Rural hospitals and health practices are at risk. But private equity might still be coming for them. With major reforms in health care payment, this would not be a problem.

I once served on the board of a Maine small hospital and at a random board meeting the treasurer reported that we would not be able to meet next week’s payroll unless several payments came through from health insurance companies. Of course, the meeting agenda suddenly changed. About an hour later, the treasurer came back in and informed us two payments had just cleared and we would be OK  … for now.

In our current system, it is hard to be financially successful in rural health. Low volumes of people with good insurance and high volumes for those without — such as mental health, addiction and the rural poor — don’t make for a robust hospital bottom line.

Other countries with universal governmental financed systems don’t leave their hospitals and rural practices with the concern for financial survival, nor allow private equity to extract wealth. Instead, with yearly budgets, these hospitals organize themselves around the needs of the community. They lead out in the community through health districts and consider local needs. Any rural hospital board member would rather hear how the local health district has opened new offices for addiction treatment, mental health or primary care, than just struggling to meet payroll.

So, for their communities, why don’t rural hospital boards look into major health care payment reform?

Henk Goorhuis, MD
Auburn