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More rural hospitals being pushed toward the brink of closure

by John R. Fischer, Senior Reporter | September 26, 2022
Between 2010 and 2021, 136 rural hospitals closed.
Low reimbursement, staffing shortages, regulatory barriers and low patient volumes drove 136 rural hospitals to close shop between 2010 and 2021.

A record 19 closures alone among these facilities took place in 2020, fueled by the financial challenges of the pandemic, according to a new report by the American Hospital Association.

This has curtailed access to care for patients in rural communities. And access has only become more difficult with recent surges in labor, drug, supply and equipment expenses.

“We must ensure that hospitals have the support and flexibility they need to continue to be providers of critical services and access points for patients and communities,” said AHA president and CEO Rick Pollack in a statement.

A major economic driver, rural hospitals support one in every 12 rural jobs in the U.S. and are often the largest employer in their communities. They added $220 billion to their communities’ economic activity in 2020.

About 35% of all hospitals and health systems in the U.S. are in rural areas, including critical access facilities; frontier hospitals, which care for six or fewer residents per square mile; and sole community hospitals for Medicare beneficiaries.

Maintaining access and quality of care at these facilities involves investments in flexible models of care, decreasing cumbersome regulations, forming partnerships, and expanding state Medicaid programs, according to the report.

Many of these places are currently supported by the Medicare-dependent Hospital program, which supports rural practices where Medicare patients make up a significant percentage of inpatient days or discharges; and the enhanced Low-Volume Adjustment program, in which CMS provides additional payments to around 500 rural facilities for higher costs associated with a low number of discharges.

Both of these programs expire on September 30, 2022. AHA is urging Congress to extend both through the Rural Hospital Support Act Senate bill and the Assistance for Rural Community Hospitals Act House bill.

Dr. Julie Yaroch, president of ProMedica Bixby and Herrick Hospitals, says that more efforts also need to be made in attracting and retaining employees, restoring pipelines for technicians, increasing housing, accelerating the adoption of new equipment, and expanding bandwidth.

“Minutes matter. And when our community members are having to travel further for treatment, we’re going to see a difference in the outcomes and quality of the care that we can deliver for common diagnoses such as stroke or heart attacks,” she said in a video testimonial on rural healthcare for the American Hospital Association.

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