Health care reform and rural hospitals

A story on the McClatchy news service a few days ago ran under the headline, "Rural hospitals fear healthcare overhaul won't help them." It features Peach County Regional Medical Center in Fort Valley, population 8,005, in central Georgia. An excerpt from Halimah Abdullah's story follows:

Overhauling the system could offer a lifeline to hospitals, doctors and nurses that serve the nation's small towns and agricultural communities, they say. But they also fear that Congress might not provide either enough money or the right incentives to allow rural hospitals to cover their costs and recruit talented medical professionals. That, they fear, will make it nearly impossible for smaller hospitals to remains in business.

Blue Dog Democrat, Jim Marshall, from nearby Macon, Georgia, offered these observations:

Cash flow for rural hospitals is a challenge. An awful lot of our decisions concerning reimbursement flow from decisions in the 80s and we use a big city hospital model for determining costs for what reimbursement rates should be provided. It's unrealistic to expect the same cost efficiencies in low volume rural hospitals that you can obtain in high volume urban hospitals.

Another reason that rural hospitals are struggling is that they treat so many uninsured patients. The number of uninsured visits to rural emergency rooms is 33% higher than in areas with adequate doctors' offices and clinics, and hospitals are often uncompensated or under-compensated for these services. The challenges facing rural hospitals are thus linked to the broader health care and economic crises--and the consequences of these crises for rural residents.

On a somewhat related note, I recently came across this Rural Doctoring blog. The physician/author writes about her experiences working in two rural hospitals in northern California. Also, the Blog for Rural America is doing a lot of excellent coverage of rural medical debt and about health care reform generally. Read a recent post here.