Why are so many small-town Tennessee hospitals failing?

Jun 7, 2019

Credit cdc.gov

JAMESTOWN, Tenn. (Osborne)    -- Tennessee will likely see another of its rural hospitals close this coming week.

The federal government has announced that it will stop Medicaid/Medicare reimbursements to struggling Jamestown Regional Medical Center on Wednesday. It’s the only hospital in Fentress County, home to some 18,000 people and located north of Crossville near the Kentucky border.

Tennessee Democrats routinely blame the rash of hospital closures on the 2015 rejection of Medicaid expansion by Republican state lawmakers, but a leading medical publication suggests expansion isn’t the only factor contributing to small hospital failure.

Ayla Ellison is Managing Editor of Becker’s Hospital Review. Ellison noted at risk hospitals share several common problems. For example, she said failing institutions are generally located in areas of declining population and see a higher number of uninsured patients.

In addition, Ellison said “The patient population that these hospitals are treating are typically poorer and sicker patients, so they’re using - sometimes - more resources to treat the patient.”

Ellison also said at risk hospitals have a hard time hiring practitioners and can’t afford to buy the latest medical technology.

Thriving rural hospitals also appear to share some common characteristics. Ellison said they tend to make good use of simple, inexpensive technology. She cites telemedicine as an example. They also tend to form partnerships with larger hospitals in nearby cities.

Finally, Ellison said don’t look to Washington for help. She sees no indication Congress will settle on a solution.

“As far as the immediate future, there doesn't appear to be any immediate changes for how rural hospitals are going to be reimbursed,” she said.

Becker’s has published a list of recent hospital closures by state.