Literature Review

States with the most rural hospital closures in the past 20 years Becker's CFO Report; by Mariah Taylor; 6/28/24 Since January 2005, 192 rural hospitals have closed or converted, according to data compiled by the University of North Carolina's Cecil G. Sheps Center for Health Services Research. Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. 

Governor on hand for PACE openingNews-ExpressKy, Pikeville, KY; by Terry L. May; 6/7/24Mountain View PACE (Program of All-Inclusive Care for the Elderly) was created to help adults 55 years old and older with complex care needs to avoid nursing homes and to receive care and services necessary to help them be safe, comfortable, and healthy while maintaining a more independent lifestyle, Mountain View PACE Medical Director Dr. James Rummel Jr. said. ... “For those of us who have aging parents, we see this cycle of people who are having a hard time living well at home so they tend to do this circle of home to the ER to the hospital to the nursing home for rehab then back home and it keeps repeating.” ... “We are not trying to replace anybody,” Rummel said. “We are trying to augment the system to fill the gaps. We are a niche type of healthcare system.” ... “What a great day in Pikeville and Pike County,” Governor Beshear said. “How we treat our seniors says something about us and our values as a people." 

Noncompete ban may squeeze rural hospitals, report shows Modern Healthcare; by Alex Kacik; 5/2/24 The federal noncompete ban may squeeze rural nonprofit hospitals that continue to see labor costs rise, a new report shows. Last week, the Federal Trade Commission voted to finalize a rule preventing most employers from enforcing or issuing contracts that restrict employees from working for a competitor. ... Larger hospitals are more likely to have the financial flexibility to offer clinicians and staff higher wages, likely at the expense of smaller, rural hospitals, Fitch Senior Director Kevin Holloran said.

One-third of West Virginians may soon have a harder time getting health care after lawmakers declined to fully fund Medicaid Mountain State Spotlight, by Erin Beck; 4/18/24Across West Virginia, it’s already hard for many people to access health care. And unless state lawmakers change the budget they passed last month, it’s about to get even more difficult, especially for people who live in the most rural areas and those considered lower income. Starting in July, at the start of the next fiscal year, West Virginia officials will be forced to dramatically cut the state’s Medicaid budget. Roughly one-third of the state’s population relies on the government health insurance program. ... [Lawmakers] gave the program about $150 million less than was needed. 

City-country mortality gap widens amid persistent holes in rural health care access KFF Health News, by Jazmin Orozco Rodriquez; 4/9/24 The health disparities between rural and urban Americans have long been documented, but a recent report from the Department of Agriculture’s Economic Research Service found the chasm has grown in recent decades. In their examination, USDA researchers found rural Americans from the ages of 25 to 54 die from natural causes, like chronic diseases and cancer, at wildly higher rates than the same age group living in urban areas. ... In 1999, the natural-cause mortality rate for people ages 25 to 54 in rural areas was only 6% higher than for city dwellers in the same age bracket. By 2019, the gap widened to 43%.

[Rural Hospitals] A popular healthcare myth debunked Becker's Hospital CFO Report, by Laura Dyrda; 3/28/24Many in the healthcare industry assume rural hospitals are inherently worse off financially than urban hospitals. It's easy to see why. ... But a February Kaufman Hall report refutes the financial divide between rural and urban hospitals. When comparing rural and urban hospitals as a collective, the firm found no statistically significant difference in average operating margin. Rural and urban hospitals on average have similar operating margins and financial performance. So why do we often associate more dire financial struggles with rural hospitals over urban ones?

When the American Dream becomes survival: Short doc chronicles rural healthcare crisis PBS - KET, by Nathan Duke; 3/17/24 Director Ramin Bahrani’s acclaimed films ... focus on people struggling to survive due to economic challenges or failing to achieve the mythologized American Dream. His latest, the short documentary If Dreams Were Lightning: Rural Healthcare Crisis, is a startling look at the challenges facing rural communities in which hospitals are closing and leaving residents without options for care. The film incorporates themes from Bahrani’s previous work, but its subjects’ struggles are far from fictional. 

The 19 rural emergency hospitals, by state Becker's Hospital CFO Report, by Andrew Cass, 3/15/24Nineteen hospitals have converted to the rural emergency designation since the law that created the designation took effect in January 2023, according to data from University of North Carolina's Cecil G. Sheps Center for Health Services Research in Chapel Hill.  Here are the hospitals that have converted to rural emergency status, by state: ... [Click on the title's link to view]

Rural-urban disparities and trends in utilization of palliative care services among US patients with metastatic breast cancerJ Rural Health; by Jincong Q Freeman, Adam W Scott, and Ted O Akhiwu; 2/20/24Purpose: To assess trends and rural-urban disparities in palliative care utilization among patients with metastatic breast cancer.Conclusions: In this national, racially diverse sample of patients with metastatic breast cancer, the utilization of palliative care services increased over time, though remained suboptimal. Further, our findings highlight rural-urban disparities in palliative care use and suggest the potential need to promote these services while addressing geographic access inequities for this patient population.

418 rural hospitals at risk of closure, breakdown by state

Kansas hospital to transition to rural emergency hospital Becker's Hospital CFO Report, by Maeline Ashley; 2/12/24La Crosse, KS-based Rush County Memorial Hospital has decided to transition to a rural emergency hospital due to ongoing rural healthcare challenges like reimbursement changes, cost increases, governmental change, and a local population decrease.

Study investigates perceived barriers to cancer care in rural South DakotaMedical Xpress, by Addison Dehaven; 1/24/24... To assess the barriers of cancer care, the research team interviewed 18 health care professionals who work closely with American Indians, frontier and rural populations. Through interviews and analysis, they were able to determine three distinct themes that constitute as barriers and challenges for those with cancer: access, time and isolation.

The Long Decline: Health care access grows difficult in shrinking rural communitiesAlabama Reflector, by Alanda Rocha; 1/18/24The lack of health care providers in rural Alabama is stark. Most of Alabama’s rural counties have significantly more people per primary care physician than urban counties. Butler County ... has just one primary care physician per 4,900 residents ... As rural Alabama continues a decades-long population collapse, residents who remain — many of them older people — face increasing barriers to health care, a trend seen around the nation.