December 13, 2022 – To understand just how different a rural hospital is from a metropolitan one, Larry Bedell said to picture a Friday night high school football game. Traditionally, mixed in with the crowd of spectators would be not just the nurses, technicians, front office staff and doctors of the local hospital, but the hospital executives as well. Patients and providers know each other on a first name basis. “It’s not just a job,” said Bedell, executive director for the National Rural Health Association (NRHA) Services Corporation.
Indeed, the stakes are personal for rural hospital leaders. And the margin for error is smaller. Because rural hospital margins are so tight financially, a bad decision could cost the community their facility. “And there’s not another facility on the next block, like in a metro area,” Bedell said. “I live in Kansas City, a mid-market town. I live within 10 miles of probably 25 hospitals. In a rural community, there’s usually not another hospital for over 30 miles. There’s not someplace else for those people to get care if anything happens to that facility. That’s quite a bit of stress if you care about that community.”
Judging by recent headlines, rural hospital leaders are facing an incredible amount of stress in today’s marketplace. The American Hospital Association released a report this year highlighting the variety of causes that resulted in 136 rural hospital closures from 2010 to 2021, and a record 19 closures in 2020 alone. These include many longstanding pressures, such as low reimbursement, staffing shortages, low patient volume and regulatory barriers, as well as the continued financial challenges associated with the COVID-19 pandemic. Recently, expenses for labor, drugs, supplies and equipment have also increased dramatically, ultimately causing difficulties in maintaining access to care for people in rural communities.
“While many hospitals and health systems are facing unprecedented challenges, those faced in rural America are unique,” said AHA President and CEO Rick Pollack. “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.”
Rural hospitals and health systems make up about 35% of all hospitals across the country and include critical access hospitals (no more than 25 acute care beds and more than 35 miles from the nearest hospital), frontier hospitals (six or fewer residents per square mile) and sole community hospitals (hospitals for Medicare beneficiaries in isolated communities), among other Medicare designations. Rural hospitals are major economic drivers, supporting one in every 12 rural jobs in the U.S. and contributing $220 billion in economic activity in their communities in 2020.
Read more in the latest issue of Repertoire Magazine.