Solutions for Georgia’s Rural Hospitals

Georgia Governor Nathan Deal received recommendations from the Rural Hospital Stabilization Committee created in 2014 to identify and provide solutions for the needs of the state’s rural hospital community.

Identifying the needs of the rural hospital community so that residents can receive good healthcare, the Governor announced appointments to the Rural Hospital Stabilization Committee representing professionals in the healthcare system, legislators, CEOs, local officials, and business owners.

On February 23, 2015, the Rural Hospital Stabilization Committee submitted a Final Report to the Governor http://gov.georgia.gov/documents/rural-hospital-stabilization-committee-final-report.

The Committee heard testimony reporting that four rural hospitals have closed in recent months, with eight hospitals having closed or attempted to reconfigure in the last two to three years. In addition, 15 rural hospitals are considered financially fragile, with six hospitals operating on a day-to-day basis.

The committee addressed Emergency Department (ED) stressors in rural hospitals that can contribute and lead to their closure. The Committee discussed the merits of scaled down hospital operations and the possibility of creating a stand-alone ED. After careful consideration, it was determined that stand-alone EDs are not financially viable

The establishment of a four-site pilot program based upon an integrated hub and spoke model is included in the recommendations. This model would relieve cost pressures on emergency departments and ensure that the best and most efficient treatment is received by patients. The proposed hubs would be initially implemented at Union General, Appling Health System, Crisp Regional, and Emanuel Regional Medical Center.

The pilot program aims to increase the use of new and existing technology and infrastructure in smaller critical access hospitals, provide ambulances with Wi-Fi plus telemedicine technology, and equip telemedicine in school clinics, federally qualified health centers, and increase use in public health departments.

The four pilot sites and spokes will need to address software systems and process improvements such as fully installed EHRs, fully developed ICD-10 software, advanced case management processes, and work to improve technology in physicians’ offices. Additionally, the committee encourages the four pilot sites to continue to work with the state Department of Community Health http://dch.georgia.gov to seek improvements in the regulatory systems.

The Committee also recommends maintaining existing Certificate of Need laws to protect existing rural hospital infrastructure. Other legislative fixes include expanding the scope of practice for midlevel providers, such as nurse practitioners and physician assistants to help bolster healthcare resources in rural communities.

The Committee is requesting $3 million to be appropriated to the Georgia Department of Community Health, State Office of Rural Health (SORH) http://dch.georgia.gov/state-office-ruralhealth. The SORH would than grant this money to the four sites for hardware, software, program development, process improvements, and training needs as well as to implement monitoring, and doing an evaluation of all the costs involved.

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