Latest news with #hospitalclosures
Fox News
02-07-2025
- Health
- Fox News
‘Crisis brewing' in Trump Country as hospitals shutter at alarming rate, top ER doc warns
There is a healthcare crisis brewing in the nation's heartland, as evidenced by a landmark study conducted by the RAND Corporation in conjunction with top national emergency physicians. The study from the Arlington nonprofit research institute found that emergency rooms (ERs) are no longer the safety net but the proverbial "front door" to the U.S. healthcare system, particularly after a 1986 law passed requiring ERs to stabilize patients or deliver babies from women in labor regardless of their ability to pay. That has led to instability and hospital closures across the heartland, including in states where a dozen or more have closed, like Texas, Oklahoma, and Tennessee. States like West Virginia, Pennsylvania, the Carolinas and Alabama have also been affected. "This RAND study is the first ever that points to this crisis, which is that the emergency departments and the care that patients receive in them usually is so critical that, especially for time-sensitive conditions that patients can have, just the fact that you have to travel as far as you might have to, or that even in some cases if a hospital is close to you, but it still doesn't have the resources to operate efficiently," said Dr. Randy Pilgrim, an ER doctor and chief medical officer for emergency room services company SCP Health in Atlanta. "[I]n emergency medicine, we do time-sensitive, high-quality care as long as we have the resources to do it. And this study shows that we really have a crisis brewing here." Nearly $5.9 billion in emergency services go unpaid every year, the study found. Overcrowding and spates of violence towards staff have exacerbated the problem. EMTALA, the aforementioned law, is essentially an unfunded mandate in many cases, and lack of funding for hospitals that treat a large proportion of that uncompensated care — which tends to fall in rural areas or poor neighborhoods in cities — leads to the dual issue of higher patient volumes and more uninsured patients being seen. Many hospitals outside of cities cannot fully account for the funding gap, Pilgrim said. "The economics of reimbursement for physician care play a huge role. … We need more physicians generally in America, and we need physicians to feel like they can and will go to where they're needed," he said. "Physicians won't go where they are needed if there's not enough resources or reimbursement to attract them." Rural hospitals characteristically pay less than higher-end urban hospitals and have fewer local resources. With hospital demand "higher than ever," all of the above factors mean help is needed now. Pilgrim said he has met with HHS Secretary Robert F. Kennedy, Jr., and other top officials at the agency, to discuss the issue — and hopes Washington can help. "Secretary Kennedy… did a beautiful job of listening to what we were saying about the impending crisis that would probably happen during this administration," Pilgrim said. "And he was concerned about it because he could tell that you can't make patients healthy unless you have a healthy healthcare system for them to engage. So I'm very encouraged about what Secretary Kennedy and his staff are doing to try to make a difference on the pieces that they control." He also said Congress must act, particularly as 10,000 Americans turn 65 every day and are therefore eligible for Medicare, which presents a different environment than separate Medicaid. "That's where we see more volume of patients, more complexity, and much more clinical demand. But if the reimbursement in Medicare doesn't keep pace with that demand, once again, you're in this vicious cycle where emergency departments will be at greater risk, starting with the rural and underserved areas and moving forward from there." Some in Congress have banded together to advocate for healthcare-related issues, including members of the bicameral "Doctors Caucus." One member, Rep. Greg Murphy, R-N.C., is a urologist from Greenville who previously served as chief of staff at a Level-I trauma center. "Congress cannot leave rural America behind," he said. "The most important thing Congress can do is to fix dwindling Medicare reimbursements for rural providers and ensure health insurance companies don't play games with denied care and denied payments," he said, pinning the decrease at 33% since 2001 if adjusted for inflation," Murphy told Fox News Digital. The lawmaker added that many hospitals in his area do not have commercial payers as part of their funding sources to help offset losses from Medicare and Medicaid disbursement amounts — and that all hospitals must root out waste as well. Pilgrim was also asked why Americans outside the heartland with more reliable emergency care should be supportive of added funding or resources miles away from them. "In a large city like Atlanta, if rural healthcare is not healthy and patients have to go somewhere else, they will eventually end up in your hospital… So spending a dollar somewhere else besides in your own hospital if you're in a better place makes a lot of sense for you…" he said.
