• Timothy Osborn

Rural healthcare in crisis!

Rural counties in America are suffering the greatest threat to healthcare in recent years...

Approximately 102 rural hospitals have closed between 2010 and 2019 according to the Rural Report published by the American Hospital Association. The loss of critical access hospitals and healthcare services is significantly impacting healthcare accessibility within the heartland of America.


States that adopted the Medicaid expansion opportunities provided by the ACA - "The Affordable Care Act" tend to be doing better than those states which have not clearly moved toward formal Medicaid expansion for uninsured individuals. The decline of rural healthcare is staggering and it should be alarming to the vast majority of individuals in our country. Much effort needs to be accomplished and taken by state legislators, community leaders and healthcare practitioners (especially those serving rural communities) to assure sustainable, accessible and affordable healthcare is available to rural communities.


I grew up in a small town along the Ohio River in Southeastern Indiana. The community was knit together by common beliefs, family ties and similar needs and challenges. There is nothing more beautiful than the joy of living in a rural community, but equally there is nothing more tragic than to be facing a medical emergency and knowing your closest hospital is more than 25 miles away. Sadly, these nightmares are becoming more real every day in rural communities.


The Osborn Group, LLC has allocated specific resources, talent and focus on developing solutions for rural healthcare providers, hospitals and communities in an effort to be a part of the solution for rural communities struggling with access to quality healthcare services, and a voice of change within the political culture that we face in the healthcare debate today. Politics fall to the wayside when a healthcare emergency hits home and someone is standing in the emergency waiting room wondering if a family member will live or die. Healthcare is about "providing care and addressing matters of health". You cannot have a healthcare system when the current political climate undermines what it means to care.


The economic impact of one critical access hospital within a rural community is profound. On average, 170 jobs are created and salaries or wages further contribute approximately $7 million to the local economy (not including property taxes, county/city taxes or other additional economic benefit). When a rural community looses a hospital, the impact is substantial and will most likely be felt for many years to come. One such story can be found in the article entitled "Tennessee's Rural Hospitals are Dying Off - Who's Next". The article addresses the fact that the state of Tennessee has lost 10 rural hospitals since 2010 and currently 15 additional rural hospitals are noted to be at "high risk" of closure. This is just unacceptable in a modern age where healthcare services should be more widely accessible and affordable.


What is happening in rural communities causing the decling trend and healthcare crisis we see today?


1. Many states have not adopted the Medicaid expansion opportunities under the ACA "Affordable Care Act" which has prevented access to billions of dollars of funding for state Medicaid programs. The funding would further supply high poverty communities (of which many are rural) with increased health insurance coverage for uninsured individuals reducing the burden of indigent care on hospital and/or healthcare service providers. Every state needs to specifically assess whether participation in Medicaid expansion is needed to assure adequate healthcare services are covered and remain available and accessible.


2. Rural community leaders, in some regions of the country, have not served their communities well when failure to promote emphasis on healthcare initiatives is overlooked during the process of creating economic development plans. I'm proud of my small town in Indiana because they did have the foresight to incorporate emergency services, medical facilities

and community development within the economic development goals that were created when the casino industry moved into the Ohio River valley. The communities along the Ohio River leveraged their positions to require casino operators to "contribute" toward community based projects such as EMS services, medical facilities, fire department equipment, parks, and public improvements - that was smart! Rural community leaders need to plan for healthcare in the future by assessing and addressing economic development goals today. Too often, rural communities develop a false expectation that someone will take care of it or help them if they need it; but, as in the case of Tennessee's hospital crisis - no one is stepping up to bail out the systematic healthcare problems facing rural communities. Rural community leaders need to employ sound judgment, leadership, specific strategy and engage future thinking to assure healthcare services are available, accessible and sustainable. It's not just the "state's problem". Where is local leadership?


3. One of the greatest strengths of a rural community is found in the collective ability of community residents to pull together and overcome significant challenges or serve one another with true heartfelt compassion and effort. If ever rural communities need to come together, now is the time and "healthcare" must be a part of that discussion and recipient of that effort. Town hall meetings, focus groups or task force teams should be created to identify a strategic plan for solving the rural healthcare challenges of the community. Potential partners for this effort could be local foundations, non profit organizations and/or philanthropic individuals. At minimum, each rural community should plan and be proactive vs. facing the loss of a significant healthcare provider and wondering how to pick up the pieces later. Start today and don't wait for tomorrow. The crisis is real.


If your community would like to begin the discussion of access to rural healthcare and address the potential crisis you may face regarding the sustainability of healthcare services, potential loss of emergency services provided by a hospital, or the need to develop a comprehensive needs assessment or strategic plan with specific emphasis on future healthcare needs - we would love to help facilitate that discussion and effort. The healthcare consulting team of The Osborn Group, LLC consists of seasoned healthcare executives, practitioners and financing experts with specific tenures in rural healthcare markets. It would be our honor to serve with you.

(C) Copyright 2019 - The Osborn Group, LLC - All rights reserved. Sharing is permitted and appreciated.


About the Author - Timothy G. Osborn is the Senior Consultant/Founder at The Osborn Group, LLC where "we build top talented teams to enhance and create next level solutions for operations, leadership development, content marketing, healthcare consulting, engagement, talent acquisition, startups and business growth!"


"Expect exceptional experiences every time!"


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