Rural America is facing a health care crisis as more and more hospitals shutter, but one hospital in Crockett, Texas (pop. 6,500), bucked the odds and reopened after its closure, Charlotte Huff reports for Kaiser Health News.
Timberlands Healthcare faced the same problems as many other struggling rural hospitals: It was overstaffed, located in a state that didn't expand Medicaid, Houston County residents didn't want to raise property taxes to help fund the hospital, it was too small to have any leverage when negotiating reimbursement rates with insurers, and its board members had little background in health-care management but were in charge of financial decisions.
The hospital closed with only a few weeks' notice in the summer of 2017. its now-bankrupt management company, Little River Healthcare, was one of many that engage in the questionable practice of funneling laboratory billing through rural hospitals to get bigger federal reimbursements.
"The late-July reopening of the newly named Crockett Medical Center makes it a bit of a unicorn in a state that has led nationally in rural hospital closures," Huff reports. "Since January 2010, 17 of the 94 shuttered hospitals [in the U.S.] have been in Texas, including two that closed in December, according to data from the University of North Carolina’s Cecil G. Sheps Center for Health Services Research."
Timberlands Healthcare faced the same problems as many other struggling rural hospitals: It was overstaffed, located in a state that didn't expand Medicaid, Houston County residents didn't want to raise property taxes to help fund the hospital, it was too small to have any leverage when negotiating reimbursement rates with insurers, and its board members had little background in health-care management but were in charge of financial decisions.
The hospital closed with only a few weeks' notice in the summer of 2017. its now-bankrupt management company, Little River Healthcare, was one of many that engage in the questionable practice of funneling laboratory billing through rural hospitals to get bigger federal reimbursements.
"The late-July reopening of the newly named Crockett Medical Center makes it a bit of a unicorn in a state that has led nationally in rural hospital closures," Huff reports. "Since January 2010, 17 of the 94 shuttered hospitals [in the U.S.] have been in Texas, including two that closed in December, according to data from the University of North Carolina’s Cecil G. Sheps Center for Health Services Research."
The new hospital has many of the same services it did before, albeit on a smaller scale: a primary care clinic, a 24-hour emergency room, and 25 beds. But unlike Timberlands, Crockett doesn't deliver babies. Closing obstetrical services is a common tactic for struggling rural hospitals, since it's one of the most expensive units, Huff reports.
Crockett supporters hope they can convince locals to approve a property tax to keep the new hospital open. That's what happened with the struggling hospital in Clifton, Texas, northwest of Waco. Adam Willman, CEO of Goodall-Witcher Hospital Authority, told Huff that he and other hospital supporters convinced locals that a property tax was worth it, to preserve emergency services.
Rural leaders are lobbying the state legislature to help rural hospitals stay open with measures such as increasing hospital reimbursements for Medicaid patients. Rural leaders "also support a congressional bill, HR 5678, that would make it easier for rural hospitals to close their inpatient beds but retain some services, such as an emergency room and primary care clinic," Huff reports. "Under current federal regulations, facilities that make such a move are no longer considered a hospital and can’t be reimbursed by Medicare and Medicaid at hospital rates, which are often higher than payments to clinics or individual doctors. Those lower rates make it harder for stripped-down facilities to keep up their operations."
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