Associated Press
02-07-2025
- Health
- Associated Press
How an empty North Carolina rural hospital explains a GOP senator's vote against Trump's tax bill
WASHINGTON (AP) — Though patients don't rush through the doors of this emergency room anymore, an empty hospital in Williamston, North Carolina, offers an evocative illustration of why Republican Sen. Thom Tillis would buck his party leaders to vote down President Donald Trump's signature domestic policy package. Martin General is one of a dozen hospitals that have closed in North Carolina over the last two decades. This is a problem that hospital systems and health experts warn may only worsen if the legislation passes with its $1 trillion cuts to the Medicaid program and new restrictions on enrollment in the coverage. Tillis' home state showcases the financial impact that more Medicaid dollars can have on hospitals in rural and poor regions throughout the country. Tillis said in a floor speech on Sunday, explaining his vote, that the GOP bill will siphon billions of dollars from Medicaid recipients and the health system in his state. 'Republicans are about to make a mistake on health care and betraying a promise,' said Tillis, who has announced he will not seek re-election because of his opposition to the bill. Along with Republicans Susan Collins of Maine and Rand Paul of Kentucky, he joined all Democrats in voting against the bill. Tillis later accused the president and his colleagues of not fully grasping the full impact of the bill: 'We owe it to the states to do the work to understand how these proposals affect them. How hard is that? I did it.' For Martin General Hospital in Williamston, North Carolina's decision to expand Medicaid came just too late. The emergency room abruptly closed its doors in the eastern North Carolina county that's home to more than 20,000 people in August 2023. The closest hospital is now about a 30-minute drive away. Then-Democratic Gov. Roy Cooper faulted the state's failure to expand the Medicaid program to more low-income adults sooner to prevent Martin General's closure. North Carolina began offering Medicaid expansion to its residents in December. Today, more than 673,000 people are receiving this coverage. Now, Tillis and other state officials are worried the Republican bill, which will limit how much Medicaid money is sent back to providers, threatens funds for hospitals in their state again. And it could trigger a state Medicaid law that would close down North Carolina's otherwise successful expansion of coverage unless state legislators make changes or locate funds. The Medicaid dollars that Republicans seek to scale back in their bill have helped buttress the remaining rural hospitals across North Carolina, said Jay Ludlam, a deputy health secretary who leads North Carolina Medicaid. 'This has been a lifeline for our rural hospitals here in North Carolina and has helped provide and keep them open,' Ludlam said. 'Rural hospitals play an integral role in communities both as a point of access for health care but also for the local economy because of the contributions that those hospital and hospital systems make to those communities.' Republicans have responded to concerns with a provision that will provide $10 billion annually to rural hospitals for five years, or $50 billion in total. Around the country, 200 hospitals have closed or shuttered emergency services in the last two decades, many of them in red states across the southeastern and midwestern U.S. States that have declined to expand Medicaid coverage, the health insurance program for the poorest of Americans, have seen the closures accelerate. Tennessee, for example, has shed 500 beds since 2014, when a federal law first allowed states to expand Medicaid coverage to a greater share of low-income people. It's one of 10 states that has not expanded Medicaid. More than 300 hospitals could be at risk for closure if the Republicans' bill becomes law, an analysis by the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill found last month. The center tracks rural hospital closures. 'Substantial cuts to Medicaid or Medicare payments could increase the number of unprofitable rural hospitals and elevate their risk of financial distress,' the analysis concluded. 'In response, hospitals may be forced to reduce service lines, convert to a different type of health care facility, or close altogether.' — Associated Press writer Gary D. Robertson in Raleigh, North Carolina, contributed to this report.
