Hospital closures, Medicaid expansion to lead rural health meeting agenda

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.