Financial, technological struggles leave future in doubt for rural hospitals

Times are tough for rural hospitals, and evidence does not suggest things are going to get any better.

Although one of the most rural states in the union, Maine's rural facilities have been struggling to make ends meet. Facilities such as Mayo Regional Hospital in Dover-Foxcroft have seen their patient census dwindle from full capacity 25 years ago to just 25% capacity today. The lack of patients has led to severe financial stress.

“We are actually one of the more financially healthy rural hospitals, and we have a $1 million hole in our budget,” Marie Vienneau, Mayo's chief executive officer, told the Portland Press-Herald.

By contrast, hospitals in Portland, the state's major urban area, have been expanding. State-of-the-art technology allows urban facilities to offer more specialized surgeries. As a result, patients are sent to the bigger hospitals for operations. 

The situation raises questions about the viability of rural healthcare as a whole. Some 62 million Americans live in rural areas of the United States, making their ongoing access to suburban and urban hospitals more difficult. And the closure of rural hospitals can also create grave economic issues, because they are often the region's largest employer. Altogether, as many as 13 percent of rural hospitals across the U.S. are currently vulnerable to closure.

In Texas, 15 rural hospitals have closed in just the past four years alone, according to the Texas Organization of Rural and Community Hospitals. The drop in oil prices is expected to leave the remaining facilities vulnerable.

“The closures are trending west,” John Henderson, CEO of Childress Regional Medical Center, told the Lubbock Avalanche-Journal. “With the downturn of the oil and gas markets, it’s just a matter of time before you see some out here. I think the thing that allows us to hold on a lot longer than others is that they have the tax revenue to hold them up a little bit, but that’s suffered recently too.”

The dearth of specialty services among rural hospitals has forced some oncology patients with even breast cancer—among the most common and treatable forms of the disease—to travel as much as 160 miles round-trip to obtain care, according to the Avalanche-Journal.

And though many tout the benefits of telemedicine to connect rural patients with doctors and nurses in urban areas, some people aren't convinced it will offer the same type of care they had with their rural providers. 

“You can work with a doctor,” Kristin Hougard told the Las Vegas Review-Journal. Hougard worked with a doctor at Nye Regional Medical Center in Tonopah, Nevada, until it closed last year,"You can’t work with a doctor on a TV screen.”

In addition, the article noted that rural clinics can't necessarily pin their hopes on telemedicine. They still need to fund the technology and find technical staff who can maintain the online and video conferencing equipment.