A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies

From Kaiser Family Foundation:

Executive Summary

The number of rural hospital closures has increased significantly in recent years. This trend is expected to continue, raising questions about the impact the closures will have on rural communities’ access to health care services. To investigate the factors that contribute to rural hospital closures and the impact those closures have on access to health care in rural communities, the Kaiser Commission on Medicaid and the Uninsured and the Urban Institute conducted case studies of three hospital closures that took place in 2015: Mercy Hospital in Independence, Kansas; Parkway Regional Hospital in Fulton, Kentucky; and Marlboro Park Hospital in Bennettsville, South Carolina. Two of these hospitals were in states that did not adopt the Medicaid coverage expansion under the Affordable Care Act (ACA) (Kansas and South Carolina), while one of the hospitals was located in a Medicaid expansion state (Kentucky). Key findings include the following:

A number of factors contributed to the rural hospital closures, including aging, poor, and shrinking populations, high uninsured rates and a payer mix dominated by Medicare and Medicaid, economic challenges in the community, aging facilities, outdated payment and delivery system models, and business decisions by corporate owners/operators.

The hospital closures reduced local residents’ access to care, especially emergency care. While inpatient hospitals in these and other communities may not be sustainable, without new models of health care delivery in place, hospital closures can lead to gaps in access. The closures led to an outmigration of health care professionals and worsened pre-existing challenges around access to specialty care. Some communities were able to adapt to fill in gaps in access to primary care. Elderly and low-income individuals were more likely than others to face transportation challenges following the closures, and were thus more likely to delay or forgo needed care.

New care models may be better able to address the health care needs of rural communities.  Some rural hospitals may be able to adapt and new models may be created to address changing demographics and delivery systems.  Such reconfiguration may require federal support and assistance as well as regional planning efforts. A state’s decision about the Medicaid expansion has an important impact on hospital revenues and access to care, but the sustainability of rural hospitals depends on a broader set of factors.


Oregon hospitals stock up on snakebite antidote, blood supplies ahead of eclipse

From Becker’s:

Hospitals across Oregon are treating the Aug. 21 solar eclipse as an “emergency event,” stocking up on extra supplies and ensuring every health facility is adequately prepared for the influx of people, according to The Oregonian.

With no precedent, Jeff Absalon, MD, executive vice president and chief physician executive of St. Charles Health System in Bend, Ore., said hospital leaders turned to their counterparts in a small South Dakota town that attracts an average of 1 million people for an annual motorcycle rally.

“One of the key things that we learned was that the need for acute care services oftentimes just mimics the increase in the population,” said Dr. Absalon. This means there will most likely be more patients with food poisoning, broken bones, strokes and heart attacks, and more emergency surgeries for traumatic injuries.

Doctors Coming Around To Single-Payer Healthcare

From Forbes:

Citing simplicity, fewer hassles with insurers and more stable coverage for patients, U.S. physicians increasingly support a single-payer healthcare system, new reports indicate.

A new analysis shows more than half of U.S. physicians support a single payer healthcare system with 42% “strongly” in favor and another 14% “somewhat” supportive, according to a new survey of more than 1,000 doctors by MerrittHawkins, a nationwide healthcare staffing firm. “Physicians appear to have evolved on single payer,” MerrittHawkins senior vice president Travis Singleton said of the poll.

Mosquitoes test positive for West Nile in many southern Illinois counties

From WSIL:

Already this year, several southern Illinois counties reported finding mosquitoes carrying the potentially deadly West Nile virus, but so far no southern Illinois cases of the virus have turned up in humans.

A report from the Illinois Department of Public Health shows one batch of infected mosquitoes turned up in White, Washington, Perry, Alexander and Johnson Counties, each.

Jackson and Union counties report two positive batches, Saline County has had 3 this year, Massac reports four positive batches, and Gallatin County tops the list with six batches of mosquitoes testing positive for West Nile.