In a first for Breaking Barriers, we are revisiting a topic of great importance and relevance – the health of rural hospitals. We are excited to welcome my classmate, Dr. Kevin Stevenson, a renowned healthcare executive with a wealth of knowledge and experience in the field. Our discussion will focus on the myriad challenges rural hospitals face and explore potential solutions to these pressing issues.
Dr. Stevenson is a board-certified healthcare executive, with a deep understanding of acute and post-acute operations and governance. His expertise extends to physician engagement, business development, strategy development, marketing, and crisis communications, all of which are crucial elements in the operation and sustainability of rural hospitals.
Beyond his executive role, Dr. Stevenson hosts the podcast ‘I Don’t Care with Dr. Kevin Stevenson‘ on MarketScale Radio, where he often discusses pressing issues in healthcare, including the challenges faced by rural hospitals.
Dr. Stevenson’s leadership has been recognized in his roles as Past President of the American College of Healthcare Executives for both the Central Texas and North Texas Chapters. His commitment to community service is evident in his involvement in the Waco community, where he serves on several boards and committees. His insights from these experiences will undoubtedly shed light on the community aspect of rural healthcare.
In the realm of education, Dr. Stevenson has twice been elected to the Board of Trustees of the 38,000-student Keller Independent School District in Texas, where he served as President for two years. His perspective on the intersection of education and healthcare will provide a unique lens through which to examine the state of rural hospitals.
Join us as we delve deeper into the challenges, triumphs, and future of rural healthcare with Dr. Stevenson.
The Challenges of Rural Hospitals
Rural hospitals across the United States face a multitude of challenges, many of which have been exacerbated by the COVID-19 pandemic. These include:
- Limited Resources: Rural hospitals often operate on tight budgets and may lack the financial resources to invest in advanced medical equipment or hire specialized staff.
- Staffing Shortages: Recruiting and retaining qualified medical professionals can be challenging in rural areas, leading to staffing shortages.
- Access to Care: Due to their remote locations, rural hospitals may struggle to provide comprehensive healthcare services to their communities, leading to gaps in care.
- Transportation Issues: Patients in rural areas often have to travel long distances to reach the nearest hospital, which can delay treatment in emergency situations.
- Lower Patient Volume: Rural hospitals often have lower patient volumes compared to urban hospitals, which can impact their revenue and financial stability.
- Lack of Specialty Services: Rural hospitals may not have the resources to offer specialized medical services, forcing patients to travel to urban areas for certain treatments.
- Telemedicine Infrastructure: While telemedicine has the potential to greatly improve access to healthcare in rural areas, many rural hospitals lack the necessary infrastructure and technology.
- Insurance and Reimbursement Challenges: Rural hospitals often serve a higher percentage of patients who are uninsured or underinsured, which can lead to financial difficulties.
- Aging Population: Rural areas often have a higher proportion of elderly residents who require more healthcare services, putting additional strain on rural hospitals.
- Closure of Rural Hospitals: Over the past decade, many rural hospitals have closed due to financial difficulties, further limiting access to healthcare in rural communities.
A Conversation
During our conversation, Dr. Stevenson highlighted how the pandemic had exacerbated existing challenges for rural healthcare providers. The cost of staffing had skyrocketed, leaving many hospitals financially strained. Rural hospitals, which had already struggled to attract healthcare professionals, found themselves in an even more precarious position as staffing costs soared.
“Line staff and that’s really been exacerbated in rural healthcare because they already had an issue getting people in there and now they were relying, a lot of rural hospitals even before the pandemic were relying on contract labor. “
Furthermore, the changes in healthcare coverage during the pandemic added to the financial stress. Many individuals lost insurance or became underinsured, impacting rural hospitals’ ability to collect payments for services rendered. Managed care companies offered meager reimbursement rates, causing further strain on already stretched resources.
“With the change in the overall workforce that so many people, lost coverage or or had yeah or became underinsured or uninsured, of course. So then you start looking at it from the from the collection side. “
“Hospitals were having a hard time having a hard time with. That you’re seeing just the compression on all of healthcare with cost going up and with with collections and reimbursements such as they are, managed care even the last year we had a 20% increase in in salary. ”
“Wages and benefits, and we still have managed care companies come to us with like 2 and 3% reduction for all contracts. It’s like have you not seen you what’s going on with hospitals and health systems? “
The conversation took a closer look at the political and economic factors contributing to the predicament of rural hospitals. Dr. Stevenson revealed that some hospitals in Texas, for example, were kept open due to pressure from oil-rich communities, despite the lack of inpatient admissions or a local physician. These hospitals relied heavily on public funds and were seen as sources of community pride, making it difficult for them to close their doors.
As the discussion continued, the focus shifted to potential solutions. Dr. Stevenson mentioned the emerging policy of designating rural hospitals as “rural emergency hospitals,” which provided a lifeline for struggling facilities. This designation allowed them to receive federal funds to retool and reshape their services, focusing on outpatient care and ancillary support for emergency departments. However, Dr. Stevenson acknowledged that while this policy had potential, a significant number of rural hospitals would still face closure without public funds.
“Typically a hospital is going to be one of the largest employers in the in the city or in the county, and it’s a source of pride for communities to have a hospital. “
In the end, their conversation shed light on the immense stress faced by rural hospitals. The financial challenges, staffing issues, and political dynamics combine to create an uphill battle for these vital healthcare institutions. As policymakers grapple with the complex task of revitalizing rural healthcare, it becomes increasingly clear that innovative solutions, adequate funding, and a comprehensive understanding of the challenges are essential to secure the future of these vulnerable hospitals.