Rural Hospital Closures and Opportunities for Healthcare Staffing Solutions
Rural America, often characterized by its picturesque landscapes and close-knit communities, is facing a healthcare crisis of monumental proportions: the closure of rural hospitals. This trend, which has been steadily increasing over the past few decades, is having a profound impact on the health and well-being of rural residents. Yet amid these challenges, there are emerging opportunities to embrace alternative clinic settings, apply current technologies and leverage physician staffing solutions to help alleviate the impact of these closures.
According to US News & World Report, between 2005 and 2019, on average ten rural US hospitals closed each year. That rate doubled in 2020 but shrank to only six closures in 2021 and 2022 owing to the federal grants hospitals received during the height of the pandemic. Now that that assistance has ended, however, more than 600 rural hospitals – nearly 30% of the total – are at risk of near-term closure and more than 200 are at immediate risk.
A big difficulty for rural hospitals is the daily startup costs of maintaining necessary functions. Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform (CHQPR) characterizes the issue this way, “The problem owes to the need for hospitals to have a certain number of staffers on duty every hour of every day, while reimbursement is based on the number of patients treated”. Hospital visit rates have not returned since the pandemic. Urban hospitals serve larger populations and make ends meet due to the constant churn of patients coming in and out. But rural hospitals serving sparsely populated areas are less likely to see enough patients on average to cover their continuously escalating costs of care.
How Do Hospital Closures Impact Rural Areas?
A rural hospital is often the only game in town. It typically provides all healthcare services in an area – from x-rays and lab testing to primary and in-patient care. Removing even one of these hospitals can leave an entire community without local medical care options, including critical emergency and mental health services. Patients are forced to travel longer distances to receive care, which can result in delayed treatment, increased costs and diminished outcomes.
Moreover, losing hospitals has knock-on economic effects in rural communities as they are often the largest employers. Their closure not only affects healthcare jobs but also has repercussions on the local economy. Businesses that rely on the hospital for clientele, such as pharmacies and restaurants, may also suffer.
What Challenges Do Rural Hospitals Face?
To understand the gravity of the situation, it’s essential to recognize the unique challenges rural healthcare systems face.
Demographic Distribution: According to the U.S. Census Bureau, rural America accounts for approximately 19% of the country’s population, yet it spans 97% of its land area. This demographic distribution results in a sparse population, making it economically challenging for hospitals to sustain themselves.
Economic Pressures: Rural hospitals are often financially fragile due to lower patient volumes, limited payer mix, and higher rates of uncompensated care. Medicaid, a key source of revenue for rural hospitals, covers a larger proportion of patients in rural areas compared to urban ones.
Infrastructure Upgrades: Supporting rural hospitals in upgrading their infrastructure and technology can enhance their capacity to provide quality care and attract healthcare professionals.
Policy Flexibility: Policymakers should consider flexible regulations that cater to the unique needs of rural hospitals, including innovative care delivery models and alternative payment methods.
Workforce Shortages: Recruiting and retaining healthcare professionals in rural areas is a persistent challenge. Many healthcare providers prefer urban settings due to the higher salary potentials, access to specialized facilities, and a broader patient base. This shortage of healthcare personnel further exacerbates the challenges faced by rural hospitals.
How Can Physician Staffing Efforts Support Rural Communities?
Rural Health Clinics
The establishment of rural health clinics has been a growing response to the closure of hospitals in these areas. Such clinics offer a wide range of healthcare services, including primary care, preventive care, and specialty consultations. Nurse practitioners, physician assistants, and medical support staff are in high demand to staff these clinics.
Mobile Healthcare Units
Some rural communities have embraced the concept of mobile healthcare units, which bring medical services directly to residents. These units can be staffed by a diverse range of healthcare professionals, including physicians, nurses, medical assistants, and pharmacists. They serve as a lifeline for populations living in remote areas with limited transportation options.
Locum Tenens and Travel Nursing
The closure of rural hospitals often creates short-term healthcare staffing gaps that can be filled by locum tenens providers and travel nurses. These professionals work temporarily in underserved areas to ensure continuity of care. These assignments offer flexibility, competitive compensation, and the chance to make a meaningful impact in communities facing healthcare challenges.
Telehealth and Telemedicine
The benefits of telehealth and telemedicine have been invaluable in the wake of rural hospital closures. Healthcare professionals, including physicians, nurse practitioners, and mental health specialists, can now provide remote care to patients in underserved areas. Telemedicine not only ensures continued access to care but also opens up employment opportunities for healthcare providers willing to serve rural populations from a distance.
What Benefits Can Healthcare Staff Gain from Working in Rural Settings?
Career Advancement
Healthcare professionals working in rural areas often gain exposure to a diverse range of cases and medical conditions, enhancing their clinical skills and experience. This can be a valuable asset for career advancement and professional growth.
Competitive Compensation
Owing to the high demand for healthcare staff in rural areas compensation packages are often competitive, including signing bonuses, student loan repayment programs, and housing assistance. This can provide financial stability and incentives for healthcare professionals to choose rural placements.
Professional Fulfillment
Working in rural areas provides healthcare professionals with the opportunity to make a significant difference in the lives of underserved populations. Many find deep satisfaction in knowing they are addressing critical healthcare disparities and improving access to care for those in need.
Can the Patient Be Saved?
The above lays out how the trend of hospital closures in rural America is a critical issue that demands immediate attention. Rural communities deserve equitable access to healthcare services, and the closure of hospitals exacerbates health disparities and economic challenges. Addressing this crisis requires a collaborative effort involving policymakers, healthcare providers, and local communities to ensure that healthcare access remains a fundamental right for all Americans, regardless of where they live.
While the closure of hospitals in rural areas has undeniably created challenges for these communities, it has also ushered in opportunities for healthcare staffing to help address these challenges. Telehealth, rural health clinics, mobile healthcare units, and locum tenens positions are avenues through which healthcare professionals can contribute to improving access to care in underserved rural areas. These opportunities not only benefit healthcare providers by offering professional fulfillment and career advancement but also by bringing much-needed healthcare services to rural communities – yielding better health outcomes for all. As physician staffing solutions continue to evolve, rural areas have the potential to build resilient and sustainable healthcare systems that bridge the gaps left by hospital closures.