The challenge of keeping rural hospitals open

Rural hospitals are in a tricky situation, where costs are high but incoming revenue is low.

Hospitals have openly talked about the problem of keeping their doors open, but for facilities in rural communities it might be their only resource. The challenge for these hospitals in particular is that these locations have a smaller patient population, while the cost of care continues to rise, the Hospitalist reported.

"These acute medical care deserts are primarily a result of declining reimbursements from Medicare and Medicaid, combined with a lack of newly insured Americans, a group that was expected to increase at a much faster pace than it has," Hospitalist contributor Danielle Scheurer wrote.

Compound this problem with the rise of pay-for-performance strategies like readmission reduction or value-based purchasing, these facilities are unable to get a steady flow of funds to cover the cost of keeping doors open. As the red tape gets tighter, more than 36 million Americans may be in the position to travel 40 minutes to an hour to see a practitioner.

North Adams Regional Hospital in North Adams, Massachusetts, was recently one of the many practices closed due to a lack of resources. Many of its patients relied on Medicare and Medicaid assistance, which eventually led to a $50 million debt with only $10 million to work with, according to reports that Fierce Health Finance cited. At this time, patients were given three days notice to make the necessary arrangements.

Often times, these smaller practices may see a handful of patients per day. Over the years, these hospitals experienced steep cuts in hospital beds and services to patients, which made it increasingly difficult to offer quality care.

Rural hospitals that don't want to be in similar predicaments may need to transform how their mindset of being an acute care hospital and one that focuses on a "spectrum of care."

"For the most part, as long as the specialty of hospital medicine keeps its ear to the ground on what is coming, ensuring that we can all be flexible and responsive in meeting the needs of the population we serve, our specialty will be prepped and ready for the 'sign of the times,"' she wrote.

Through the use of alternative treatment settings, including account receivable services, the cost of maintaining a hospital could significantly decrease. Also, utilizing health information technology innovations like telemedicine and electronic health records can streamline the health care experience.