Many Rural Hospitals May Close

Over 500 attendees, top experts, and leaders from Capitol Hill and the Federal agencies discussed their views on a number of serious issues facing the rural health community at the 27th Annual “Rural Health Policy Institute” presented by the National Rural Health Association (NRHA)  on February 4-6, 2016 in Washington D.C.

The top item for discussion focused on the possible closing of many rural hospitals. The report “2016 Rural Relevance: Vulnerability to Value Study” released by iVantage Health Analytics, describes how rural hospital closures continue to escalate which could result in 11.7 million patients losing much needed healthcare access.

According to the report, “Since 2010, more than 60 rural communities have experienced a hospital closure and the 2016 analysis suggests that the situation is worsening for many rural communities. The report’s “Hospital Vulnerability Index” has identified 673 facilities which are now vulnerable or at risk for closure.

NRHA is calling on Congress to enact the “Save Rural Hospitals Act” (H.R. 3225) introduced by Representatives Sam Graves (R-MO)  and Dave Loebsack (D-IA)

The Act would create an innovative sustainable delivery model for the future of rural healthcare designated as “Community Outpatient Hospitals” (COH) to create an innovative delivery model to ensure emergency access for rural patients.

Critical Access Hospitals (CAH) and rural hospitals with 50 beds or less as of December 31, 2014, would be eligible to become COHs. The COHs must provide emergency medical and observation care not to exceed an annual average of 24 hours a day for seven days and be able to transfer patients in a timely manner who require a higher level of care or inpatient admission.

In addition, based on community needs, a COH would be able to provide medical services in addition to emergency services but could also provide skilled nursing care, infusion services, hemodialysis, home health, hospice, nursing home care, population health, and telemedicine services.

COHs would be encouraged to provide primary care through a FQHC or look alike or rural health clinic and would not operate any inpatient acute care beds but can operate swing and observation beds.

Also, grants are included in the bill for rural emergency medical services. Hospital-based grants are available to assist rural hospitals with the change to value-based payment models and for rural hospitals working on population health. In addition grants would be available for eligible rural hospitals to develop and implement strategies to develop successful emergency medical service programs.

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