None of Georgia's struggling rural hospitals have signed onto the state's plan to save money by scaling back operations, the Associated Press reports.
The plan by Gov. Nathan Deal's (R) administration was intended to reduce costs for rural hospitals by restricting their services to emergency care and a handful of outpatient services. The plan was open to any facility serving a county with a population under 35,000, with the freestanding emergency departments (EDs) no farther than 35 miles from a general hospital and offering 24-hour care.
But hospital leaders were skeptical of the plan from the beginning, with financial consultants telling a state committee that freestanding EDs were unlikely to turn a profit, according to the article. These areas' demographics make it an uphill struggle to break even, analysts said, due to above-average poverty levels, widespread lack of insurance coverage and too few patients. EDs need 35 to 40 patients daily to offset expenditures, said Charles Horne, an accountant for Draffin & Tucker LLP, and Georgia's rural hospitals would take a loss of up to $1.2 million under Deal's plan.
Instead of opening stand-alone EDs, other struggling hospitals in the state slash payrolls, according to the Albany Herald. In November, Columbus Regional Health, in response to two years of losses, eliminated more than 200 positions, which included 99 terminations. However, these cuts are less drastic than the ones Georgia providers made during the worst parts of the Great Recession, according to the article. The state's decision not to expand Medicaid has compounded rural providers' problems, FierceHealthFinance previously reported.
Rural healthcare has been experiencing a crisis for years and facilities are desperately in need of workers. The aging population is exacerbating the problem, according to NBC News. The crisis is particularly acute in states such as Montana, where more than 60 percent of primary care physicians practice in only five counties.