Rural Texas hospital's new, scaled-back model could show how a new federal program could save others like it

Bowie, Texas (Wikipedia map, adapted)

As federal pandemic dollars end, many rural hospitals face possible closure. The small town of Bowie, Texas, pop. 5,000, has a revamped model that could change that fate, reports David Montgomery of Stateline. "The federal Rural Emergency Hospital program launched in January is to preserve at least some health-care services in rural communities that can’t support a full-fledged hospital. . . . It provides higher Medicare payments and other dollars to small rural hospitals that shed inpatient services and instead staff a round-the-clock emergency department and provide observation care. . . . Because Bowie Memorial Hospital closed before the Rural Emergency Hospital program launched, it isn’t eligible to participate. However, the town’s pursuit of the same strategy independently makes it a case study for how the program might play out elsewhere."

The new model provides a bittersweet solution. "The revamped facilities will transfer people who need inpatient care to full-service hospitals nearby. But for many rural communities, the conversions to fewer services will be a bitter pill to swallow," Montgomery notes. "In Lock Haven, Pennsylvania, hospital officials say scaling back to an emergency department is 'the best model of care to meet the needs of this community.' But Mayor Joel Long worries that the absence of a full-scale local hospital could endanger residents. Long told Montgomery, "That travel time [to a full-scale hospital] could make all the difference in the world to one of our citizens. You know — whether they survive or not.” 

In Bowie, the hospital will operate as a satellite of one in Jacksboro, 30 miles away, having local emergency care is considered a positive change. "Earlier this month, 31 residents showed up at the Bowie Community Center for a presentation by Frank C. Beaman, the man in charge of the hospital’s transformation. Although the timetable has been delayed by construction setbacks related to supply chain shortages and other issues, Beaman said he is hopeful the facility can open sometime around summer," Montgomery reports, "Bowie's economic director, Janis Crawley, said the residents of Bowie will be happy whenever the doors swing open. Crawley told Montgomery, "They're excited about it. No. 1, it's going to bring back jobs. No. 2, it's going to bring back the life to an entire block that has sat empty.” The old hospital accounted for 474 jobs.

Without some changes, many rural hospitals are likely to close. A study by the Chartis Center "reported that 143 rural hospitals have closed over the past 13 years, and another 453 are vulnerable to closure," Montgomery reports. "Moreover, costly services such as obstetrics and chemotherapy 'continue to vanish at an alarming rate,' the report said. . . . At least 43% of the nation’s rural hospitals are in the red, but in states such as Texas that haven't expanded Medicaid under the Affordable Care Act, more than half of rural hospitals are losing money, according to the report."