Rural Alabama hospital closes, highlighting struggles of rural hospitals nationwide

On Sept. 1 a hospital serving some of Alabama's poorest counties will close its doors, making it the seventh rural Alabama hospital to close in eight years. The J. Paul Jones Hospital in Camden had been open for 60 years, Christopher Harress reports for Alabama.com. That puts Alabama third on the list of states with most rural hospital closures. Georgia is in second place with six closures and Texas is in first place.

Rural hospitals all over the country are struggling, partly because many rural residents rely on Medicaid, but Medicaid is not a big money maker for hospitals. That's especially true in Alabama, where a complex federal formula gives hospitals less reimbursement for treating Medicaid patients than almost any other state. Republicans in Congress want to cut Medicaid, which may worsen the problem. Hospitals that remain open in rural areas are coping by cutting back on expensive specialized services such as obstetrics, as these maps show:

Alabama.com graphic

"Alabama is without doubt facing a rural health crisis," says Jim Carnes, policy director at Alabama Arise, a non-profit advocate group for low-income residents. "The hospital closures, along with other medical facilities, have already had and will continue to have dire consequences for residents in rural areas." Dale Quinney, executive director of the Alabama Rural Health Association, a non-profit organization dedicated to preserving and enhancing the health of rural Alabama citizens, told Harress that 34 of the 46 rural hospitals that report annual income were operating at a loss.

An increased rural population and better jobs that offer private insurance would help improve the issue, but barring that, an expansion of Medicaid, building hospitals with fewer beds, allowing nurse practitioners to take over routine medical care, and embracing telehealth could help. Telehealth is becoming an increasingly popular solution to rural health, but implementation in Alabama may be difficult because of two things: there is no required telehealth reimbursement law, and rural areas may not have the necessary access to broadband internet.