Who’s Responsible for Helping Rural Hospitals?

By Mike Williams, RCHC Board Member

From the ACA to the BRCA to the newest ACA Repeal efforts—what’s in place, what’s been proposed, legislation that’s pending—the national conversation continues around the government’s role, and responsibility, in health care. What’s the best way to serve citizens without access to health care? How can we help those who can’t afford to seek health care services?

Passage of the Affordable Care Act brought health and hope to millions. It offered health care coverage to many who had previously been uninsured, along with a measure of confidence for struggling rural hospitals—hospitals that serve a high percentage of Medicaid patients in communities across the country. States which expanded Medicaid had higher median rural hospital operating margins than non-expansion states. By recent counts, 32 states (including D.C.) have implemented Medicaid expansion; 19 states, including Texas, have not.

The rural safety net is tightening. Since 2010, 26 states have seen at least one rural hospital shut its doors, with the most closures in the South according to the North Carolina Rural Health Research Program.

Thirteen hospitals have closed in Texas, the most in any state. Tennessee is next on the list with eight hospitals shutting down since 2010. Georgia is in third place with six closures, followed by Alabama and Mississippi, where each state has seen five hospitals disappear. The results are particularly devastating to Medicaid recipients.

In Texas, 46 percent of children in rural areas and small towns are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) compared to 41 percent in urban areas. Hospital closures matter to them—and should matter to more of us.

Moving ahead, let’s work together to make sure our neighbors have the health care services and resources they need. That’s the inspiration behind the creation of the Rural & Community Healthcare Collaborative (RCHC), a 501(c)3 charitable organization dedicated to raising funds for struggling rural hospitals confronting financial viability. Created in 2016 by Community Hospital Corporation leaders driven to help small and rural hospitals succeed, RCHC makes available no- and low-cost consulting services to hospitals in need.

For more information about these efforts vital to rural communities, please visit the Rural and Community Healthcare Collaborative or Community Hospital Corporation.