Saving Rural Healthcare in Tennessee

Many rural hospitals across the country work diligently to provide needed healthcare to their communities. Yet today, they’re concerned about their own health, with good reason. That’s certainly the case here in Tennessee.

Since 2010, eight Tennessee rural hospitals have closed their doors (Becker’s Hospital Review, August 15, 2017). They’re not alone. Thirteen have closed in Texas; six in Georgia. Why is this happening? How can we address this issue?

To start, the availability of physicians and hospital employees in a time of shortages is a very real concern. Add this manpower concern to other economic challenges — uncompensated care, as well as a larger percentage of patients on Medicare and Medicaid seeking care at rural hospitals — and the issue comes into sharper focus. These are among the reasons our rural hospitals are closing.

We cannot forget the health of rural Tennesseans or allow the gap in access to quality services to widen. It is time for innovation. Without access to hospitals, our older adults with diabetes living in rural communities will not have access to wound care. Too many in our communities suffer from depression and chronic illnesses. They need access to local hospitals. The pregnant mother should not be forced to drive hours for critical prenatal care, or worse, forgo care due to unreliable or unavailable transportation. And to combat Tennessee’s opioid crisis, hospital and health resources need to be here.

These are some of the difficulties we face. They may not be unique among rural hospitals across America, but we definitely feel them close to home. In all my professional years working to improve hospital operations and services in Tennessee, I firmly believe that now is the time.

More than “talk” about how Tennesseans can work together collaboratively to support the needs of rural communities and residents, we must act. In rural counties, hospitals are often among the top employers in a region, providing substantial income to local economies (Shelbyville Times-Gazette, June 23, 2017). For every hospital employee, full-time or part-time, another job is supported in the community. The loss of a hospital is bad for health outcomes and the local economy.

Tennessee Senator Bo Watson will introduce legislation creating a $100 million grant program for economic development in rural Tennessee to help keep businesses and industries in rural areas. This program is modeled after a similar initiative in South Carolina bringing together agencies and resources to develop successful, sustainable strategies.

In Tennessee, how can we help our hospitals and ourselves? Should we invest in telemedicine, expanding the scope and reach of various services and service providers including physicians to serve patients remotely?

Could the development of rural-urban hospital partnerships prove beneficial? A rural facility could serve as a much-needed access point and guide a patient to a larger hospital for major procedures, returning the patient to his/her community for post-care recovery. Could we create a feeder system geographically dispersed with better than adequate access and quality services?

Can rural hospitals enhance patient care by using physician extenders such as nurse practitioners and others?

Finally, we should continue to examine the good work others are doing to improve health in rural communities. A new 501(c)3 charitable organization created in 2016, the Rural and Community Healthcare Collaborative (RCHC), is dedicated to raising funds for struggling rural hospitals confronting financial viability. They offer a Healthy Hospital Report Card to help communities discover and evaluate health needs.

Let’s keep talking and start acting for better health in Tennessee.