All three of the rural hospitals in Oregon’s Coos County are losing money. Humboldt County's four rural hospitals in California are facing a similar situation.
In fact, 10 out 17 rural hospitals across far northern California and southwest Oregon are in the red, according to a recent report by health care consulting company Chartis. It was created from data collected this year.
Hospitals that serve rural residents often operate at razor margins, according to Michael Topchik, director of Chartis’ center for rural health, but more are losing money now than anytime in the last ten years.
“We've been in the midst of a rural hospital closure crisis for more than a decade. Some 160-plus rural hospitals have closed. And what we see is that that is actually accelerating,” said Topchik.
Rural hospitals tend to serve more people who are uninsured. Topchik said federal cuts in Medicare payments to hospitals and debt reimbursement have contributed to budget woes.
Also, the growing popularity of Medicare Advantage, offered by private insurers, has made getting repaid for care more difficult. Hospitals with a small staff are now responsible for more paperwork and have a higher chance of being denied reimbursement compared to traditional Medicare.
Topchik said that hundreds of health centers are at risk of closure. And those that don’t close may still cut back service to residents. The study noted 25% of the country’s rural obstetric units shut between 2011 and 2021, while 382 providers stopped offering chemotherapy services around the same timeframe.
According to the study, almost half of those struggling rural hospitals are found in 10 states that have yet to expand Medicaid.
