Several types of special rural designations have been created. These are:
Rural hospitals face a series of issues. These include workforce shortages, rising health care costs, aging hospital facilities, finding access to capital, and purchasing new information systems. Rural hospitals are smaller in size, and have limited assets and financial reserves. Rural hospitals offer a broad range of services to meet the needs of their communities however, they often provide limited services in areas such as cardiac, alcohol and drug, psychiatric, and neonatal.
Rural hospitals have a higher amount of Medicare and Medicaid patients due to their populations being older. Patients may lack health insurance. Rural residents may have lower incomes and are more likely to suffer from chronic diseases.
Patients may lack transportation to reach alternative hospitals and may suffer from reductions in access to care when rural hospitals close.
Health reform for small and rural hospitals brings both opportunities and challenges.
Expansion of coverage should help improve access to care. The law includes various Medicare payment protections to enhance reimbursements to hospitals. Incentive programs and changes aimed at helping rural hospitals include rural physician incentive payments, low-volume hospitals payment adjustments, changes to graduate medical education resident placement, and changes in CAH, home health, and laboratory service payments.
Challenges including reimbursement rates, information technology, remoteness, low population density, financial resources to upgrade facilities, and primary care physician shortages, and other workforce shortages will continue.
Last Reviewed: 7/16/2013