Hospital closures in rural areas of the US hit their highest point in the past decade last year, with 19 rural hospitals shutting down, according to a new report.
The number of rural hospital closures slowed somewhat during 2016 and 2017 but there has since been an uptick, with 34 facilities shuttering in the past 24 months, the analysis by the Chartis Center for Rural Health found.
Since 2010, 120 rural hospitals have closed, with states in the south faring worst, with Texas, Tennessee and Oklahoma leading the way. The analysis found that hospitals located in states that have not adopted the expansion of Medicaid – a public insurance program that provides health coverage to low-income families and individuals – have a lower average operating margin, putting them at greater risk of closing.
Using a model that shows risk factors for hospitals, the report found that 453 rural hospitals across the US are vulnerable to closure. Being in a state that has accepted expanded Medicaid help decreases the likelihood of closure by 62% on average, according to the analysis.
Previous studies have consistently shown that Medicaid expansion helps stave off hospital closures and yet states such as Texas have refused the federal funding that covers 90% of the costs of the expansion.
The issue has become a political point of contention in rural America, which has suffered from a lack of healthcare availability to treat growing problems such as the opioid epidemic.
Leading Democrats hoping to replace Donald Trump as US president have, to varying degrees, supported an expansion of government-assisted healthcare to the large number of uninsured and underinsured Americans.
The situation with rural hospitals threatens to deteriorate further, though, as the Chartis report warns: “Many of the states hit hardest by the closure crisis also see the highest levels of vulnerability which threatens to further erode the delivery of healthcare services at the local level.”