A few rural communities chose an emergency-only hospital instead of no local hospital

Rural hospitals continue to face uphill battles to stay open and fiscally afloat. Many have reduced specialty services to cut losses, and hundreds have shut down. To stem closures, the federal government began offering hospitals the option to remain open as emergency care facilities, allowing for higher Medicare funding and reimbursement payments, reports Anna Claire Vollers for Stateline. "But there's a catch: Participating hospitals must stop all inpatient services. No labor and delivery, no inpatient surgeries, no inpatient psychiatric units."

The new designation means rural emergency centers have two patient care options: Treat and release or stabilize and move to a bigger "flagship" hospital, most likely in a metro or urban area. It's a difficult change for communities, but some have decided an ER-focused hospital is a better alternative than no hospital at all. Vollers writes, "More than two dozen hospitals across the country, including five in Mississippi, have taken the offer. . . . Community reaction has been mixed, said Chad Netterville, director of the Mississippi Hospital Association's Rural Health Alliance."

The change isn't a silver bullet for rural hospitals that face multiple issues, including an aging, sicker population and a payer mix that includes more uninsured or under-insured patients. With that combination, many smaller hospitals are deeply in debt, but their closure could hurt rural residents. "Nearly one-third of rural hospitals around the country are at risk of closing, according to a new report from the Center for Healthcare Quality & Payment Reform, a national health policy research group," Vollers reports. "Research suggests rural hospital closures increase community death rates, harm local economies and force patients to travel farther for care."

With few financial tools available, some "27 hospitals have joined the program, out of 1,700 that researchers estimate are eligible, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina," Vollers reports. "In the middle of it all, rural communities are waiting to see what this 'better-than-nothing' approach to health care will mean for them."