A new report from the AHA highlights the variety of causes that resulted in 136 rural hospital closures from 2010 to 2021, and a record 19 closures in 2020 alone. These include many longstanding pressures, such as low reimbursement, staffing shortages, low patient volume and regulatory barriers, as well as the continued financial challenges associated with the COVID-19 pandemic. Recently, expenses for labor, drugs, supplies and equipment have also increased dramatically, ultimately causing difficulties in maintaining access to care for people in rural communities. 
 
"While many hospitals and health systems are facing unprecedented challenges, those faced in rural America are unique,” said AHA President and CEO Rick Pollack. “We must ensure that hospitals have the support and flexibility they need to continue to be providers of critical services and access points for patients and communities."
 
The report outlines several pathways for rural hospitals to achieve financial sustainability, including additional federal support, flexible models of care, decreased regulatory burden, partnership arrangements and state Medicaid expansion. In addition, AHA continues to urge Congress to extend the Medicare-dependent Hospital and enhanced Low-volume Adjustment programs, which are set to expire this month. The programs provide vital support for geographically isolated rural hospitals with low patient volumes. 
 
“Without the appropriate support and evaluation of existing policies by the state and federal government, rural hospitals will continue to be on life support,” the report notes.

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