Hospi­tal clo­sures, Med­i­caid ex­pan­sion to lead ru­ral health meet­ing agenda

Modern Healthcare - - THE WEEK AHEAD - —Jaimy Lee

At­ten­dees at the Na­tional Ru­ral Health As­so­ci­a­tion an­nual meet­ing this week in Las Ve­gas will hear a lot about re­cent clo­sures of ru­ral hos­pi­tals in states such as Alabama, Louisiana and Texas.

There have been few ru­ral hospi­tal clo­sures across the coun­try over the past 15 years. But mul­ti­ple hos­pi­tals in the South have closed, in­clud­ing 10 in Alabama in the past three years, and oth­ers are wor­ried about sur­viv­ing. Alan Mor­gan, the as­so­ci­a­tion’s CEO, blamed the clo­sures on a num­ber of fac­tors, in­clud­ing re­im­burse­ment cuts, state de­ci­sions not to ex­pand Med­i­caid un­der Oba­macare, and broader changes in the mar­ket.

“All of these forces are hit­ting ru­ral hos­pi­tals at the same time,” he said.

Ge­or­gia’s Repub­li­can Gov. Nathan Deal, who has op­posed Med­i­caid ex­pan­sion, last month pro­posed that ru­ral hos­pi­tals in his state be al­lowed to keep op­er­at­ing even if they of­fer fewer med­i­cal ser­vices than re­quired for li­cen­sure. At least four ru­ral hos­pi­tals in Ge­or­gia have closed in the past two years, in­clud­ing Lower Oconee Com­mu­nity Hospi­tal in Glen­wood, a 25-bed crit­i­cal-ac­cess fa­cil­ity, which closed ear­lier this year. Safety-net hos­pi­tals in Florida, an­other Repub­li­can­led state that has re­fused to ex­pand Med­i­caid, are con­cerned about a pro­posed new Med­i­caid fund­ing model be­ing con­sid­ered by the state Leg­is­la­ture that they say would cost them hun­dreds of mil­lions of dol­lars a year.

Other dis­cus­sions at the up­com­ing con­fer­ence will fo­cus on ac­cess to spe­cialty care in ru­ral ar­eas, work­force trends, new med­i­cal tech­nol­ogy adop­tion and its ap­pro­pri­ate­ness for ru­ral hos­pi­tals, and how the pa­tient- cen­tered med­i­cal home model is play­ing out in ru­ral clin­ics.

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