Bram Sable-Smith, who spent a year doing in-depth reporting on an endangered rural hospital in Pemiscot County, Mo., as part of an AHCJ Reporting Fellowship on Health Care Performance, did a tip sheet on how to report on the threat to rural hospitals, in the context of a wave of closures.
The former health & wealth reporter at KBIA-Columbia, Mo., and Side Effects Public Media, who is now transitioning to a freelance career in Madison, Wis., notes that at least 87 rural hospitals have closed across the country since 2010, around 700 more are at risk of closing and 41 percent operate with negative margins – i.e., they are losing money.
The problem is generally more intense in states that have declined to expand Medicaid under the Affordable Care Act. The payer mix – the role of Medicaid and Medicare in particular – is a key part of the rural health care economics, he notes. And IRS 990 forms – particularly if examined carefully for changes and trends over the years – are a particularly valuable reporting tool.
Beyond Sable-Smith’s work, rural health – particularly hospital and maternity ward closures – has been getting some much needed attention of late. Among the more notable pieces published recently is this harrowing New York Times piece story by Jack Healy: “Today,” Healy wrote, “researchers estimate that fewer than half of the country’s rural counties still have a hospital that offers obstetric care, an absence that adds to the obstacles rural women face in getting health care.”
North Dakota Sen. Heidi Heitkampf pointed to some of the concerns catching the eye of senators from rural states in a recent episode of the Pulsecheck Podcast with Dan Diamond. “I think rural health care is on life support,” she said.