Rural hospitals are closing at alarming rates; more than 80 have shut down since 2005, and another 700 are at risk of doing so. The standard policy response is more subsidies and federal aid. But rural healthcare is struggling largely because the system blocks competition, innovation, and new providers. The solution is not more government funding–it is removing the barriers that prevent healthcare providers and emerging technologies from serving rural patients. Rural healthcare can improve if policymakers allow competition and expand provider supply.

Rural communities face healthcare provider shortages. Part of the reason is that doctors tend to practice in urban areas, but outdated regulations also play a role. Many states restrict the ability of advanced practice registered nurses (APRNs) and pharmacists to provide routine care without physician supervision. APRNs have repeatedly shown they are just as capable as physicians of performing annual checkups, and many studies have demonstrated the benefits of allowing local pharmacists to administer vaccines and provide other routine services. These restrictions reduce the supply of providers in areas where physicians are already scarce.

Because these shortages are partly artificial, they have a straightforward fix: remove the restrictions. Expanding the scope of practice for qualified providers would allow APRNs to practice independently within defined scopes and permit pharmacists to perform routine services that often go unattended when patients must drive hours to receive them. More local healthcare providers mean greater access for patients in rural communities that face some of the largest barriers to care.

Just as a simple reform can increase patients’ access to routine care, another can help rural patients connect with specialists who do not exist in their communities. Telemedicine allows patients to consult physicians anywhere in their state–or even across the country through interstate compacts that allow doctors to practice across state lines. Yet many states do not participate in these compacts. These rules prevent rural patients from accessing specialists who may be hundreds of miles away, as well as general practitioners and APRNs capable of remote routine checkups.

Allowing telemedicine without burdensome restrictions, such as rigid requirements for in-person visits, would dramatically expand patients’ choice of providers. This means access to care that was previously unavailable. Paired with interstate medical licensing reciprocity and cross-state practice, patients in rural areas could gain access to the same medical professionals as those in urban areas without hours of travel.

Those same labor shortages can be addressed in another way as well: artificial intelligence. AI diagnostic tools can bring specialty healthcare services to rural areas while also freeing physicians’ time to see more patients by easing the burden of notes and documentation, as well as follow-up calls, and other time consuming but necessary tasks. AI allows a small number of clinicians to serve far more patients by automating routine analysis.

AI can also improve rural healthcare by enabling more care to occur outside traditional medical facilities. Remote monitoring tools powered by AI can track chronic conditions such as diabetes, heart disease, or respiratory illness through wearable devices and connected health apps. Algorithms can analyze patient data in real time and alert clinicians when intervention is needed, allowing providers to manage large numbers of patients without requiring frequent in-person visits. This approach is especially valuable in rural communities where hospitals may be far, and provider shortages are severe. By reducing unnecessary visits and focusing clinicians’ attention on patients who need care most urgently, AI can make rural healthcare more efficient for patients that cannot easily travel to hospitals.

Rural healthcare is not a small issue. One in five Americans lives in rural areas. While rural healthcare presents unique challenges, these shortages are not inevitable–they are often the result of restrictive policies. Expanding providers’ scope of practice, increasing telehealth availability, and encouraging the use of AI in healthcare would dramatically expand access and save lives. Instead of propping up failing systems with subsidies, policymakers should remove the barriers healthcare providers and new technologies from serving rural Americans with lower-cost care and more efficient 21st-century medical tools.

If lawmakers want to improve rural healthcare, they should stop restricting the supply of care and allow markets to work.

Justin Leventhal is a senior policy analyst for the American Consumer Institute. He wrote this for InsideSources.com.