The Daily Yonder recently posted an Analysis on Why Rural Hospitals are Closing. It’s an interesting look at various factors – worth reading especially if you aren’t living it. Part of the answer is that people aren’t saying in rural hospitals anymore. Younger people choose to go elsewhere when they can and even older folks are going for procedures but not to recuperate. Part of the reason I suspect that hospitals are getting less use is that telehealth tools do allow people to stay home longer.

It’s nice to see that telehealth is addressed in a proposed solution that would keep health care options in rural areas– the Rural Emergency Care Hospital Act…

Senator Chuck Grassley (R) of Iowa and Senator Cory Gardner (R) of Colorado have introduced Senate  Bill 1648, “The Rural Emergency Care Hospital Act.” The act would reduce hospitals’ financial reliance on vanishing inpatients.

The act would let rural hospitals with fewer than 50 beds, including Critical Access Hospitals, be re-designated as “Rural Emergency Hospitals.”  Such hospitals could maintain an emergency room and  ambulance and telemedicine services, as well as other traditional hospital functions, including convalescent skilled nursing care. But they could stop providing acute inpatient care.  Medicare would pay the hospital 110 percent of its costs of emergency room and ambulance services.  The hospitals would be permitted to charge Medicare for the costs of telemedicine back-up.  The emergency rooms and physicians staffing them would have to meet some new quality requirements.

The bill would let small rural hospitals save money by getting out of the inpatient care business.  They would be generously reimbursed for their emergency care, including “observing” patients, that is, keeping them for a day or so.

Would these changes be sufficient to keep failing small rural hospitals afloat?  That depends on whether local people use them.