Rural hospitals are in financial distress, forcing many to shut their doors. According to a 2018 GAO report, 64 rural hospitals closed between 2013 and 2017, which is more than twice the number of closures in the preceding five-year period. In my home state of Tennessee, 10 hospitals have closed since 2012, creating “healthcare deserts” across rural areas.

It’s a complicated issue, but many known factors play a part in this trend, including:

• Revenue pressure. Rural areas have fewer commercial payers than more urban markets, which means these hospitals have a higher volume of state-funded healthcare with lower reimbursement rates.
• A complex patient population. As the U.S. population ages and struggles with chronic conditions, these issues are more extreme in rural areas. For example, studies show 18% of people are aged 65 and older in rural communities, compared with 14% in urban areas, and 18% have limitations due to chronic conditions, compared with 13% in urban communities. These patients require more services and more specialties than younger, healthier patients.
• Attracting and retaining providers. Remote locations have a harder time recruiting full-time physicians, especially in specialties such as orthopedics or neurology. While rural patients still need these services, rural hospitals are often only able to offer them once a week or once a month with alternating coverage for subspecialties. It leads to lack of access to care for patients, burned out physicians and loss of revenue for organizations.

These factors remain a challenge for rural and critical access hospitals across the country. And it ultimately limits access to care for vulnerable rural populations.

Connecting with the rural community

As rural hospitals close, residents are more likely to delay or forego care altogether. Lack of access to care within their communities forces patients to drive longer distances – often an hour or two – to the nearest hospital.

One way some rural hospitals are keeping patients healthier and relieving revenue pressure is to better connect with patients on a regular basis, inviting them to participate in routine, preventive care. Engagement platforms that enable sending text messages to alert them about upcoming health fairs or reminding them about screenings that are covered by insurance, can help patients address health issues early and potentially avoid unnecessary trips to the emergency room. Improving access to basic health measures can keep patients out of the hospital, which is very expensive care.

While engaging patients is a step in the right direction, the plight of rural hospitals continues and is a multi-factorial problem to solve.

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