Rural hospitals play a critical role in the health care landscape, providing accessible coverage for residents of hard to reach, isolated communities. Mounting data is showing that these essential organizations, however, are at risk of becoming extinct.

The facts 

The data about the closure of rural hospitals is sobering. Recent research has found that:

• 673 rural hospitals across 42 states are at risk of closing in the U.S., according to a report from iVantage Health Analytics.
• 355 of these hospitals are in communities with “great health disparities,” or areas with high risk of medical conditions.
• These closures would result in 99,000 health care jobs lost.  

Why are rural hospitals at risk of closing?

More than 62 million Americans live in rural areas and depend on these critical access hospitals. There are many challenges that rural hospitals face, such as caring for patients who are older and poorer, offering a larger variety of outpatient services and administering care in smaller-sized facilities, according to a report from the American Hospital Association. 

According to the National Rural Health Association, hospitals in these areas are vulnerable to being shuttered because of rising cuts to hospital payments. Sequestration, or expansive reductions in federal spending due to debt, that began in 2013 has in turn caused hospital closure rates to spike. The association notes that debt cuts have contributed to rural hospital closure rates being 6 percent higher in 2015 compared to just five years prior.

As the American Physical Therapist Association explains, changes in payment structures for hospitals caring for Medicare patients have caused some providers in rural areas to be unable to fulfill their cost-sharing payment requirements, thus leading to them being forced to close their doors.

“It is an escalation of these policies and it is the cumulative impact of these policies,” said Michael Topchik, senior vice president for iVantage, in an interview with the Healthcare Financial Management Association. “And I think we will see them be increasingly impactful next year.”

The fight to save rural hospitals 

Physical, occupational and speech-language therapists all have a stake in keeping rural hospitals open. Therapists who travel to and work in remote communities at local hospitals, community organizations and individuals’ homes help rural residents lead healthy, productive lives.

Recognizing this mission, APTA has joined in on the fight to protect rural hospitals and the critical access to care that they provide. Along with the NRHA, the organization is actively supporting the Save Rural Hospitals Act, or HR 2957. The act, which was introduced by Rep. Sam Graves (R-MO), would step back Medicare cuts to ease financial pressures on rural hospitals. It would also re-classify rural facilities as community outpatient hospitals (COHs), which would help these hospitals have access to greater resources, as APTA detailed.

“This bill shines a light on the rural health crisis in Missouri and across the country,” said Rep. Graves in his presentation to Congress. “If we accept this reality – and neglect this much needed conversation, rural hospitals in Missouri will continue to close, leaving thousands without access to health care, putting lives in jeopardy and affecting every family in rural America. That’s simply not acceptable.”

The bill is currently in the introduction phase and was referred to the Subcommittee on Health in July.

What therapists can do 

Therapists of all disciplines can come together to support the protection of rural hospitals across America. They can call or write letters to their state’s politicians to support HR 2957, share information about the challenges facing rural hospitals with colleagues, students and mentors and stay up to date on rural health news from the APTA and NRHA.

They can also seek out travel assignments, advocacy and volunteer opportunities in states that are especially vulnerable to rural hospital closure. According to the iVantage report, Southern states are particularly at risk to having their rural health care facilities closed, with Mississippi at a 79 percent rate of vulnerability, followed by Louisiana at 58 percent, Georgia at 53 percent and Texas at 50 percent. Texas has the largest number of at-risk rural hospitals of any state, at 75, while Mississippi follows with 42 facilities.

By supporting the protection of rural hospitals, therapists can help ensure that patients of all ages in remote areas receive the critical care and health coverage they deserve.