Advocates call rural hospital closures a ‘crisis,’ urge action to be taken

Critical Access Hospital's in Texas. (Provided by Texas Organization of Rural & Community Hospitals)
Critical Access Hospital's in Texas. (Provided by Texas Organization of Rural & Community Hospitals)

AUSTIN (KXAN) — After two rural hospitals in Texas closed their doors this summer, advocates are urging lawmakers to ensure smaller communities aren’t left without emergency health care services.

“Rural hospitals struggle by nature, but what has happened over these last five years are these increased Medicare cuts and underpayments that Medicaid is making… Crockett and Trinity, they’re the latest two victims,” Don McBeath, director of government relations at Texas Organization of Rural & Community Hospitals (TORCH), told KXAN on Monday.

“The rural hospitals are not asking for anything above and beyond what they essentially always had, but they are asking to reverse some of these cuts because that’s what’s put them financially upside down.”

Hospitals in Trinity and Crockett closed their doors on Aug. 1 and July 1, respectively. That means since 2013, there have been 18 rural hospitals across the state which have closed, said Dave Pearson, CEO of TORCH. Of those closures, four were temporary closures, three were replaced with freestanding emergency services or an urgent care center, but 11 of those communities are still without emergency of hospital care.

“The real tragedy is many of these closures could have been avoided and are primarily the result of Medicare cuts by Congress in recent years totaling more than $50 million a year for Texas rural hospitals, coupled with underpayments in the Texas Medicaid program to rural hospitals approaching $60 million a year,” Pearson said in a news release.

During this past regular session, the Texas Legislature directed the Health and Human Services to “evaluate Medicaid funding initiatives for rural inpatient and outpatient hospital services, including determining the percentage of estimated allowable hospital cost reimbursed by payments for services provided to managed care clients; the percentage of wrongful denials; the average wait time for final payment; and any remedies taken to improve compliance of vendors,” according to the agency’s budget.

But, since the report’s findings aren’t due to the Legislative Budget Board and Governor’s Office until Aug. 1, 2019, McBeath said it is likely that additional rural hospitals will close over the next two years unless Medicare funding to affected hospitals improves.

In Central Texas, Lakeside Hospital, the only emergency trauma hospital in Bastrop, closed its doors in 2010 with little to no warning.

And there are a number of rural hospitals in the Central Texas area with 50 or fewer beds.

“Congress and the Texas Legislature have apparently not fully realized the magnitude of the crisis despite our efforts to educate them about the situation,” McBeath said in a news release. “They need to take quick and strong action to put the brakes on the closure slide.”

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