Rural hospitals may not be able to keep their doors open as the coronavirus pandemic saps their cash, their CEOs warn, just as communities most need them.
As the coronavirus sweeps across the United States, all hospitals are facing cancellations of doctor visits and procedures by a terrified populace — profitable services that usually help fund hospitals. Meanwhile, the institutions also find themselves needing to pay higher prices for personal protective equipment such as face masks and other gear that’s in short supply. Vice President Mike Pence called on hospitals nationwide Wednesday to delay elective surgeries to free up capacity and resources for future coronavirus patients.
The American Hospital Association responded Thursday by asking Congress for $100 billion for all hospitals to offset coronavirus costs, citing rural hospitals' inability to withstand huge losses for long.
"If we're not able to address the short-term cash needs of rural hospitals, we're going to see hundreds of rural hospitals close before this crisis ends," warned Alan Morgan, the head of the National Rural Health Association , which represents 21,000 health care providers and hospitals. "This is not hyperbole."
Well before the COVID-19 threat, rural health care's profitability had collapsed nationwide due to a combination of narrowing Medicare reimbursements, a larger share of patients lacking high-paying private insurance and the hollowing out of rural America. Given such pressures, more than 120 rural hospitals have been forced to close over the past decade.
Those hospitals in small-town America that have survived rely heavily on moneymakers such as elective surgeries, physical therapy and lab tests to make their razor-thin margins work. But, according to the Chicago-based Chartis Center for Rural Health, almost half of them still operate in the red .
So the added financial hit from the coronavirus outbreak could be the final straw for many rural hospitals — exposing the complicated business dynamics at play within the United States' critical public health infrastructure.
"This virus, and what it is causing for these hospitals, is the perfect storm that will close these hospitals at a time this country critically needs them," said Robin Rau , CEO of Miller County Hospital in southwestern Georgia. "This is going to be the death blow to them."
Two weeks ago, she started eliminating all medical services that were not urgent. She estimated that has cut off at least half of the hospital's revenue. Other CEOs warned similar cuts at their hospitals mean they won't make payroll in the coming weeks.
The National Rural Health Association, along with many rural hospital executives, is lobbying for immediate cash assistance, no-interest loans, Medicare reimbursement adjustments and other suggestions to alleviate the pain. The association favors a bailout plan being from Sens. John Barrasso (R-Wyo.) and Michael Bennet (D-Colo.), which in initial drafts called for the equivalent of a three-month advance based on hospitals' previous patient numbers, according to Bennet's office.
"Rural hospitals have already been closing their doors at startling rates, and this crisis will only exacerbate that fact," Bennet said in a statement to KHN. "There is an incredible opportunity for rural hospitals to shoulder some of the burdens of caring for patients and helping to meet possible bed shortages."
Still, many rural hospital CEOs worry any assistance may come too late. Related Stories
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