America’s Rural Hospitals Are Dangerously Fragile

Source: Brian Alexander, The Atlantic, January 9, 2018

… Last November, however, Circleville’s voters chose another direction, one that, in other places, has resulted in an economic hit to the community—mostly in the form of job losses and stagnant wages—as well as a lowered quality of care. At the urging of city and county leaders, and Berger’s administrators, residents voted to allow local politicians and the hospital’s board to begin a process to turn Berger, one of the last publicly owned and operated hospitals in the state, into a nonprofit private corporation. Following that, Berger would most likely be integrated into a larger regional system, probably the Columbus-based nonprofit Ohio Health, with which Berger has an ongoing relationship. …
 
… Hospitals have been struggling—especially independent public and/or nonprofit hospitals located in smaller cities and rural towns. Last year, for example, the National Rural Health Association, a nonprofit, estimated that 673 rural facilities (with a variety of ownership structures) were at risk of closure, out of over 2,000. And with the new tax legislation, and events like the merger of the drugstore chain CVS and the insurer Aetna, the turmoil looks to get worse. In response, stand-alone nonprofit hospitals have been auctioning off their real estate to investors, selling themselves to for-profit chains or private-equity firms, or, like Berger, folding themselves into regional health systems. …