Friday, December 19, 2014

Rural Hospitals in Critical Condition

A recent USA Today article highlighted the struggles facing rural hospitals.  Authors Jayne O’Donnell and Laura Ungar report that since 2010 43 rural hospitals have closed—with the number of closures seeming to increase every year, and still more currently in danger of closure.

“The Affordable Care Act,” the authors write, “was designed to improve access to health care for all
Americans…But critics say the ACA is also accelerating the demise of rural outposts that cater to many of society’s most vulnerable….Hospital officials contend that the law’s penalties for having to re-admit patients soon after they’re released are impossible to avoid and create a crushing burden.”

O’Donnell and Ungar also point to low Medicare and Medicaid reimbursements and high costs of EHR implementation as further blows to rural hospitals.  Rural hospital closures, the article explains, harm not just patients, who must now resort to long commutes to the closest hospital, often at times when every minute counts, but also the rural community in which the closure occurs, as rural hospitals are often an integral part of the local economy.

The authors note that struggling rural hospitals tend to face one of two options: either they must try to partner with larger, more financially-solvent health systems, or they must hope that local councils will implement increased taxes to provide the funds to keep the lights on.  Neither of these options, as O’Donnell and Ungar explain, has proven to be a satisfactory solution across the board.

While the article maintains that Medicaid expansion to all states would help, they also note that such expansion will not solve all of the problems facing rural hospitals, and the authors pass on this advice from stakeholders: “[A]dvocates say government can do more; state legislatures can adopt policies that bolster small hospitals, and the federal government can pay Medicare and Medicaid providers at least their costs and revamp the critical access program in light of the ACA.”