Wednesday, August 31, 2011

Tough Times for Rurals

By Haydn Bush August 29, 2011

Will new federal incentives for health IT and physician recruitment help rural hospitals negotiate tricky terrain?

While perusing the health care headlines Sunday afternoon after a weeklong vacation, I stumbled across an alarming article in the Columbia, S.C.-based State newspaper on troubling times for South Carolina's rural hospitals. The article found, via an analysis of CMS data, that only half of the beds in South Carolina's 30 rural hospitals were filled on an average day between 2007-09. Overall, occupancy rates fell by 8 percent during that period, the newspaper found.

The rest of the article detailed the reasons for the decline, which it characterized as a "vicious cycle" marked by lagging volume that makes it difficult for rurals to afford the capital investments in health IT and infrastructure, trouble recruiting physicians and reductions in Medicare and Medicaid payments. It was a sobering, well-researched read, and one with implications far beyond South Carolina, since finding cash for capital investments and recruiting physicians are ever-present concerns for rural providers.

Earlier this month, as part of a wide-ranging White House initiative focusing on the rural economy, HHS announced two new programs aimed to alleviate some of that pressure. The first would give rural hospitals and clinicians access to two existing capital loan programs currently administered by the USDA. The Community Facilities Program, which offers loans for community facilities projects, could be used to help offset the costs of EHR implementation; the Distance Learning and Telemedicine Grant Program is available to spur the growth of telehealth.

In addition, HHS is preparing to expand the National Health Service Corps loan repayment program to allow participation by critical access hospitals, which would be able use the loans to recruit physicians to their facilities.

It will take more, of course, than two relatively small federal programs to solve the major financial and structural crises facing rural providers. But amid the bleak picture for rural providers in South Carolina and many other states, it's heartening to see some movement to address those concerns.

Send your thoughts on what might help rurals to hbush@healthforum.com

Haydn Bush is the senior online editor for Hospitals & Health Networks magazine.

The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association.

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Source: http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=374000388

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