By Paula Walter
Leaders in Congress have been working on replacing the Affordable Care Act that was implemented under President Obama. Some of the proposed cuts to the program included drastic changes to Medicaid, or TennCare in Tennessee. These changes could negatively impact Tennessee and other rural sections of the country where TennCare or other Medicaid state programs provide healthcare for many.
According to a “State by State Breakdown of 80 Rural Hospitals Closures” from Becker’s Hospital Review, Tennessee takes the lead in the country in the rate of rural hospital closings. Many of these hospitals receive funding from federal programs, such as Medicaid. If funding is cut, these facilities could be on the cutting block. In Tennessee alone, there are 108 medical and surgical hospitals.
According to data collected from the Tennessee Joint Annual Reports on Hospitals, if changes are made to TennCare, 37 hospitals could see large cuts or even closings. If they close, 26 counties in Tennessee would not have a hospital. This includes Johnson County. Not only would these closings have a negative health impact on the community and its people, but also could result in job loss and a blow to the state’s economy.
According to “Economic Impact of Rural Health Care” from the National Center for Rural Health Works, hospitals are one of the largest employers. Should cuts be made, there are over 14,000 people in the state who could face the possibility of losing their jobs. The Johnson County Community Hospital is considered to be one of the hospitals at risk. Figures show 73 people are employed at Johnson County’s only hospital.
According to data from Healthcare Management Partners, LLC, rural hospitals are faced with different challenges than hospitals in larger cities. These hospitals rely more on payments from the government than city hospitals. In 2015, Medicare or Medicaid reimbursed more than 63 percent of rural hospitals inpatient days. Enrollment in these programs is typically higher in rural communities than larger cities.
“There’s no question that rural hospitals all across America are struggling, and the rural hospitals in our area are no exception. Nationwide, 80 rural hospitals have closed since 2010. Mountain States currently operates six rural hospitals in Tennessee and Virginia, employing 1,136 people,” said Anthony Keck, senior vice president and chief development officer of Mountain States Health Alliance. “Not only are these facilities important outposts for critical health services, but also centers of employment and economic activity. Right now, one of the issues most critical to the sustainability of rural hospitals in our area is the proposed merger between Mountain States and Wellmont Health System. A primary goal of our proposed merger is to generate synergies that would allow us to continue offering necessary health services in our rural communities.”