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Rural or otherwise, running a hospital is no walk in the park

An article in NC Health News has little faith in the salvation of rural hospitals through health system consolidation. But hope springs eternal: the numbers are more nuanced than we think.

Running a hospital is serious business.

Sure, we can talk theoretically all day about payors, providers, and the pandemonium that is healthcare . . . but the reality of the situation is that keeping the lights on in any hospital – the places that save people’s lives — is no easy feat. Big or small, urban or rural, it’s not an easy operation to run.

Here at Un-covered, we’ve discussed the painful reality facing many rural hospitals specifically. We’ve weighed the pros and cons of hospital consolidation. And we’ve combatted some myths about larger health systems.

According to a NC Health News article, hospitals are just as likely to close, whether they’re acquired or not. The new findings, from the Journal of the American Medical Association (JAMA), also found that while big health systems have more cash on hand, not every big system that acquires a rural hospital is able to keep it open.

Interestingly, though, the article is more of a “yes, but” situation:

  • Yes, large health system partnerships can’t always save a struggling rural hospital.
  • But, the alternative is no better – without the possibility of system support, the hospitals are likely to close regardless.

Stuck between a rock and a hard place? Well, there is one solution – health insurance companies could own up to their critical position within the healthcare system. And they could actually uphold negotiation rates that are sustainable for providers, instead of cutting them at every turn, which has happened in California, Connecticut, and North Carolina. From sea to shining sea, we’ve seen just how severely rate cuts impact hospitals’ sustainability.

Why? Because it’s expensive to run a hospital. Hospitals are open 24/7, staffed by highly trained individuals who went through years of schooling and medical training to serve the patients who walk through their doors. It takes hundreds of physicians, nurses, physical therapists, occupational therapists, X-ray technicians, assistants, and social workers — just to name a few. From care for a broken hand to a heart attack, a hospital has to be prepared to treat anything and (just about) everything.

So, instead of poking holes in the solutions, we need to redirect the attention to the true driver of healthcare’s fragility. Because health insurers control the pocketbook – and so they control the future, of all hospitals, big or small.

Original Article:

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