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Prevent the demise of rural American hospitals


While it often takes hours by car to access the best medical care, rural hospitals are essential. Whether it’s in northern Illinois or small town Oklahoma, rural hospitals are the backbone of our communities. They don’t just provide essential health care to communities, they also boost the local economy and are among the region’s largest employers.

The COVID-19 pandemic is pushing many rural hospitals to the brink of extinction and poses a serious threat to America’s rural economies. Even before this public health crisis, rural hospitals faced financial uncertainty. Until 2020, half of all rural hospitals were operating with negative margins and one in four was at risk of closing. Nationwide, 120 hospitals have been closed over the past decade, and 2019 was the worst year so far for that grim statistic. When a rural hospital closes, jobs disappear, doctors leave and patients lose access to care. Neighboring businesses struggle to stay afloat, and families are often forced to put down roots.

We cannot allow this to continue.

The COVID-19 pandemic has accelerated and exacerbated the tensions facing our rural hospitals. All hospitals were forced to acquire additional personal protective equipment (PPE) and to reduce and / or postpone elective and outpatient services. Nationally, 76 percent of rural hospital revenues come from these elective surgeries. And with the shift in transmission of COVID-19 to rural areas, our hospitals, especially those located near particularly vulnerable populations such as nursing homes or meat processing facilities, are seeing an increase in cases. and hospital capacity constraints. On average, rural hospitals have only one month of cash.

According to the American Hospital Association, hospitals have already lost about $ 202 billion since the start of the pandemic, with another forecast of $ 120 billion in losses in 2020. But more than numbers on a financial sheet, if a hospital closes because of this pandemic, there would be catastrophic long-term consequences for the community.

In the last two coronavirus relief programs, Congress has provided $ 175 billion to meet the immediate emergency funding needs of hospitals and providers. These funds have helped close a fraction of the huge cash flow shortages that rural hospitals face, but more measures are needed to ensure the stability of the most vulnerable hospitals for the months and years to come.

Many readers may think things are going so badly in Washington, DC right now that Republicans and Democrats can’t work together on anything. But when it comes to preserving rural hospitals, we can and must work together.

We introduced the Rural Hospital Closure Relief Act, which would update Medicare’s Critical Access Hospital designation to enable some of the most vulnerable rural hospitals (those suffering financial losses in areas where providers are in short supply and serving low-income communities) to benefit from quality for higher health insurance payments. Specifically, our bill would restore the power of states, which ended in 2006, to provide flexibility in the requirement that an eligible critical access hospital be within 35 miles of another hospital. This 35 mile threshold does not always reflect all the circumstances or needs of rural areas.

In Illinois and Oklahoma, as well as states like Tennessee, New York, Iowa, and Kentucky, dozens of hospitals would qualify for this financial lifeline and provide the stability needed to continue serving. their communities with quality care.

There are many ideas for meeting the challenges of rural health care delivery, and we support many of these proposals. The cost of inaction is felt across rural America. If a progressive Democrat and a conservative Republican can find common ground, so should the rest of the US Senate. That is why we must pass and pass the bipartisan law on shutting down rural hospitals before it is too late for too many communities.

Durbin is the Senate Minority Whip and sits on the Supply Committee. Lankford is the junior senator from Oklahoma and is a member of the Credit Committee.