Rural hospitals continue to be in crisis, with the National Rural Health Association reporting that 48 were forced to close their doors since 2010 and another 283 nationwide are in financial trouble, according to a Washington Post analysis.
Why, exactly are rural hospitals in such dire straits? There are a variety of reasons, the Washington Post reported. They include all the well-known culprits, such as declining reimburements under the Affordable Care Act, the decision of many states not to expand Medicaid eligibility under that same law, and the 2 percent automatic reduction under sequestration.
However, there are also several other factors driving the trend. They include a declining patient base due to the depopulation of rural areas; more elderly and uninsured patients; high-wage demands by physicians to work in remote regions; the need for expensive equipment; the inability to provide a broad array of specialty services and too many money-losing emergency and urgent care services.
"If there was one particular policy causing the trouble, it would be easy to understand," Mark Holmes, a health economist at the University of North Carolina, told the Washington Post. "But there are a lot of things going on."
In states such as Georgia, two-thirds of its rural hospitals operate in the red.
Meanwhile, the Independent Journal Review reported that political gridlock in Washington makes it unlikely that lawmakers will address the rural hospital crisis anytime soon.
There could be a massive wave of rural hospital closings similar to the ones that occurred back in the early 1980s, when Medicare shifted from a prospective payment system, according to the Washington Post. More than 400 rural facilities shuttered in the years immediately after that change was made.