Monday, July 14, 2014

Rural hospitals at risk; they blame Obamacare and some states' lack of Medicaid expansion

Fewer patients are being admitted to rural hospitals, instead choosing to go to larger hospitals, and more rural hospitals continue to shut their doors, because of Republican-controlled states' refusal to expand Medicaid under federal health reform. From "1996 to 2012, the average number of acutely ill inpatients at critical access hospitals fell by half, from an average of 8.7 to 4.35 per hospital per day," retired rural pediatrician Wayne Myers reports for the Daily Yonder. Meanwhile, the National Rural Health Association says 14 rural hospitals closed in 2013, Abdulai Bah reports for Aljazeera America.

If the number of rural patients admitted to critical-access hospitals continues to fall, most of the inpatient business at those hospitals will be gone in the next decade, Myers writes: "Inpatient care accounts for a third or less of the revenue of critical-access hospitals, but it’s a vital stream of money for institutions that operate in the black by only 1 percent of their budgets, on average."

Fewer patients means hospitals are closing, and closures affect more than just inpatients, Myers writes. "When a hospital closes, other problems with health services arise. Communities frequently lose medical clinics associated with the hospital, specialist practices and other treatment services like physical and occupational therapy." (Read more)

Shuttering hospitals can also have dire consequences on the rest of the community, Bah writes. When North Carolina's Pungo Hospital closed earlier this month, it left 25,000 people in two of North Carolina’s poorest counties, Beaufort and Hyde, with only a 24/7 urgent care clinic for treatment. The closest hospital is 30 miles away. (Story of America photo by Eric Byler: Sign outside Pungo Hospital)

"The 50-bed Pungo Hospital was the largest employer in the predominantly African-American community of Belhaven," Bah writes. "It represented roughly 10 percent of the funds the town received each year by providing utilities such as electricity to its residents and businesses, said Town Manager Guinn Leverett. Belhaven is now considering raising property taxes by 10 percent to make up the loss of that revenue."

"The closure of Pungo Hospital is in part due to North Carolina’s refusal to expand Medicaid, Vidant Health said in a statement," Bah writes. "Other considerations, including the failing state of the 60-year-old facility also contributed to the decision to close it. The hospital ran close to a $1.8 million deficit last year—although it’s unclear what caused the shortfall."

Failing to expand Medicaid has hurt hospitals in other Republican-controlled states, such as Georgia, Alabama and Tennessee, Bah writes. Georgia has shut down four hospitals in the past two years and as many as 15 more are on the chopping block. Alabama has closed six rural hospitals in the past 18 months and 22 more are in financial trouble. Haywood Park Community Hospital in Brownsville, Tennessee announced in April that it would end inpatient and emergency room services on July 31, leaving most of the county's 10,000 residents without no access to an emergency room. (Read more)

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