Student Name

Capella University

NHS-FPX6008 Economics and Decision Making in Healthcare

Professor Name

Submission Date

Lobbying for Change

To,

The Honorable Governor Bill Lee,

Governor of Tennessee,

State Capitol, Nashville, TN 37243, United States.

Dear Governor Lee,

I am writing to ask you to join and take action to combat the dire shortage of access to health care services in the rural communities in our state. Emergency departments continue to struggle with this issue, overwork health care workers, and cause serious health consequences for underserved populations. Urgent action is required for these vulnerable communities to help move towards equitable, timely and sustainable care. As I’ve been exposed to the front lines I’ve seen that a lack of timely care can cause avoidable patient suffering and complications.

Tennessee has a high population of people living in rural areas, including those served by Greenfield Medical Center, who are often geographically separated from timely, preventative, and coordinated health care due to workforce deployment issues, geography, and infrastructure limitations (Ranjit & Kissoon, 2021). As a result, healthcare providers are experiencing unprecedented burnout and turnover, while preventable complications and declining health outcomes are killing many patients, many of whom are your constituents. This is a crisis that persists and continues to impact the health and economic well-being of the rural communities statewide.

Filling the rural Tennessee health care access gap will have a profound impact on the patient and provider levels in Tennessee communities, including those served by Greenfield Medical Center. Better access will lead to reduced E.R. crowding, chronic illness management, preventable admissions, and burnout and the retention of providers will increase provider satisfaction with their jobs (Sartini et al., 2022). Those changes are likely to build confidence in the community and improve the continuity of care; the opposite is likely to occur if action is not taken. Staff shortages and high turnover will continue if action is not taken. Health care costs attributed to unnecessary inpatient hospital stays will increase, and health and economic disparities in rural communities will worsen.

Improving health care access in rural Tennessee would help those communities and provide an economic opportunity. Hawrilenko et al. (2025) point to telehealth systems as a promising option for rural health systems with challenging case transportation and costly emergency care travel. Efficiently addressing the chronic care needs of the community would significantly improve the overall health of the community. Rajamani et al. (2021) demonstrate that the digital divide and the lack of telehealth system connectivity can be addressed through a community-based patient engagement and technology use training. Retaining telehealth staff can also be a high cost. Arredondo et al. (2023) value the cost of rural turnover due to a lack of staff incentives (e.g., student loan forgiveness and signing bonuses) to be greater than $40,000 to $60,000 annually, per staff. The Health Resources and Services Administration (HRSA, 2025) value this incentive as more than two-thirds of the primary care shortage areas are in rural areas. Ghorbanzadeh et al. (2021) state that the integrated collaborative care approach of the interprofessional team can eliminate duplicate services and hospital readmissions, thus enhancing the system’s efficiency and sustainability. The RN Code of Ethics (ANA, 2015) supports access to care and the elimination of racial and ethnic disparities. Sun et al. (2021) and Malayala et al(2021) note that culturally sensitive health care models can improve outcomes while also establishing a trusting, long-term relationship with neglected communities.

Working as a nurse at the Greenfield Medical Center, I see how the care gap affects patients, but also the care providers. Patients often present too late and too critically to be saved. Some die when they could have easily been saved had they come to the ER sooner. It contributes to staff burn out, high turnover, and creates a heartbreaking moral dilemma to treat patients with completely avoidable conditions (Silverman et al., 2021). I have learned the importance of specific solutions to these issues from my experiences. Our organization has been in the planning process with a focus on expanding telehealth, creating provider incentive programs, and utilizing inter-disciplinary care teams, and has learned the importance of strategic resource utilization and strategic risk mitigation as a means of ensuring sustainable and equitable care for our rural population.

Health care in rural areas is still a serious issue with important implications for the health, safety, and economic well-being of Tennesseans. Overcoming this issue with sustainable evidence-based interventions will have health benefits, will decrease cost, and save faith in the medical healthcare system (Berry et al., 2023). Governor Lee, please take the lead on expanding rural broadband, promoting the use of telehealth, rebate programs for health care providers, and using the available grant money to make a long-term and proactive impact in rural communities. We can all thank you for your leadership and your continued commitment to the health of the people of Tennessee.

Sincerely,

Brandon Miller