Alan Morgan, CEO, NHRA

The continuing trend of rural healthcare providers struggling to keep their doors open has worsened and will continue to worsen if action isn’t taken soon, the National Rural Health Association (NRHA) warned this week. 

Citing data released by iVantage Analytics, the Association published a new report, “2016 Rural Relevance: Vulnerability to Value Study,” indicating that a total of 673 rural hospitals are currently at risk of closure, with 210 at an “extreme risk” of closure. 

Those 673 rural hospitals currently serve 11.7 million patients who would be left without speedy access to emergency care if their local facilities were to close. Since 2010, a total of 66 rural hospitals have closed nationwide, the Association reported, noting that the closure rate of rural hospitals was six times higher in 2015 than in 2010. 

“Closures of this magnitude would mean millions of rural patients across the country will lose access to their closest emergency room, and rural economies will suffer a devastating blow,” said Alan Morgan, CEO of the NRHA.

Such rural hospitals often are a top employer in rural communities, accounting for as much as 20 percent of their local economy, the Association noted. According to iVantage, if 673 additional hospitals were forced to shut their doors, nearly 100,000 direct healthcare jobs and another 137,000 community jobs would be lost, accounting for $277 billion in overall losses over 10 years.

“Our 2016 analysis suggests that the situation is worsening for many rural communities,” said Michael Topchik, iVantage’s senior vice president. “Each year, our study’s methodology is rigorously reviewed to ensure this benchmark report reflects the impact of many pressure points converging on rural healthcare.”

The trend has become so prevalent, the NRHA has a term for it: “medical deserts” are forming across the nation, the Association warned, noting that when rural hospitals close, physicians, physician assistants, nurses, and other healthcare providers often leave their community to seek employment opportunities elsewhere. Seventy-seven percent of rural U.S. counties are already considered Primary Care Health Professional Shortage Areas, and rural hospital closures are on the rise in large part due to continuing Medicare cuts, officials said. 

“Bad-debt reductions, sequestration cuts, and other cumulative Medicare cuts hurt rural hospitals disproportionately hard because per-capita rural America is older, poorer, and sicker than their urban counterparts,” Morgan said.

The NRHA is calling on Congress to enact the Save Rural Hospitals Act; the bipartisan legislation, introduced by U.S. Rep. Sam Graves (R-Mo.) and Rep. Dave Loebsack (D-Iowa), will “stop the flood of rural hospital closures and strengthen the rural health delivery system by eliminating numerous cuts in Medicare to rural hospitals,” the Association said in a statement.  

Additionally, the bill creates what the NRHA described as “an innovative, sustainable delivery model for the future of rural healthcare.”

NRHA is a nonprofit organization with a membership of more than 21,000 individuals and organizations, all of whom share the common bond of an interest in rural health.

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Mark Spivey is a national correspondent for

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