Rural Healthcare Facing Existential Threats

Recent issues in Oklahoma, Nebraska portend a growing crisis.

The news coming out of Oklahoma was grim: Pauls Valley Regional Medical Center couldn’t keep its doors open, despite a GoFundMe campaign, as well as a reported solicitation from country music star Toby Keith. And in September, Latimer County General Hospital, a 33-bed facility in the small rural city of Wilburton, Okla., population 2,972, closed for business. Three of the five Oklahoma rural health centers closed for good in October, adding to the list of 90 other rural hospitals that have closed since 2010, according to the University of North Carolina’s Cecil G. Sheps Center for Health Services Research.

The U.S. Government Accountability Office (GAO) recently reported that from 2013 to 2017, a total of 64 rural hospitals closed, more than twice as many as during the previous five-year period. In its report, released in September, the GAO attributed the closures to financial distress, “exacerbated in recent years by multiple factors, including the decrease in patients seeking inpatient care and across-the-board Medicare payment reductions.” On the other hand, the GAO reported that rural hospitals located in states that increased Medicaid eligibility and enrollment experienced fewer closures.

“There are a variety of reasons for this, but it is important to keep this critical issue in front of legislators and our communities,” Leslie Marsh, executive officer of Lexington Regional Health Center (LRHC) in Lexington, Neb., told Monitor Mondays listeners recently.

Of particular concern, according to Marsh, are what she described as obstetrics (OB) deserts in the rural health landscape: deserts created by closures, abetted by declining margins and other workforce issues.

Marsh said that in 1985, approximately 54 percent of rural hospitals provided OB services, but now, only 24 percent provide this type of care.

“Those of us living and working in rural areas are all too familiar with this alarming trend,” Marsh said. “ER has become the new OB department for some rural facilities.”

Marsh said one strategy in keeping rural healthcare vital involves sharing information on the economic impact that rural hospitals have on the local economy and on state tax revenues. She believes there is a business case to be made.

“Lexington Regional Health Center adds about 424 jobs, $55 million in revenue, and $1.5 million in local and state tax revenue,” Marsh said. “Job creation through any hospital – typically a major employer in rural communities – equates to real economic gains and or losses.”

Marsh used the metaphor of a three-legged stool to make her point about rural hospitals being an integral part of the community, noting that the other two legs are the municipal government and the schools.

“Without any one leg, the community becomes unstable and declines,” Marsh warned. “We need to share this important information with legislative bodies, community leaders, and other key stakeholders.”

“LRHC’s total economic impact of $55,762,552 helps foster revenue creation for hospitality industries, including lodging, transportation, and tourism, restaurants, and the construction industry,” a news release posted on the LRHC website reads. “The hospital’s economic impact includes induced effects, impacting real estate, insurance, electricity, and entertainment businesses through increased personal income and spending.”

Lexington, population 10,146, according to 2014, data, is one of four towns located under Dawson County’s expansive blue skies and among vast prairie lands. Food manufacturing is the largest job creator in Lexington. One plant alone provides jobs for 2,900 workers. At that plant, LHRC provides an onsite medical and therapy clinic, with physical and occupational therapy services offered through its occupational medical and rehabilitation clinic. In another manufacturing plant, LHRC provides what it describes as a “corporate wellness” menu of options.

“We are very interested in keeping care local, which has helped us achieve growth and finance targets,” Marsh said in a recent email. “Rural (healthcare) matters – together we make a meaningful difference in the lives of nearly 20 percent of the population.”

Comment on this article

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

Related Stories

Trends in Healthcare for 2024

Trends in Healthcare for 2024

Healthcare in the United States in 2024 will see many dramatic innovations driven by information technology and microelectronics, by the brilliance of neurological and biomolecular

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

This Leap Year, celebrate success with a 29% discount one day ONLY! Use code LEAP24 on February 29th at checkout to unlock this offer! Click here to learn more.
It’s Heart Month! Use code HEART24 at checkout to receive 20% off your cardiology products. Click here to view our suite of Cardiology products!