them in the South — that haven’t expanded Medicaid. Michael Meit, the director of East Tennessee State University’s Center for Rural Health Research, believes doing so would be an obvious solution to the problem of growing rural health disparities. More people would be covered by insurance, Meit said, and hospitals could make more money.

“They’re providing a lot of uncompensated care,” he said of rural health systems in those states.Miller acknowledged that Medicaid expansion can help, but argued that pinning hopes on that alone has “let the private insurance plans off the hook.”

“In some cases, the small hospitals are losing more money on private insurance than they are on Medicaid, which is really kind of remarkable,” he said, “but that’s how little they get paid ... by the private insurance plans.”

Low Medicaid reimbursements play a role inof licensing data from 44 states, data from the National Council for Prescription Drug Programs and the American Community Survey. It’s consistent with prior research that documents where urban “pharmacy deserts” are more likely to be concentrated.

The AP also analyzed data from 49 states and found those with the fewest retail pharmacies per capita include Alaska, Oregon and New Mexico. About two-thirds of retail pharmacies in those states were owned by chains, while independent pharmacies tend to concentrate more in urban markets or states with bigger populations.Drugstores have become

in recent years, sometimes by design or necessity — especially for customers who work multiple jobs and can’t easily get to a doctor. Many pharmacies, including, offer clinics and more than a dozen vaccines to treat patients. They’ve also encouraged pharmacists to counsel patients more on managing conditions like diabetes or high blood pressure.