Rural hospital closures leave communities to fend for themselves, may make states expand Medicaid

With rural hospitals closing at the highest rate in decades, communities left without are forced to address residents' medical needs with a patchwork of local services or face driving miles away to obtain critical medical services. According to the North Carolina Rural Health Research Program, 83 rural hospitals have closed in the U.S. between Jan. 2010 and Jan. 2018, Berkeley Lovelace Jr. and John Schoen report for CNBC.

Patrick County, Va. (Wikipedia map)

Their example: In Stuart, Va., the 25-bed Pioneer Community Hospital closed last year, leaving the nearly 19,000 residents in Patrick County without an emergency health facility close by. They now handle emergencies with six volunteer rescue squads who respond to 911 calls and drive patients to the nearest hospital, Martinsville Memorial, at least 45 minutes away. When Pioneer closed in September, some residents had to travel three to four hours to receive needed care, said Debbie Foley, Patrick County's director of economic development.

Not only did local residents lose their most important source of medical care, about 100 people lost their jobs. Reasons for hospital closures vary for every community, according to Mark Holmes, director of the North Carolina Rural Health Research and Policy Analysis Center, part of the program that tracks rural hospital closures. "One factor can include social demographics: Rural populations are often older, sicker and poorer than urban populations, he said. Other factors include decreased demand for inpatient services, consolidation in the health-care space, and a state's decision of whether to expand Medicaid," Lovelace and Schoen report.

Beth O'Connor of the Virginia Rural Health Association said rural hospitals may play a key role in getting Virginia Republicans to allow Medicaid expansion, since two-thirds of the hospitals that have closed in the past eight years were in states that did not expand Medicaid, Michael Pope reports for NPR affiliate WTVF at Virginia Tech. Medicaid is a key financial resource for rural hospitals nationwide, reducing the amount of uncompensated care hospitals must provide and insulating them from worse financial problems. O'Connor told WTVF that expanding Medicaid would help more rural hospitals stay open.

A special Senate session on Medicaid expansion is scheduled for later this month. Quentin Kidd, a political science professor at Christopher Newport University, told WTVF that he thinks more rural Republican lawmakers will soon support expansion because "they all know that at the end of the day the dollars and cents are going to be meaningful to their rural hospitals and they need those rural hospitals to stay open."