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Another Rural Hospital Closure – And How We Can Prevent More


Lakeland Community Hospital in Haleyville, Alabama has announced that it will close its doors by the end of 2017. Lakeland Community Hospital is the only facility in Winston County, and its absence will result in job loss, reduced care options, and increased travel times for the county’s residents. Since 2010, eighty-three critical rural hospitals have closed and today, 674 additional facilities are vulnerable and could close. This represents more than one-third of rural hospitals in our country.  Even further, one in three rural hospitals are in financial risk of closure, and 41% of rural hospitals operate at a negative financial margin.
 
Rural hospitals provide essential, lifesaving local access to health care close to home for the 62 million Americans living in rural and remote communities like Haleyville. If a rural hospital closes, 20% of the rural economy vanishes and other health providers in the community, who are almost always hospital based, leave the rural area. Lakeland’s closure will effect the jobs of nearly 90 local hospital employees. The depth of health workforce shortages, chronic poverty and chronic disease is crippling rural America.
 
A number of factors have created the rural hospital closure crisis, and in the case of Lakeland Community Hospital, the primary reason for the hospital’s closure is continued cuts in hospital payments. Debbie Pace, CEO of Lakeland Community Hospital, said of the closure decision:
 
“Unfortunately, as with many other rural healthcare facilities in the Southeast, we are unable to continue operations due to such drastic reductions in reimbursement. I want to thank the Lakeland hospital staff, physicians and board for their dedication and service to the community… Additional reductions from CMS reimbursements for low volume adjustments for rural hospitals and further reductions from commercial insurance carriers have made operating rural hospitals extremely difficult.”
 
As Lakeland CEO Debbie Pace mentioned, rural hospitals are reliant on programs like Low Volume Adjustments. Unfortunately, Congress let the Low-Volume Adjustment program expire on October 1, along with other critical rural Medicare extenders, including Medicare Dependent Hospitals, rural ambulance payments, Medicare Therapy Caps, and the geographic index floor under the Medicare physician fee schedule. We will continue to urge Congress to reauthorize these essential Medicare extenders.
 
Additionally, NRHA is proud to support the bipartisan Save Rural Hospitals Act. This legislation would provide rural hospitals with financial and regulatory relief to allow them to stay open and care for rural residents who are older, poorer and have higher rates of chronic disease than their urban counterparts. CMS currently spends 2.5 percent less on rural beneficiaries than on those in urban areas.
 
Medical deserts are appearing across rural America, leaving many of our nation’s most vulnerable populations without timely access to care. The Save Rural Hospitals Act will stop the impending flood of rural hospital closures and provide needed access to care for rural America.  Additionally, it will create an innovative delivery model that will ensure emergency access to care for rural patients across the nation. We need a multi-pronged approach to solve this crisis- legislation including the Save Rural Hospitals Act and reauthorization of the Medicare Extenders will go along way in beginning this important work to save our rural hospitals and communities.

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