Hospitals at Risk of Closing Due to Funding and Due to Costs to Deliver Healthcare
I have used commentaries from the Center for Healthcare Quality and Payment Reform (www.CHQPR.org) previously at Angry Bear. While they do write about healthcare, they also cover the plight of providing healthcare. They would include medical personal rural hospitals, hospitals in general, costs of healthcare, and how the US government supports healthcare. Today, the issues are healthcare in rural areas, rural hospitals, and small hospitals. All are which are subject to costs and the lack thereof funding. It is a serious issue and mostly in rural areas.
GOP senators say $15 billion hospital fund is not enough
Left-leaning news Independent of the political spectrum had this to say or report about the politics of funding rural and small hospitals. The Senate is talking about funding and are concerned about a lack of funding. They are also dealing with tr__p and his demands for cutting costs so as to continue the 2017 tax bill passed under reconciliation. The underlying factor here is tr__ p does not give a damn about hospital funding or anything else.
What concerned Senators are saying about rural and small hospitals. To which, tr__p has no concerns about whether rural and small hospitals are funded properly.
Funding
GOP senators are saying say a proposed $15 billion fund for rural hospitals is not enough to assuage their concerns about the impact of Medicaid cuts in the Senate reconciliation bill.
Why does their thoughts matter? Winning over senators concerned about cuts to the Medicaid provider tax is crucial to passing the measure this week.
What are Senators saying: Sen. Susan Collins said after a GOP lunch meeting Wednesday she still wants $100 billion for the provider relief fund.
- And she added that even if that amount were provided, “I don’t think that solves the entire problem.”
- “The Senate cuts in Medicaid are far deeper than the House cuts,” she added. The Senate limits the Medicaid provider tax more than the House.
After leaving the lunch, Sen. Roger Marshall had this to say, he wants $5 billion per year, compared to the current proposal’s $3 billion per year.
- Pointing to hospitals and community health centers: “My calculations would say $5 billion a year would take care of all the needs of rural America.”
- Upon entering the lunch, Sen. Josh Hawley said; “$15 billion is “not going to suffice for years and years.” Instead, he thought, ” it might be a fine very short term figure.”
Inside the room: For the third day in a row, Sen. Thom Tillis raised his concerns with the Medicaid provider tax changes to the entire conference.
- On Wednesday, he said he would not be comfortable voting to move forward on the whole package without greater clarity, per one attendee.
The bottom line: Concerns around the provider tax and size of the rural hospital fund still need to be smoothed over before the measure would appear to have the votes to pass this week.
Yesterday, I had posted a piece taken from a national policy center CHQPR, “Rural Hospitals at Risk of Closing.” There is more to this piece which discussed rural and small hospital funding.
Millions of Americans No Longer Have Hospital Care in Their Community
More hospitals have closed or have eliminated the ER, in patient care, and other patient services. Most due to costs versus revenue for each service.
Over the past decade, more than 100 rural hospitals have closed. As a result, the millions of Americans who live in those communities no longer have access to an emergency room, in patient care, and many other hospital services that citizens in most of the rest of the country take for granted.
In addition, 40 hospitals have eliminated inpatient services since the beginning of 2023 in order to qualify for federal grants that are only available for Rural Emergency Hospitals (REHs). Every year, more than 7,000 rural residents had received inpatient care in those hospitals, but now seriously ill individuals in their communities will have to be transferred to a hospital far from home in order to receive the services they need.
Hundreds More Rural Hospitals Could Close in the Near Future
More than 700 rural hospitals– one-third of all rural hospitals in the country– are at risk of closing because of the serious financial problems they are experiencing. Over 300 of these rural hospitals are at immediate risk of closing because of the severity of their financial problems. (See Rural Hospitals. org for the methodology used to estimate risk of closing.)
• Losses on Patient Services: Almost half of the rural hospitals in the country lose money delivering patient services. It costs more to deliver health care in small rural communities than in urban areas, and many health insurance plans do not pay enough to cover these costs.
• Insufficient Revenues from Other Sources to Offset Losses: Many hospitals have managed to remain open despite losses on patient services because they receive local tax revenues or government grants. However, there is no guarantee that these funds will continue to be available in the future or that they will be sufficient to cover higher costs. The special federal assistance many hospitals received during the pandemic has now ended. As a result, more than one third of rural hospitals lost money overall in 2023-24.
• Low Financial Reserves: The hospitals at greatest risk of closing have more debts thanassets, or they do not have adequate net assets (i.e., assets other than buildings & equipment, minus debt) to offset their losses on patient services for more than a few years.
Rural hospitals are at risk of closing in almost every state. In the majority of states, over 25% of rural hospitals are at risk of closing, and in 11 states, 50% or more are at risk. (Two charts below illustrate percentage of charts shy funding and those hospitals at a risk of closing [I combined both charts]).
Rural Hospital Closures Harm Patients and the Nation’s Economy
Most at-risk hospitals are in isolated rural communities, where closure of the hospital would force residents of the community to travel a long distance for emergency or inpatient care. More over, in many cases, the hospital is the only place where residents can get laboratory tests or imaging studies, and it may be the principal source of primary care in the community. As a result, closure of the hospital would cause a loss of access to many essential healthcare services. In addition, rural hospital closures threaten the nation’s food supply and energy production, because farms, ranches, mines, drilling sites, wind farms, and solar energy facilities are located primarily in rural areas, and they will not be able to attract and retain workers if health care isn’t available in the community.