Already in fiscal crisis, rural hospitals face COVID-19

LDI’s Eighth virtual ‘Experts at Home’ seminar on May 29 brought together top academic and government experts to discuss the impact of the COVID-19 pandemic on rural health and hospitals.

As COVID-19 continues its accelerating spread from high-density cities into rural counties, the Leonard Davis Institute of Health Economics (LDI) focused its eighth virtual seminar on rural populations' unique pandemic-related vulnerabilities. 

Two vehicles parked outside the Harris Sub-Regional Clinic in Alaska

Entitled “Rural Health in America During COVID-19,” the session brought together top rural health experts and was moderated by LDI Senior Fellow Joanna Hart, an assistant professor of medicine at the Perelman School of Medicine and head of LDI’s newly-formed Rural Health and Policy Research Working Group.

“The 20% of the U.S. population that lives in rural areas consists of generally older individuals with more chronic conditions who are more likely to be under or uninsured,” said Hart. “They are more likely to be experiencing poverty and have limited access to health care. Even before COVID-19, rural hospitals faced significant financial challenges and operational limitations. The volume and acuity of COVID-19 cases in those areas will quickly overwhelm the very limited resources of many rural communities.”

The plight of rural hospitals has been a subject of much concern and debate in recent years; since 2005, 172 of these facilities have closed. Last year, the number of closings set an annual record as 15 more rural hospitals went under, leaving their surrounding communities without the kind of care only hospitals can provide.

“Rural hospitals tend to have lower days of cash on hand, and higher rates of negative operating margins,” said panelist Lisa Davis, director of the Pennsylvania Office of Rural Health and Outreach. “So they’ve been struggling traditionally. Then, a pandemic like COVID-19 comes along and they need to essentially pivot on a dime and close down service lines that tend to bring in revenues such as surgery, outpatient services, emergency departments. They don’t have the economies of scale to be able to rely on other sources of revenue.”

Read more at Penn LDI.