"Give us a little help and allow us to keep innovating," says Grande Ronde Hospital CEO Jeremy Davis.
Hospitals everywhere are feeling squeezed, but rural facilities especially are struggling to make ends meet and their mission will be made even more arduous if lawmakers don’t intervene.
Grande Ronde Hospital CEO Jeremy Davis knows that reality better than most as the leader of a nonprofit in rural Oregon, which is why he shared his insight before the Senate Finance Committee in a May hearing called “Rural Health Care: Supporting Lives and Improving Communities.”
Davis’ appearance allowed him advocate for rural hospitals during a time when many facilities are either shutting down or on the brink of closure as provisions from the pandemic run out.
The CARES Act provided rural hospitals with temporary funding and expansion of telehealth, but with capital since drying up and telehealth flexibilities set to expire on December 31, rural health once again needs Congress to take action, Davis told HealthLeaders.
“Now, with that funding having gone, most of these rural hospitals were already struggling heading into the pandemic and the pandemic didn't make them better,” Davis said. “It further challenged vulnerabilities within their operating structure within the reimbursement climate. So now that we're past the pandemic, there's kind of this reckoning and we're starting to see those rural hospitals are picking up steam that are that are vulnerable to closure.”
Since 2020, 37 rural hospitals have closed their doors, according to data compiled by the University of North Carolina’s Cecil G. Sheps Center for Health Services Research.
Many of the ones that remain open aren’t faring much better. A report by healthcare advisory firm Chartis earlier this year found that 50% of rural hospitals are operating at a loss, up from 43% in 2023.
Making telehealth flexibilities permanent, which Davis and many other rural hospital leaders are asking for, isn’t going to solve all of rural health’s problems, but it will help the situation from getting worse.
“Most importantly with some of these telehealth flexibilities, you look at behavioral health in our country. There's just an unmet need and we found as a result of telehealth that a lot of these patients felt more comfortable accessing these services in the comfort of their home because they weren't coming into a clinic and feeling like they were going to be judged and people thinking why they're there,” Davis said. “So we've been building this capacity. We've been trying to expand broadband. We've been doing this for a purpose. We, in some aspects, met the challenges of COVID head on with having some of that infrastructure in place because we had technology. Let's not go back. Let's go forward.”
Outside of telehealth, Davis unsurprisingly highlighted low reimbursement as the other area lawmakers should consider.
Most hospitals and clinics don’t receive adequate reimbursement when it comes to Medicaid or Medicare, Davis said, and the funding rural providers received during the pandemic went a long way to offsetting that.
While the pandemic is over and leaders aren’t necessarily expecting an infusion of $100 billion into hospitals again, Davis just wants a little aid in making it an even playing field for rural health.
“One of the things that I said in my testimony is, as a rural hospital administrator, we're looking for a help up, we’re not looking for a handout,” he said. “We want to be good stewards of the resources. We recognize funding is complex but trust us, enable us. There's a lot of really good people that are working in rural that are used to doing some great things with limited resources.
“As one of our hospitalists told me when I first arrived here, we fight above our weight class. There are a lot of rural hospitals in this country that fight above their weight class. So give us a little help and allow us to keep innovating, keep trying and see some of the amazing things that we can do.”
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Jay Asser is the contributing editor for strategy at HealthLeaders.
KEY TAKEAWAYS
Jeremy Davis, CEO of Oregon-based Grande Ronde Hospital and HealthLeaders Exchange member, recently testified in front of the Senate Finance Committee on rural healthcare, where he emphasized the importance of making telehealth flexibilities permanent and increasing reimbursement.
In an interview with HealthLeaders, Davis explained the difficult positions rural hospitals are in and why Congress is receptive to changes that will address vulnerabilities.