Closing At An Alarming Rate


About 20% of Americans live in rural areas. Rural hospitals are vital to providing quality healthcare to these communities. But hospitals are closing at an alarming rate. In 2016, 21 hospitals closed around the country, and 15 of these were in rural locations. In the last decade, almost 100 rural hospitals have closed. Why are these facilities struggling? Why are rural hospitals losing patients to metropolitan areas?

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The elephant in the room

Although providing medical services to underserved populations is necessary, healthcare as an industry is costly. The challenges small hospitals face are often financial. Rural hospitals struggle with bringing in adequate revenue, have fewer commercial payers and face difficulties with staff retention.

A varied patient population

Hospitals rely on having commercial payers. Rural hospitals often have fewer commercial payers, which can lead to lower reimbursement rates. Additionally, 18% of the population in rural communities, on average, is made up of patients aged 65 and older. This rate compares to only 14% in urban areas. Older patients often have more complex needs and chronic conditions. If the local hospital cannot provide the services and specialties that these patients require, then the elderly population will seek healthcare in a more metropolitan area.

A smaller range of services

One of the reasons patients seek services outside of rural communities is simply that patients have a need for services that the local hospital does not provide. Rural hospitals are typically much smaller than urban counterparts, with only an average of 37 inpatient beds as opposed to 211. These small hospitals usually offer fewer services and are less likely to have cardiac services, psychiatric care, alcohol and drug units, or neonatal ICU services, to name a few.

Patient engagement

One of the ways community hospitals can retain patients is to engage the community regularly. Sometimes patients seek care in metropolitan areas due to a misconception that the quality of care is better there than at home. Connecting with the community and building trust is crucial for rural hospitals to stay open. One of the ways hospitals can do this is by using telehealth and communication platforms to send regular reminders about preventive care, screenings, and common health issues.

Improving patient experience

Decreasing wait times, improving throughput, and reducing inappropriate admissions all contribute to better patient experience. Using remote case management teams and employing hospitalists are two critical strategies for strengthening these markers. When patients are satisfied with the care, the likelihood increases that those patients will remain loyal to the local hospital.