Rural hospitals face numerous challenges, according to a report released Monday by the American Hospital Association.
Some hospitals have merged with larger systems to deal with these challenges, the report said. There have been 380 rural hospital mergers between 2005 and 2016 and 95 rural hospital closures since 2010.
More than twice the number of hospitals closed between 2013 and 2017 compared to the previous five-year period.
Below is a list of some of the challenges rural hospitals face, according to the report.
- Rural hospitals have a “challenging payer mix” since many of their patients rely on Medicare and Medicaid, which reimburse less than the cost of providing the care.
- Many rural hospital patients are older, sicker and poorer than the average patient nationally.
- It can be difficult for rural hospitals to recruit and retain health care professionals. “Primary care is experiencing widespread professional shortages in rural areas,” the report stated. “Nurse practitioners, midwives and physician assistants have helped to address the shortages.”
- The “limited number of behavioral health providers is particularly striking,” the report added.
- The cost of updating facilities to deliver health care in line with the 21st century is another challenge.
- Some procedures that used to be done on an inpatient basis are now outpatient, which can financially impact rural hospitals.
- The high cost of prescription drugs impacts hospitals and patients, the report says.
- Inadequate health insurance can leave providers with “higher rates of uncompensated care,” the report said. States that did not expand Medicaid under the Affordable Care Act have higher numbers of uninsured people, it added.