Future of rural hospitals remains cloudy; oil bust contributed to closures in Texas

Many rural areas in Nevada lack medical care
(Las Vegas Review-Journal graphic)

From January 2010 through August of this year, 76 rural hospitals had closed, according to the Rural Health Research Program at the University of North Carolina at Chapel Hill. The future doesn't look much better for many rural hospitals that have stayed in business, but have struggled to make ends meet, Ron Shinkman reports for Fierce Healthcare.

"The situation raises questions about the viability of rural health care as a whole," Shinkman writes. "Some 62 million Americans live in rural areas of the U.S., making their ongoing access to suburban and urban hospitals more difficult. And the closure of rural hospitals can also create grave economic issues, because they are often the region's largest employer. Altogether, as many as 13 percent of rural hospitals across the U.S. are currently vulnerable to closure."

Many reasons are often cited for rural hospital closings: a trend among the states toward managed care rather than fee-for-service Medicaid; payment reductions by Medicare; doctor and staff shortages; a high proportion of poor and elderly patients; and declining rural populations; contributing to low patient counts.

One area that hasn't been talked about as much is the downturn in the oil industry, Shinkman writes. "In Texas, 15 rural hospitals have closed in just the past four years alone, according to the Texas Organization of Rural and Community Hospitals. The drop in oil prices is expected to leave the remaining facilities vulnerable."

While telemedicine has been touted for reaching rural patients, not everyone is comfortable with the format, Pashtana Usufzy reports for the Las Vegas Review-Journal. Kristin Hougard, who suffers from partial paralysis, used telemedicine to consult with a doctor, and told Usufzy, "You can’t work with a doctor on a TV screen.”