Georgia will try hub-and-spoke model for rural hospitals

Rural hospitals continue to struggle in Georgia, with some being forced to close their doors. That has prompted lawmakers to consider a variety of options, including a new proposal by a rural health committee assembled by Gov. Nathan Deal to essentially remake that state's five dozen rural providers into a holistic system.

Deal's committee has put forth a proposal that would in essence place all of the state's rural providers into a "hub and spoke" arrangement, the Atlanta Journal-Constitution reported. Larger regional hospitals would then direct patients to the facility that would provide the most appropriate care. The intent is to take the burden of having to provide specialized services that may be too costly to offer in the long-term off of smaller facilities.

In addition to those changes, a lot of patient care delivery would shift over to non-physician providers such as nurse practitioners and physician assistants. 

Four hospitals would be designated as hubs statewide in a pilot project: Union General, Appling Health System, Crisp Regional and Emanuel Regional Medical Center. The state would appropriate $3 million toward the project and for related infrastructure.

Georgia, like many other Southern states, has seen its rural healthcare system struggle, particularly as it did not expand Medicaid eligibility in conjunction with the Affordable Care Act. That, along with cuts  in Disproportionate Share Hospital payments have proven disastrous to the smaller rural hospitals.

Nearly two-thirds of Georgia's rural hospitals are losing money, and about a third have experienced budget deficits for at least the past five years. Deal has made other proposals in the past, such as creating freestading emergency departments without a full hospital, but this proposal is far more comprehensive.

"Just as a medical emergency can't wait, neither can we wait to act upon these recommendations," Deal said in a statement, the Journal-Constitution reported. "It is my hope that these efforts are not a temporary fix, but rather the beginning of a long-lasting road to recovery for our rural health systems."

To learn more:
- read the Atlanta Journal-Constitution article 
- check out the rural hospital report (.pdf)

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