Keokuk, Iowa; Crisfield, Maryland; Jellico, Tennessee; Bowie, Texas. Those are four very different regions of our country, all of which represent a dangerous trend: Each has seen their local hospital close since the start of 2020, and they don’t. single.
Since start; As a result of the COVID-19 pandemic, up to 25 rural community hospitals have closed, stopped inpatient care or severely reduced services.
Congress kept that number from going much higher, saving many hospitals from closing by providing vital support during the height of the pandemic that enabled millions of patients in rural areas to continue their care. access to care.
While the peak of the pandemic is behind us, the need for these small community hospitals remains. It’s important for lawmakers to step up activity again, this time preventing nearly $2 billion in cuts by the end of the year, which could lead to more shutdowns. In fact, a recent survey found that of the remaining full-service rural hospitals, 46% are operating on negative margins by 2021.
It’s important to remember that these are not just statistics–they represent small and medium-sized communities that do not have direct access to timely and routine lifesaving care. The closures have also had a major impact on the local economy, with rural hospitals often being among the top employers in the city, not to mention a key driver of economic growth.
While hospital closures are in the spotlight, growing shortages of doctors and other health care providers in rural areas are also approaching crisis levels. The numbers are alarming: Nationwide, 20% of the population lives in these small communities, but only 10% of doctors practice there. For example, this lack of doctors causes many residents to drive hours for everything from prenatal care to cancer treatment.
Although rural hospitals face a multitude of challenges, timely solutions are available to ensure people in these communities have access to the care they need. It begins with congressional action in the ongoing lame duck session.
The Medicare Dependent Hospital (MDH) and Low-Capacity Hospital (LVH) designations expire on December 16 and must be renewed. The problem is that Medicare and Medicaid reimburse less than the cost of providing care, which results in rural hospitals paying $5.8 billion in Medicare underpayments and 1.2 billion dollars. billions of dollars in underpayments for Medicaid in 2020. These programs were created to ensure that nearly 700 qualified rural hospitals can continue to provide much-needed services in their communities. them by better reflecting the real costs of providing care in rural areas – where patients are more likely to be older, poorer and sicker than patients in rural areas . urban area. If lawmakers don’t act before the end of the year, rural carers could face a $600 million annual shortfall.
A law that’s been in place for more than a decade could push many rural hospitals over the financial brink if Congress doesn’t step in. The Pay-As-You-Go Act of 2010 (PAYGO) could result in $37 billion in cuts to Medicare reimbursements by 2023. This would affect the entire system of care. health – especially providers in small communities, where more and more patients, because of demographics, are dependent on the plan for care. Hospitals on the brink may be forced to close, while hundreds of others may have to reduce access to care by eliminating services. Congress should waive these impending Medicare cuts once and for all by the end of the year.
The midterm elections have left us with a narrowly divided government, which often leads to legislative deadlock. But we hope that in the coming Congress, lawmakers will continue to demonstrate bipartisan support for rural health needs such as expanding telehealth, increasing support mental health and substance abuse treatment, as well as strengthening the care workforce.
The clock is ticking. Rural Americans need legislators to stand up and secure access to care before many in small towns suffer the same fate as those in Keokuk, Jellico, Bowie and Crisfield – forced to move Travel extra miles and lose precious minutes when life-saving care is needed.
