Even with better and safer care in some categories, rural hospitals find themselves in survival mode. A National Rural Health Association (NRHA) sponsored study shows 673 rural hospitals are “vulnerable or at risk for closure.” Rural hospitals have been closing at a much higher rate than their urban counterparts since 2010 due to increased financial distress. The small hospitals play a significant role in providing necessary healthcare in areas that tend to have a combination of factors that disadvantage them:
- Elderly population
- Fewer patients covered by insurance plans
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- Higher percentage of chronic health conditions
- Poorer population base
- Physician shortages
- Aging structures
Closure for many rural hospitals means patients must travel an additional 30-60 miles to an urban area for treatment. Larger urban hospital systems are mostly interested in teaming with rurals when the surrounding rural area is either growing or close enough to an urban area that they can transform the facility into a clinic-type facility, while feeding patients to the larger urban facility.
Rural hospitals have banded together under a savior organization, the National Rural Hospital Association (NRHA). The NRHA is pushing legislation on the national level called the Save Rural Hospitals Act. Part of the organization’s mission is to educate legislators in every state on the important role rural hospitals play in America’s healthcare delivery system. The Save Rural Hospitals Act legislation would provide financial and regulatory relief to rural hospitals.
Reshaping rural facilities for survival
Based on this columnist’s experience in working with both urban and rural hospitals, the future for these important healthcare providers will look different than the rural hospital of yesterday. Rural hospitals will downsize the footprint of their facilities to save on operational costs. Currently, many rural hospitals have entire wings that are vacant in multistoried facilities. Reducing the facility to a single floor eliminates the need for expensive elevator maintenance, utilities and staff needs. In addition, rural facilities pay a premium for many services, since technical and specialty contractors are mostly located in urban areas and have to travel to perform services.
Telemedicine is emerging to help with many rural facility ailments; telemedicine can save on cost and cover physician shortages. One unexpected telemedicine benefit according to James Marcin, director of the UC Davis Children’s Hospital Pediatric Telemedicine Program: “When rural patients know their hospital is using telemedicine, they have a higher regard for that hospital and are less likely to bypass it for treatment at an urban facility.”