According to the National Rural Health Association (NRHA), the number of rural hospital closures has risen to 87 in the last 8 years. In addition, iVantage’s 2017 Rural Relevance Study reports that 41 percent of rural hospitals operate at a negative margin. Rural hospitals across the country are struggling to survive. The closures create a large gap in healthcare resources available in rural communities and communities can fall apart without these critically needed hospitals. Rural hospitals provide essential health care services to nearly 57 million people across the country and are often an integral part of the local economy, providing jobs and a tax base for the community. As John Henderson, CEO of the Texas Organization of Rural and Community Hospitals (TORCH) explains, “Hospitals, schools, churches. It’s the three-legged stool. If one of those falls down, you don’t have a town.”
According to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, there are likely multiple contributing factors to the number of closures, including:
- Failure to recover from the recession
- Population demographic trends
- Market trends (e.g. increased rates of merger and affiliation)
- Decreased demand for inpatient services
- New models of care (e.g. Accountable Care Organizations).
Long-standing trends – such as generally poorer financial performance in the South – may also contribute to closure rates. The potential effect of the Affordable Care Act (“Obamacare”) and/or the correlation with a state’s decision of whether to expand Medicaid may have also impacted the rate and number of closures.
Virtual care technology can be a viable delivery option for healthcare facilities and residents in rural communities. Providers and hospitals can better connect rural populations to quality care which best addresses a patients’ specific conditions as well as their related sense of urgency. According to the Institute of Medicine (IOM), healthcare quality is defined as “the degree to which healthcare services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” The IOM defines and measures quality in terms of the following properties or domains: effectiveness, efficiency, equity, patient centeredness, safety, and timeliness.
With a virtual care platform, rural patients can be connected to the quality care they need, when they need it most. By enabling consults with remote and/or offsite specialists, providers can easily reach the right specialists and obtain critical consults, improving access to care and the quality of the diagnosis. In addition, the virtual care platform can be used to follow up with the rural patient by scheduling reminders and sending appointments for post-discharge virtual visits via the communication channel of the patient’s choice – e.g., text message, SMS, email, or even a phone call. Follow-up care can be provided in a cost-effective way (for providers and patients) while minimizing the risk of appointment no-shows.
In terms of healthcare, the rural population has critical gaps in both access and quality. Although an estimated one in five Americans live and work in rural areas across the nation, there are 2,157 Health Professional Shortage Areas in rural areas compared to 910 in urban areas. Almost a third of America’s hospitals are Critical Access Hospitals. The Rural Health Information Hub reports that 19.5 percent of rural adults describe their health status as fair/poor vs. 15.6 percent of their urban counterparts. And, rural residents have more frequent occurrences of diabetes and coronary heart disease than residents of non-rural areas. Virtual care technology can help address the gap in care and help rural hospitals continue to care for the vast populations and geographies they support.