Rural Hospitals Are Critical – By: Mary Ellen Pratt, FACHE, CEO
Rural hospitals are a critical, yet vulnerable, part of our national healthcare delivery system.
Rural hospitals provide essential health care services to nearly 51 million Americans living in rural communities. The nation’s nearly 2,000 rural community hospitals frequently serve as an anchor for their region’s health-related services, providing the structural and financial backbone for physician practice groups, health clinics and post-acute and long-term care services. Typically, classification for small or rural hospitals is based on whether the hospital meets at least one of the following criteria: has 100 or fewer beds, has 4,000 or fewer admissions or is located outside a metropolitan area. The Americans that live in rural areas depend upon the hospital as an important – and often only source of health care in their community. They provide emergency department services, inpatient care, outpatient care, long-term care, and care coordination services. In addition, these hospitals often provide essential, related services such as social work and other types of community outreach.
- Quality rural health services, including emergency services, are needed in rural communities to attract business and industry, as well as retirees
- On average, the health sector constitutes 14% of total employment in rural communities, with rural hospitals often being one of the largest employers in the area
- On average, a Critical Access Hospital maintains a payroll of $6.8 million, employing 141 people
- Although rural hospitals are critical to their communities, increasingly the unique circumstances, characteristics, and challenges of rural hospitals have resulted in different approaches to healthcare than those used in an urban environment.
Rural-specific challenges include:
- Rural residents are older, poorer, and more likely to have chronic diseases than urban residents.
- Rural hospitals are typically smaller than urban hospitals.
- Rural hospitals provide a higher percentage of care in outpatient settings and are more likely to offer home health and skilled nursing; all of which have lower Medicare margins than inpatient care.
- Rural hospitals rely more heavily on reimbursement from public programs whose payments fall short of costs.
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