Go bigger, not smaller

By Zack Budryk

In an era of healthcare cutbacks, rural hospitals are hit particularly hard, and costs of care are a major driver of the rural healthcare crisis. In light of these issues, expanding services might seem like a counterintuitive solution, but it can be just the boost providers need.

Four years ago, Putnam County Memorial Hospital in Unionville, Missouri, faced a major budget deficit while struggling to provide care for a largely uninsured, elderly and low-income patient population. Reducing staff seemed like the obvious solution, but this would have put the organization at even more of a disadvantage in terms of the care it could provide. Rather than cut back, Putnam County Memorial decided to go bigger, turning a 10-bed unit into a psychiatric unit and later recruiting specialists in anesthesiology, cardiology and gynecological services. After they added these new services, revenues climbed to $22 million, and average patient volume per day increased from fewer than one to more than 12.

As unlikely as the expansion strategy seems, it could benefit other rural facilities as well, according to the Rural Policy Research Institute. "We think that's the way forward for rural hospitals, rather than just sort of a bunker mentality--saying that we can't proceed," study coauthor Tim McBride of St. Louis' Washington University told National Public Radio.


Go bigger, not smaller