Time is running out…the clock is ticking…time is not our friend when it comes to meeting the ever changing future of healthcare in rural America. If we don’t act soon, access to healthcare for many rural Americans will be lost. Small Critical Access Hospitals across the nation face closure and we have no real alternative to turn to. Just as the world is watching the Mayan Calendar count down to December 21, 2012, that may be the fate for many rural hospitals, the end of our time has come.
In the healthcare industry, we often hear; there is not enough time in the day to get everything done, I don’t have the time to address all the fires, time is the critical factor, you missed the deadline, time management…the pressing issue for many small rural and frontier hospitals is, time is running out and we have no options available. With reductions in reimbursement looming, sequestration will reduce Medicare payments by 2%, cuts in Medicaid funding in nearly every state, higher costs, ACO’s, Value based purchasing, and so on and so forth, when does the clock stop ticking and we run out of time.
There have been several initiatives through NRHA and AHA that have looked at future certification levels and reimbursement models. The problem is, the processes have been at best, dragging. Many small rural hospitals have only one choice. The Critical Access Hospital model has been the only alternative that is available. Coupled with the RHC and you have the only basic model for rural America. This model is not a sustainable model for many hospitals today.
Coupled with the 2% reduction, which ultimately means we lose money on every patient we see, many hospitals will close. Patients will lose access to services and large areas of the nation will see a significant decrease in healthcare access. Across the country, many hospitals rely on a tax base to sustain the financial losses. The trend has been that tax payers will not continue to increase taxes to sustain healthcare services. In some instances that I know of, the tax payers voted down the continuance of the tax base.
One solution has been proposed to have large systems operate and manage rural facilities. I have tried to get interested systems to look at development of a rural health system but they are not willing to look at taking on facilities that have negative operational financials. In addition, the small rural communities do not want to hand over total control to the big brothers. In many cases the tax base would also disappear as the mill levy ballots prohibit tax funds from and county, city or district to go to outside entities.
There is not enough time to keep many facilities up and operating if dramatic changes are not made quickly. In a meeting with a US Senator, his comment was, don’t bring me the, “you have to maintain what we have” options, “bring me a solution that will keep access to healthcare in rural America strong.” Folks, we have failed to do so.
Over the past two years there have been to many discussions about what we can do, but ultimately the ideas get derailed by the “this is not what I need” scenario’s. We have to put individual agenda’s and what’s in it for me thoughts aside and act to save access to rural healthcare for the health of our citizens that choose to live in rural America. If we, as leaders in our communities and within the organizations which we belong, such as NRHA, do not come together and act decisively and quickly, the fate of many rural hospitals is sealed.
Let us come together, let us offer a sound strategy and solution for a new model and let us save access to care for our patients. As an individual standing against a pack of wolves we stand no chance. As a group with many members, we can fight off the initial attacks and we can move forward with strength in numbers. Let us all fight for an evolution of small rural healthcare facilities and let us stand together and get this done. Let us bring a solution to Congress and pave the way to keep access to healthcare in our nations rural areas.