“The financial viability of our rural hospitals is declining,” says lead author and SPH Assistant Professor @c_e_carroll. @Health_Affairs @UMNRHRC https://t.co/diZLMcqMUv

Marika Cabral & I are organizing another virtual mentoring workshop for 3rd+ yr women/non-binary PhD students in health economics/health policy on Sep 29, 2023. To apply please fill out this form: https://t.co/A2svP99tH9 AND send 1-page proposal & CV to info@cswep.org.

Exploring the fate of unprofitable #RuralHospitals, @UMN's @c_e_carroll + coauthors find that 77% remained open during 2010–18, whereas 7% closed, 4% merged w/ another hospital in the same market & 13% merged w/ another hospital in a different market. #NationalPublicHealthWeek

With persistent financial distress among rural hospitals and continued consolidation, it’s important to think about how policy can support care in rural areas. Financial support to preserve access may need to be paired with regulation to address market power concerns.

At the market level, about 20% of markets served by unprofitable hospitals lost a competitor to closure or within-market merger. Out-of-market mergers affected about 30% of markets with unprofitable hospitals.

Most unprofitable hospitals (77%) continued to operate through 2018 without closure or merger. About half of these hospitals returned to profitability.

We study rural hospitals that were unprofitable in 2010 and track them through 2018. We found that 7% of unprofitable rural hospitals closed and 17% merged, mostly with competitors from outside their local market.

Low patient volumes and reliance on public payers make it hard for rural hospitals to cover the cost of care delivery. As a result, many rural hospitals have become unprofitable. Survival of unprofitable hospitals directly affects access to care and competition in rural markets

Thanks to @alanrweil and @Health_Affairs for discussing our paper on #AHealthPodyssey! We study what happens to unprofitable rural hospitals – do they close, merge, or return to profitability? With @Michael_Chernew, @ndbeaulieu10 and Rhi Euhus A short 🧵

Supporting high quality, affordable care in rural areas is immensely important. Working w/ Rhi, @ndbeaulieu10, and @c_e_carroll is wonderful, but this is just a beginning. Many empirical & policy issues remain. For starters: what are best payment models and regulatory regimes

Study in @Health_Affairs by Associate Professor Caitlin Carroll, PhD Rhiannon Euhus, Nancy Beaulieu, PhD and @Michael_Chernew investigates the the closures and mergers of rural hospitals Read about it here:

Exploring the fate of unprofitable rural hospitals, @c_e_carroll of @UMN + coauthors find that 77% remained open during 2010–18, whereas 7% closed, 4% merged w/ another hospital in the same market, and 13% merged w/ another hospital in a different market. #RuralHospitals

Not entirely surprising, but WOW: immuno-onc pretty much hit peak adoption within 2y. https://t.co/ZGm1tAyQUv by @c_e_carroll @Mblandrum Alexi Wright & @NancyKeatingMD For context, @SethRobey & I found median drug takes ~7y post-launch to hit peak ( https://t.co/5H1i0aAwJC).

They also highlight a really fantastic piece by @c_e_carroll @Arrianna_Planey @Katybkoz that describes the evolving complexity of rural health care markets (consolidation, bypass behaviors, and more). I learned a ton reading it. https://t.co/QmxAwXZcOv

Thanks to @AcademyHealth and @JHospMedicine for spotlighting some recent work on rural hospital closures. They contextualize: 1) ⬇️ economic trends in areas where rural hospitals eventually close 2) Role of bystander hospitals that remain open after closures occur

We also highlight papers on rural hospitals by @ChatterjeePaula, @atheendar, @thomas_hegland, Hannah Friedman, @gmarkholmes in the October issue of HSR. Check them out!

Second, how should we pay for rural hospital care, when maintaining services is valuable? Many rural hospitals get cost-based reimbursement (CAHs), but there are new models in the works. Rural Emergency Hospitals, for ex, will get lump sum payments, plus a fee for each patient.

We pose two key questions. First, what hospital infrastructure is needed in rural areas? Local access is important for patients who need emergency care, but patients with chronic/complex conditions may benefit from getting care at specialized, regional facilities.

Thanks to @AcademyHealth for highlighting our commentary on rural hospitals! https://t.co/cCZHLmA32v With @Arrianna_Planey and @katybkoz. @HSR_HRET