A new index by iVantage Health Analytics concluded that there are 673 financially vulnerable rural hospitals in the United States, of which 210 are on the brink of closing immediately. That is based on an examination of 71 factors in nine areas, including cost, charge, outcomes and financial stability.
The study found that 66 rural hospitals have closed their doors between January 2010 and Jan. 25 of this year. Nearly 70 percent of rural hospitals have negative operating margins.
Were all these hospitals to go out of business, the economic impact would be significant: iVantage projects that it would cost 99,000 healthcare jobs, another 137,000 of community jobs, 11.7 million lost patient encounters and a $277 billion loss to gross domestic product over the next decade. "When you consider that a rural hospital is often a community's largest employer, the loss of an immediate--or local--point of care can have a significant impact on a community," said Michael Topchik, an iVantage senior vice president, in a statement.
Texas has the most vulnerable hospitals, with 75 in all that are considered at high risk, according to iVantage. Mississippi has the largest percentage of rural hospitals that are considered vulnerable, 79 percent in all. Many of the vulnerable hospitals are in Southern states. Although many rural hospitals have been hit hard in recent years, those in states that have not expanded Medicaid eligibility under the Affordable Care Act have been hit even harder due to the higher rates of uncompensated care and smaller cash flow. There are eight states and the District of Columbia that have no vulnerable facilities at all.
Rural facilities have been trying to refocus their services in order to weather the crisis, with some focusing more on outpatient care. Others have been trying to form alliances with larger healthcare providers that have more ample financial resources.