Tuesday, April 11, 2017

78 rural hospitals have closed since 2010; here's a look at the impact on one Tennessee community

Haywood County, Tennessee (Wikipedia map)
Seventy-eight rural hospitals have closed since 2010, according to the University of North Carolina. What happens to one of these towns when it loses its hospital, especially if that hospital is the lifeline for the community? Haywood, Tenn., lost its only hospital three years ago and still hasn't recovered, Amy Goldstein reports for The Washington Post. Besides losing medical care, the town also lost jobs. Mayor Bill Rawls told Goldstein, “The emergency room now is the back of an ambulance."

Haywood is considered a "dead zone" for hospitals, with the nearest hospitals, 26 and 60 miles away, also having closed. That's nothing new for Tennessee, which ranks second for most rural hospital closures, with eight, trailing only Texas, where 13 rural hospitals have closed. Texas has nearly five times as many people as Tennessee.

Lack of medical care in and around Haywood is bad news for a town where more than 20 percent of the 18,000 residents live in poverty and the county ranks 90th out of 95 counties for health, with obesity and diabetes especially common, Goldstein writes.

One problem is that Tennessee did not expand Medicaid under federal health reform, Goldstein writes: "In 2016, just 664 Haywood County residents bought health plans through its marketplace for people without coverage through a job. By one estimate, 2,200 residents would qualify for Medicaid benefits if Tennessee expanded the program under the law." Shrtly before Haywood Park Community Hospital closed, "more than a quarter of charges were for 'self-pay' patients who lacked health insurance. Haywood Park losses grew from $4.2 million in 2010 to $6.6 million in 2013."

The year before it closed the 62-bed facility admitted 245 patients, down from 917 three years before, Goldstein reports. "When the hospital closed, Community Health Systems announced it would keep an urgent care center there. Five months later, the company announced that the urgent care was not drawing enough patients. By the end of January 2015, it was gone, too."

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