Questions raised about future of rural health care

Posted on Tuesday, April 8, 2014 at 10:08 pm

General Manager/Editor Ron Schott

General Manager/Editor Ron Schott

Currently, many Vandalia area residents can easily access area clinics and hospitals for their medical needs.
In spite of living in a rural area, Vandalia has two doctor’s offices and the closest hospital, Audrain Medical Center, in the same county. A third doctor’s office, the Hannibal Clinic, recently closed, keeping its services in Bowling Green.
While area residents are blessed to have the services currently available, two state organizations recently presented troubling information that could forever affect our health care and easy accessibility to it.
According to a survey done by both the Missouri Chamber of Commerce and Industry along with the Missouri Hospital Association (MHA), nearly 1,000 full-time equivalent positions have been reduced in the last six months alone by Missouri’s hospitals. Meanwhile a hiring freeze has been in effect for another 2,145 positions.
A joint press release indicated that “the reductions are in response to federal funding cuts, high uncompensated care costs, and changing utilization patterns.”
The group projects that from 2013-2019, payments received by Missouri’s hospitals from the federal government will reduce by nearly $4 billion.
They note that without Medicaid reform, Missouri’s hospitals will be left “without the new revenue from expanding health insurance coverage to the uninsured.”
The report showed charity care in 2012 was up 32 percent from 2010.
Missouri’s hospitals reportedly have no choice but to address the imbalance of their books by “reducing staff, delaying and canceling planned capital investments, and reducing service lines.”
“We are talking about real community hospitals that will be forced to reduce services or shut their doors,” said Dan Mehan, Missouri Chamber President and CEO in a press release. “We are talking about real people suffering from heart attacks, strokes, or other emergency medical conditions that will have to drive an hour and a half to the nearest hospital.”
The 84 hospitals responding to the survey noted 998 layoffs statewide. Half of the hospitals have a hiring freeze.
The dramatic decrease in funding causes a delay for capital improvement sections or a lost investment.
Mehan said more than $100 million would be eliminated from building improvement projects. He added that it will hurt local clinics and hospitals in being efficient and effective. Tax dollars could be lost on the borders as some state residents might go into other states for their health care needs.
Forty hospitals offered examples of service reduction options they are already taking. Those include the closing of rural health and satellite clinics; ending their home health and hospice; oncology service; hospital provided ambulance services; mental health/counseling services; wound care; and diabetes mobile outreach program.
These institutions are at this difficult decision stage potentially due to the need for medicaid reform, this according a press release on the issue.
Data is showing a need for residents to be insured through Medicaid, through their employer, or through the Affordable Care Act (ACA) marketplace.
Typically, these types of press releases do have some sort of political undertones to them, likely offering up talking points for one political party or another.
Regardless, this information came from a survey and the results of it are troubling. Missouri’s health care facilities are being forced to make tough decisions. At the end of the day, Medicaid changes and the ACA has changed their lives forever.
They are having to make tough decisions to attempt to offset more troubles in future years.
Meredith Corrado’s Rural Surgeons Film Project I wrote about a couple of months back ties into this as well. With these health care facilities making tough choices, the hiring of surgeons at smaller hospitals is going to become an even more challenging process. Her project cannot be any more timely.
At the end of the day, my prayer is for our families to have quick access to the best health facilities as close to home as possible. I hope our state and federal government representatives will stop focusing on scoring political points and spend more time on making the best decisions, whatever they may be, to ensure quality medical care.

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