AcuteCare Telemedicine Blog


Telehealth Can Play a Key Role in Saving Rural Hospitals

No matter the location, rural communities across America have one thing in common. Residents tend to be older and sicker than their fellow, “urbanites”. The introduction of the Affordable Care Act (ACA), designed to provide millions of previously uninsured or underinsured patients access to health insurance, accompanied by Medicare reimbursement cuts and other regulations is beginning to negatively impact rural hospitals. The trend has many pondering; “If you decide to live in a rural community, are you deciding to have a worse outcome if you have a stroke?” asked Dr. Jeff Feit, vice president of population health at the Valley Health system.

To date, 51 rural hospitals have closed in the US since 2010, according to the North Carolina Rural Health Research Program at the University of North Carolina at Chapel Hill. Southern states have been disproportionately affected by the increase in closing of rural facilities. Texas has seen 10 rural hospitals close, while Alabama and Georgia have each lost five just in the past five years. The National Rural Health Association has identified 283 more rural hospitals in danger of going out of business. Many rural hospitals “have been struggling on the cusp for a long time,” said Mark Holmes, director of the North Carolina Rural Health Research Program. The future of many rural hospitals is threatened by the ongoing cuts to Medicare and the failure of more than 20 states to expand Medicaid.

Maggie Elehwany, vice president of government affairs for the National Rural Health Association, says significant Medicaid cuts in the past few years have been suffocating rural hospitals. “The greatest crisis right now is the hospital closure issue,” she said. In Kansas, The Kansas Hospital Association has repeatedly told its lawmakers that failure to expand Medicaid will have dire consequences, leading some rural hospitals to shut down. Terry Hill, a senior policy adviser at the National Rural Health Resource Center has predicted, “You’re going to see a predominance of closures in the next year or so in those states that have not expanded their Medicaid eligibility.” Congress is attempting to respond to the crisis by initiating several bills to help rural hospitals recover, but they are receiving little attention by the majority of lawmakers.

In the interim, an increasing number of rural hospitals are looking to virtual healthcare options to remain financially viable and operationally relevant in a new, emerging healthcare delivery model. Telemedicine can provide many of them the means for resuscitating a community’s hospital by connecting rural patients to primary care and medical specialists as well as remote monitoring of many chronic diseases.

Establishing virtual healthcare solutions requires investment, but the investment will pay significant dividends for patients, providers and hospitals by creating broader access to healthcare networks, experts and outlying resources. While some small hospitals are debating whether they can afford to implement telemedicine, others are debating if the hospital can afford not to make the investment.