Yahoo
12-05-2025
- Health
- Yahoo
In rural America, hospitals are closing their maternity wards
Rural hospitals across the United States are shuttering their labour and delivery units, leaving rural Americans with less access to necessary medical care. Across the country since 2020, 101 rural hospitals have stopped delivering babies or announced they soon will, according to a recent report from the Center for Healthcare Quality & Payment Reform. That includes three hospitals in Texas, bringing the state to a total of 93 rural hospitals that do not provide labour and delivery services. Across the state, well over half of rural hospitals do not deliver babies. State organizations are sounding the alarm. The Rural Texas Maternal Health Assembly reported in November that 47% of Texas counties are "maternity care deserts." That's 14% higher than the national average, the assembly wrote. Rural hospitals are a lifeline to their communities, which may be located many miles from the next nearest medical facility. In medical emergencies, minutes matter - and long travel time leaves rural residents with lower odds of surviving. "Travel burden is real, and geography of Texas can be very challenging," said John Henderson, the president and chief executive of the Texas Organization of Rural & Community Hospitals. "That's okay for certain things. ... It's not okay if you're having a heart attack or a stroke or delivering a baby." For some rural Texans, labour and delivery department closures could be the difference between life and death. 'Canary in the coal mine' It's not just about maternal health - across the board, many rural hospitals are struggling financially. Half of rural Texas hospitals are at risk of closure, according to the Center for Healthcare Quality & Payment Reform. For some hospitals, the threat has already become a reality. Mid Coast Medical Center Trinity, north of Houston, announced in April that it was closing before the end of the month. "It kind of feels like a death in the family," Henderson said of the closure. For a struggling rural hospital, closing the labour and delivery unit may be an alternative to closing the entire hospital. That's in part because labour and delivery units can be costly to operate. They must be staffed around the clock, since births can't always be scheduled or sequestered to regular business hours. In rural hospitals, which often have low patient volume, the unit could go long stretches without seeing any births at all. "You're basically paying people to sit in the hospital waiting for births that are very unlikely to happen on the majority of days," said Harold Miller, the chief executive of the Center for Healthcare Quality & Payment Reform. Labour and delivery is also not a required service - unlike other services such as emergency medical care - which makes those units more likely to be chopped. "In some ways, it's the canary in the coal mine on these things," Miller said. "If they're in trouble, where are they going to look first? That's where they're going to look first." Exacerbating maternal health issues As an immediate impact of labour and delivery closures, rural residents are forced to drive further to access care. That travel time means worse outcomes for women who are pregnant or in labour, according to the assembly's November report. "The lack of local services harms the health of mothers and babies," the Assembly wrote. The impact of travel time means that "rurality in and of itself is a factor in the maternal health crisis," the assembly wrote. Long travel time also exacerbates an existing problem: Texas as a whole already falls short on maternal health outcomes. The state's infant mortality rate is about on par with the national average, according to data from The Commonwealth Fund. The maternal death rate, however, is 34.7 per 100,000 live births, the data shows, compared to the national average of 26.3 per 100,000 births. Overall, the organization ranked Texas as second to last in the country on women's health and reproductive care. A 'long-term issue' Advocates say there are potential solutions to rural hospitals' struggles. Miller said the country as a whole should pay rural hospitals for their standby costs, so they can afford to keep the doors open no matter how many patients walk through. In the meantime, he said, individual states and the federal government should take steps to protect rural hospitals. In his view, those efforts can't only be one-time grants or other short-term assistance. "The problem is, this is a long-term issue," Miller said. "There has to be some stream of money that is adequate on an ongoing basis, year after year." In Texas, Henderson pointed to a proposed bill from Representative Gary VanDeaver, R-New Boston. House Bill 18 aims to stabilize rural hospitals' and clinics' finances through grant programs, training and a new state office focused on rural hospital finance. "There are Texans who do not currently have access to hospitals and health care services that the majority of us take for granted," VanDeaver said at a public hearing for the bill in March. "We have the opportunity this session to change that." House Bill 18 was passed by the Texas House in April and is now in the Senate. Outside of legislation, Henderson said he sees promise in telemedicine. In order to survive, he said, rural hospitals and advocates need to look at unconventional solutions. "It's not going to get easier. Rural hospitals aren't going to be less vulnerable in the near term," Henderson said. "We need to be working on innovative projects and finding ways for them to work together better."
