The Affordable Care Act was designed to improve access to health care for all Americans and will give them another chance at getting health insurance during open enrollment starting this Saturday. But critics say the ACA is also accelerating the demise of rural outposts that cater to many of society's most vulnerable. These hospitals treat some of the sickest and poorest patients — those least aware of how to stay healthy. Hospital officials contend that the law's penalties for having to re-admit patients soon after they're released are impossible to avoid and create a crushing burden.
"The stand-alone, community hospital is going the way of the
dinosaur," says Angela Mattie, chairwoman of the health care management
and organizational leadership department at Connecticut's Quinnipiac
University, known for its public opinion surveys on issues including
The closings threaten to decimate a network of
rural hospitals the federal government first established beginning in
the late 1940s to ensure that no one would be without health care. It
was a theme that resonated during the push for the new health law. But
rural hospital officials and others say that federal regulators — along
with state governments — are now starving the hospitals they created
with policies and reimbursement rates that make it nearly impossible for
them to stay afloat.
"They set the whole rural system up for failure," says Jimmy Lewis,
CEO of Hometown Health, an association representing rural hospitals in
Georgia and Alabama, believed to be the next state facing mass closures.
"Through entitlements and a mandate to provide service without regard
to condition, they got us to (the highest reimbursements), and now
they're pulling the rug out from under us."
For many rural
hospitals, partnering with big health systems is the only hope for
survival. Some have resorted to begging large hospitals for mergers or
at least money to help them pay their bills. But Douglas Leonard,
president of the Indiana Hospital Association, said these days, "I'm not
sure they can get anyone to answer the phone when they call." (Full Story at USA Today)