eventy-two million Americans livein rural areas
and depend uponthe hospital serving their community as an important, and often only, sourceof care. The nation’s nearly 2,000 ruralcommunity hospitals
frequently serve asan anchor for their region’s health-relatedservices, providing the structural andnancial backbone for physician practicegroups, health clinics and post-acute andlong-term care services. In addition, thesehospitals often provide essential, relatedservices such as social work and othertypes of community outreach.
Rural communities rely on theirhospitals as critical components of theregion’s economic and social fabric.These hospitals are typically the largestor second largest employer in thecommunity, and often stand alone intheir ability to offer highly-skilled jobs.
For every job in a rural community,between 0.32 and 0.77 more jobs arecreated in the local economy, spurredby the spending of either hospitals or
The Opportunities and Challenges for Rural Hospitalsin an Era of Health Reform
AcAn HpAl AcAnApl 2011
A strong health carenetwork also adds to the attractivenessof a community as a place to settle,locate a business or retire.Rural hospitals provide their patients with the highest quality of care whilesimultaneously tackling challenges dueto their often remote geographic loca-tion, small size, limited workforce, andconstrained nancial resources. Ruralhospitals’ low-patient volumes makeit difcult for these organizations tomanage the high xed costs associated with operating a hospital. This in turnmakes them particularly vulnerableto policy and market changes, and toMedicare and Medicaid payment cuts.The recent economic downturn putadditional pressure on rural hospitalsas they already operate with modestbalance sheets and have more difculty than larger organizations accessing capi-tal to invest in modern equipment orrenovate aged facilities. Compounding these challenges, rural Americans aremore likely to be uninsured and tohave lower incomes, and they are, onaverage, older and less healthy than Americans living in metropolitan areas.
The Patient Protection and Affordable Care Act of 2010
begins toaddress some of the urgent issuesfacing the nation’s health care system,such as lack of access to health insur-ance coverage, and includes provisionsthat recognize rural hospitals’ uniquecircumstances. However, limitednancial and workforce resources pres-ent signicant ACA implementationchallenges for rural hospitals. As morerural Americans gain access to healthcoverage through Medicaid and thecommercial markets, rural hospitals will experience greater patient demandthat may strain already limited staff and capital resources. Furthermore,additional accommodations must bemade so that rural hospitals can benetfully from ACA programs, demonstra-tions and pilots.
“As we move forward with heath are reform, it wi be artiary imortat i rraareas that roviders work together, erhas i etwork arragemets, to address thesarity of resores that rra roviders ofte fae, ad to imrove the overa efieyof are throghot the heath are otim.”
Gerad Wages, exetive vie residet, north ississii Heath ervies, ., eo,
from the field