Geographic Variation in the Profitability of Urban and Rural Hospitals

The popular business quote “No margin, no mission” succinctly states the importance of profitability. The notion that if a hospital doesn’t make enough money to keep its doors open, its higher purpose is moot may be a simplistic view, but historic and recent evidence suggest that unprofitability can reduce hospital services and quality, or worse,… Read more »

Geographic Variation in Risk of Financial Distress among Rural Hospitals

From 2005 to 2015, 112 rural hospital closures have been identified (North Carolina Rural Health Research Program, 2015). Although six of these closed hospitals have since reopened, the remaining closures impact millions of rural residents in communities that are typically older and poorer, more dependent on public insurance programs, and in worse health than residents… Read more »

Prediction of Financial Distress among Rural Hospitals

From 2005 through 2015, more than 100 rural hospitals have closed their doors to patients in need of inpatient services. Though a handful of these closed hospitals have since reopened, the remaining closures leave millions of rural residents at greater risk of negative health and economic hardship due to the loss of local acute care services.  Policymakers,… Read more »

Estimated Costs of Rural Freestanding Emergency Departments

Since 2005, more than 100 rural hospitals have closed and more are at risk. Rural hospital closures jeopardize access to emergency services in the affected communities. As communities react to and/or prepare for closures, providers and policy makers seek a viable alternative for emergency services provided in a rural hospital setting. A rural freestanding emergency… Read more »

Estimating Eligibility and Uptake of Federally Facilitated Marketplace Insurance in North Carolina in the Second Open Enrollment Period

As the Federally Facilitated Marketplace (FFM) enters its third open enrollment period, focus is shifting toward examining which communities have lower uptake in coverage and how to increase enrollment. In national analysis of the first open enrollment period, Holmes and colleagues found that rural areas had lower rates of plan selections. However, these estimates are… Read more »

A Comparison of Closed Rural Hospitals and Perceived Impact

From 2010 through 2014, 47 rural hospitals,  ceased providing inpatient services in 23 states across the country (“closed”). Among the 47 closed hospitals, 26 hospitals no longer provide any health care services (“abandoned”), and 21 continue to provide a mix of health services but no inpatient care (“converted”). These closures have affected approximately 800,000 people… Read more »