According to recent data from Chicago health care advisory services firm Chartis, hundreds of hospitals in rural areas of the US are at risk of closure.
Since 2010, a total of 141 rural hospitals have closed, with another 453 “at risk of closure.” The seven states with the most hospitals vulnerable to closure include Texas (45), Kansas (38), Nebraska (29), Oklahoma (22), North Carolina (19), Georgia (18) and Mississippi (18), according to Becker’s Hospital Review.
The analysis identified seven factors that had the greatest impact on a hospital’s risk of closure. Two of them were the number of years the hospital operated without a profit and the amount of net patient revenue.
The risk of closure also depends on the average annual number of inpatients in the hospital and the average daily need for skilled nursing facilities.
The data revealed that an increasing number of rural hospitals that are still operating are abandoning essential health services, including cancer treatment and maternity care. According to Chartis, approximately 43 per cent of rural hospitals are operating at a financial deficit. Michael Topchik, national leader of The Chartis Centre for Rural Health, stated:
“As the urgency of the pandemic disappears, the return of policy-driven reimbursement cuts, population health disparities and the nurse staffing crisis will apply renewed pressure to the rural health safety net.”
Dr Kenneth Perry, an emergency department physician in South Carolina, noted that in areas where hospitals are forced to close, many patients would lose not only hospital care but also access to emergency departments.
Many patients, specifically low or under insured patients, use the emergency department as a source of primary care. With the closure of these hospitals, many patients will lose access to all of their medical care.
Chartis’ new report seeks to determine the potential impact of the Rural Hospital Emergency (REH) designation, passed by Congress in December 2020 as a means of providing emergency medical services to rural hospitals that may lack the resources to offer them.
When a hospital is designated as the REH, it can provide emergency department services, observation and possibly some outpatient services, as long as the patient’s stay does not exceed an average of 24 hours, according to the Centers for Medicare & Medicaid Services website. Topchik declared:
“For some hospitals, our data model suggests the REH designation will serve as a desperately needed relief valve to avoid closing and provide a significant reversal in fortune for the vulnerable communities they serve. But the decision to convert is highly nuanced, and as a result, we expect to see a relatively small number of hospitals embrace REH.”
