Rural US hospitals are in a world of pain
They provide care for a fifth of America's population, but their numbers are dwindling, due mostly to funding issues.
On Friday, after 42 years in service, Charlton Memorial Hospital in Folkston, Ga., will suspend most of its operations. The 25-bed nonprofit says that while it will continue to have a family practice clinic on the premises, the rest of its services -- including its 24-hour emergency room -- will be shuttered.
Charlton Memorial is the third rural hospital in Georgia to close this year, and part of a trend affecting many small community hospitals across the country. Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in Georgia, told George Health News the closure of Charlton Memorial will force local residents, many of whom are elderly and living below the poverty line, to travel long distances for health care.
Lewis also cited problems with Charlton Memorial that are common to many rural hospitals, including cash shortages, lower state payments, claims disputes with insurers and cuts to indigent care funds ahead of the federal Affordable Care Act.
According to the National Rural Health Association, while 20% of the U.S. population lives outside of America's cities and suburbs, only about 9% to 10% of doctors practice in rural areas. And in many cases, rural hospitals are often major employers in their communities, representing a large portion of the local economy.
Congress created the critical access program in 1997 after hundreds of rural hospitals across the country closed to make sure Americans living in remote areas could still access health care.
But that program has come under criticism for becoming, in the words of Kaiser Health News, "bloated and unwieldy." A report released earlier this month by the Department of Health and Human Service's Office of the Inspector General looked at the Critical Access Hospital (CAH) certification program, meant to ensure rural communities have access to hospital services. Medicare reimburses CAH at 101% of their "reasonable" costs -- rather than by payment system rates or fee schedules.
The study found that nearly two-thirds of CAHs would not meet the location requirements if required to re-enroll -- mostly because most of those facilities were too close together.
If the Centers for Medicare & Medicaid Services "had de-certified CAHs that were 15 or fewer miles from their nearest hospitals in 2011, Medicare and beneficiaries would have saved $449 million," the study said.
But supporters of rural hospitals say the government just doesn't get it.
"We are alarmed by the message this is sending to rural America," Brock Slabach, senior vice president of the National Rural Health Association, told Kaiser Health News. "Using Missouri as an example, roughly 70% of the rural critical access hospitals in that state alone would lose their designation, and face possible closure. Does that sound rational to anyone living outside of Washington, D.C.?"
A hospital is a business providing a service. Many customers are not paying for the services they receive, so the business is closing the unprofitable divisions like the emergency room.
Thanks a lot, Obama, for signing this monstrosity into law. Thanks a lot, every single one of you scumbag democrats that voted for it. And a special thank you to that RINO dunce, Susan Collins, who allowed this piece of crap legislation come to a vote in the Senate. Lest we forget, without her, Obamacare wouldn't have been possible. Oh, and let's not forget to thank Justice John Roberts, whose bastardization of the US Constitution will haunt us for generations, for upholding this cluster-monkey of a mandate. Without all of you working together in collusion, er, cooperation, none of this would have been possible.
Because rural people don't need healthcare.
Has the ACA helped anybody? I am longing for at least one example.
Reality: Not only will you lose the insurance plan you like, but your local hospital
may shut down, too.
"Using Missouri as an example, roughly 70% of the rural critical access hospitals in that state alone would lose their designation, and face possible closure. Does that sound rational to anyone living outside of Washington, D.C.?"
Yes, I live in Missouri and I think a 15 mile minimum for CAH funding is perfectly rational, in fact, given rural population densities it is still too low.
This especially in light of the rural-conservative dominated Missouri state government which turns away federal funding in refusing to participate in the ACA and slashing hundreds of thousands from Medicaid, these in favor of tax breaks for corporations and a drive to cut its already non-progressive income taxes.
There is a movement towards Swiss style farming by having everyone live in a "city hub" and go to their farms or businesses however far away to work. The movement wants everyone to live in city hubs and leave the rest of the areas to nature.
There was also a movement back in the 70s that wanted all lands between the west coast - Rockies and the Mississippi to be a National Park. Which would remove all settlements to hubs. This way the buffalo would once again be free to roam as they had 150 years or more ago. Rural areas will be the last place you will see Hospitals in the future. The trend is control the people by bundling them in their respective "Hubs".
Obama administration cut backroom deals with the nation’s top drug companies to win support for President Obama’s health care overhaul, threatening them with steeper taxes if they resisted and promising a better financial deal for the industry if they acquiesced
Obama agreed to drop his long-standing support for letting Americans buy cheaper foreign prescription drugs something the pharmaceutical industry vehemently opposed — and the drugmakers promised to mount a public campaign to sell the public on the health care legislation.
Amazingly the article doesn't even mention the OVERWHELMING reason rural (and urban) hospitals are forced to close their doors...........the 16 million illegal immigrants and the 22 million uninsured Americans that the federal government forces the hospitals to treat. This is the real reason and everything else I see commented about is either secondary or bogus.
Yes I am a retired MD. I've preached to congress many times about their "gracious and misguided" laws and regulations.
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