Iowa -- Over 60 million Americans live in rural communities, and their health depends on rural hospitals, but a new analysis from a Chicago-based consulting company reveals many of those rural hospitals are at risk of closure, especially in Iowa.
Nearly 18 percent of Iowa's rural facilities are struggling financially. In the past nine years, Iowa hasn't seen a single one of its 118 hospitals close its doors, but that all might change if things don't improve financially for rural facilities.
"Rural hospitals, rural medical care is a tough business right now for a number of reasons," Scott McIntyre, Vice President of Communications for Iowa Hospital Association said.
The Iowa Hospital Association says no single hospital is in danger of immediate closure, but there are some that are heading in that direction.
"We've seen some hospitals that have cut back a little bit. We've seen some hospitals not fill positions, which is tough because these hospitals don't have a lot of employees to start with,” McIntyre said.
An analysis on rural hospital sustainability shows out of Iowa's 95 rural hospitals, 17 of them are at a high risk of closing.
Clarke County Hospital in Osceola is not on the list of high risk, but CEO Brian Evans says he understands why others are, and it comes down to being dependent on government programs and not having enough patients to make up for those losses.
"I think as you start to see hospitals in Iowa that are running into financial issues, it's related to the Medicaid program and changes that are happening within the state, and within the Medicaid program,” Evans said. “Hospitals [are] just not getting reimbursed for services that they provide to the Medicaid patients."
But this problem is deeper than rural Iowans having access to healthcare.
"Hospitals are one of the few last places for small communities to attract young, growing families,” McIntyre said.
This same study shows out of those 17 at-risk rural hospitals, 15 of them are considered essential to their communities.
“There are certain things that organizations look for in a community when they look to relocate and healthcare is one of them,” Evans said. “Having a strong hospital, having a strong clinic providing primary care is very important to economic development.”
The challenge isn't isolated to just Iowa. Rural hospitals are at risk of closing in 34 states. The problem is most severe in Alabama, where 21 of the state's 42 rural hospitals are at risk of closure.