Why are Rural Healthcare Providers Under Such Tremendous Pressure?


Despite challenging environment, rural hospitals remain the lifeblood of many communities

A love letter to rural hospitals 

Rural hospitals provide more than just healthcare to their patients, they provide jobs, economic boosters, recruiting panache for local companies, and an overall sense of belonging in the community. They are the heartbeat of a community. And yet they are facing challenges at every turn.

Rural hospitals are often the lifeblood of a community, both literally and figuratively. Thirty-five percent of all community hospitals are rural. (AHA) and Georgia houses 3% of all community hospitals (AHA). Since 2010, Georgia has seen seven rural hospitals close – the third most in the country. Rural hospitals are facing onslaughts from all sides. In addition to the challenges we discussed extensively in “What’s next in the rural healthcare crisis,” some additional challenges include the following:

  • One in five adults in the South report having poor health. Fifteen percent of non-elderly residents are uninsured, according to the Kaiser Family Foundation, and that’s 5 percent higher than the rest of the country.
  • In 2018 (the latest year data is available), poverty rates in rural Georgia were 21%. (USDA)
  • The Office of the Attorney General reports that Georgia is also among the top 11 states with the most opioid overdose deaths, and 55 Georgia counties have an overdose rate higher than the national average.
  • Rural areas have more frequent occurrences of diabetes and coronary heart disease than non-rural areas. (Rural Health Web)
  • Lower incomes and higher rates of uninsured people contribute to higher levels of uncompensated hospital care — meaning many people are unable to pay their hospital bills.
  • Over 40% of rural hospitals nationally operate at a negative margin, meaning they lose more money than they earn from operations, Chartis reports.
  • Politics have played a part, from states declining to expand Medicare to reductions in Medicare payments and cutbacks to “bad debt1” repayments from the ACA.

The threat of closures looms for nearly 700 more rural hospitals over the next decade, according to Alan Morgan, the CEO of the National Rural Health Association. And these closures are disproportionately concentrated in the south. When a rural hospital closes, it is not only detrimental to the patients, it has a severe economic impact as well.  Some of those consequences include

  • Mortality rates rise 5.9%, according to a study done by University of Washington.
  • One reason for that rise in mortality rates is the impact of the “golden hour,” which refers to the time following heart attacks, trauma and stroke in which treatment is needed to prevent loss of heart muscle and brain tissue.
  • Greater likelihood of higher-risk, preterm births.
  • Care for mental health and substance use sharply declines, which explains the dramatic rise in suicide by rural youth.
  • When a community loses its only hospital, per capita income falls by about 4 percent, and the unemployment increases by 1.6 percentage points, according to Health Services Research.

An article that was written in partnership with Georgia Health and Huffpost, opens with this line: “If you want to watch a rural community die, kill its hospital.”

It’s a jarring statement, but, for all intents and purposes, it’s true. Rural hospitals are under tremendous pressure – and they are held to the same standards as other hospitals despite the lack of funds. While there is no silver bullet, we at Secure Records Solutions have had the pleasure of partnering with rural hospitals and helping in the areas of our focus – creating efficiencies in hospitals by reducing paper processes without paying to scan everything. Because at the end of the day, rural hospitals are held to the same regulations and requirements as healthcare providers in larger, urban areas. So we do our best to help keep their costs down while creating much-needed efficiencies. And we say thank you. We thank them for their tireless effort, for the patient care they give, and for all the benefits they provide to our broader communities.


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