Forty percent of rural hospitals are operating at a loss, according to Diane Calmus, government affairs and policy manager for the National Rural Health Association. She says the closures and financial situations can have a ripple effect on rural communities. “Not only do we see the loss of access to care at the hospitals,” she says, “but additionally oftentimes physicians, nurses, physical therapists, pharmacists are connected to those hospitals, and so when that hospital closes their services also leave the community.”
Medicare reimbursements to hospitals no longer cover the cost of treatment, Calmus says. That problem is compounded by the move to higher deductible insurance plans, which leave families unable to pay, creating uncollectible debt at rural hospitals. These smaller hospitals see a higher percentage of Medicare and high-deductible plan patients than urban hospitals, so they aren’t able to spread the cost.
The National Rural Health Association has worked to introduce the “Save Rural Hospitals Act,” which would reverse recent cuts to Medicare reimbursements to rural hospitals and make staffing requirements more flexible.
While the country focuses on health care the national debate ignores rural critical access hospitals, Calmus says. “The goals of the ACA [Affordable Care Act] are positive,” she says, “but unfortunately we’ve not seen them achieve their goals in rural America, and unfortunately in these repeal efforts we’re not seeing them fix the problem.”