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Rural hospitals: Keys to addressing top challenges with healthcare delivery

Rural hospitals face unique challenges compared to other, larger facilities. The American Hospital Association (AHA) is advocating for policy changes designed to make life easier for rural hospitals, but in the meantime, these facilities may have to get creative to successfully navigate the current healthcare landscape. 

In its 2019 Rural Report, the AHA identified some of the top challenges rural hospitals must tackle going forward, breaking them down into three big categories:

  1. Emerging. Several problems are just beginning to impact the care rural hospitals provide patients. One of the most pressing issues is the caring for patients affected by the opioid epidemic, which has hit rural communities hard. Violence in the community is also a significant threat, whether in the form of a mass shooting, human trafficking or an attack on a hospital staffer. Rural hospitals must also be on the lookout for internal issues, such as weaknesses in their cybersecurity or the ability to handle a sudden surge in patients due to a natural disaster, terrorist attack or another large-scale emergency.
  2. Recent. Many of the newest challenges rural hospitals face are directly related to healthcare coverage issues. Often, rural hospitals are caring for patients in areas where Medicaid coverage wasn’t expanded with the Affordable Care Act. This can have a negative impact on their revenue flow. A tighter budget makes it more difficult for rural hospitals to comply with other regulatory demands from the feds, such as shifting toward value-based payment models, or to keep up with the increasing costs of drugs. Rural facilities must also grapple with a patient mix that has greater behavioral-health needs.
  3. Persistent. Rural hospitals have been dealing with certain ongoing problems for a long time, including low patient volume, workforce shortages and an aging infrastructure that they don’t always have the resources to update. In addition, rural hospitals are often geographically isolated, which further limits their access to resources. Their patient mix is typically sicker (and patients often have difficulty getting to the hospital for necessary treatment), and their payors typically reimburse them at lower rates.

To help with these challenges, the AHA says that policymakers must step up and make law changes designed with rural hospitals in mind. The association wants the Centers for Medicare & Medicaid Services (CMS) to increase reimbursement so rural facilities can better cover the cost of care. It’s also asking for better value-based care models designed with the needs of rural hospitals in mind and workforce programs to address provider shortages in rural areas.

Expanded telehealth coverage is also one of the AHA’s requests. Rural facilities may need additional financial assistance to take full advantage of telemedicine for patients, and the AHA wants the feds to address this issue, along with relaxing some of the compliance requirements to make implementing telehealth easier.

Ultimately, the AHA wants a healthcare landscape that makes it easier for rural hospitals with limited resources to comply with existing laws, receive fair payment for services rendered and provide high-quality care for patients.

Tactics rural hospitals can try right now

While rural hospitals wait for legal intervention, there are some strategies they can try now to make the most of their current situation and operate efficiently with patients’ health in mind.

According to an article in Healthcare Finance News, one of those strategies involves the use of telemedicine. It may be tough for a rural hospital to afford the high-tech equipment required for remote consultations, but it may be easier to shoulder the cost by forming partnerships with other organizations and clinicians. Together, they can combine resources to offer rural patients services they couldn’t access otherwise.

Another way for rural hospitals to survive: Consider expanding into the primary care space. It makes sense: If patients see a primary care physician more often, they’re less likely to wait until they’re gravely ill to seek treatment for medical issues. That can keep costs lower for rural facilities – and lead to a healthier patient mix in the long run. Some rural hospitals may even find it beneficial to switch gears and become community clinics, working with a larger, regional hospital to provide more complex acute care for patients.

Whatever route rural facilities choose, they’ll need to think differently and find unique ways to use their limited resources to serve their communities if they want to thrive.

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