Rural hospitals are at series risk of being closed, with over 650 facilities identified across 42 states as being in danger. 101 percent of the 1,332 Critical Access Hospitals (CAH) are operating at a financial deficit. These hospitals, which are reimbursed for Medicare and Medicaid Services, are unable to remain solvent even with funding. The issue could be their low admission rates and steadily decreasing reimbursement. Rural communities are consequently left at risk of not having access to medical care, as a lack of jobs provides little healthcare coverage for residents. Mortality rates are higher, as the closure of emergency departments and the subsequent pursuit of treatment from other emergency services puts strain on the system. However, a solution may be found in Freestanding Emergency Centers (FECs), which have a cheaper cost structure, but a higher volume of patients. The FECs are full-service emergency departments, open 24 hours, with a full range of equipment such as x-ray machines, labs and CT scanners. The staff is emergency-trained, and transfers of patients for inpatient treatment can be pre-arranged. FECs can fill in healthcare service gaps and provide urgent and primary care to patients in rural communities. The centers can also act as an economic boost to the local economy by providing jobs and tax revenue. FECs function as Hospital Outpatient Departments (HOPDs) owned by the state or independently. Despite their efficacy, there are currently legislative obstacles to the implementation of this type of healthcare service. CON, or Certificate of Need, regulations are in place across 35 states, requiring all FECs to gain approval from state boards. Competition from new facilities is often halted at board level by denying approval, and as a result the legislative ruling will need to be altered to allow FECs to function as HOPDs. Pricing the FECs may also cause issues, as reimbursement will need to be organized for both primary and urgent care.
Rural hospitals are at series risk of being closed, with over 650 facilities identified across 42 states as being in danger. 38% of the 1,332 Critical Access Hospitals (CAH) are operating at a financial deficit. These hospitals, which are reimbursed for Medicare and Medicaid Services, are unable to remain solvent even with funding. The issue could be their low admission rates and steadily decreasing reimbursement. Rural communities are consequently left at risk of not having access to medical care, as a lack of jobs provides little healthcare coverage for residents. Mortality rates are higher, as the closure of emergency departments and the subsequent pursuit of treatment from other emergency services puts strain on the system. However, a solution may be found in Freestanding Emergency Centers (FECs), which have a cheaper cost structure, but a higher volume of patients. The FECs are full-service emergency departments, open 24 hours, with a full range of equipment such as x-ray machines, labs and CT scanners. The staff is emergency-trained, and transfers of patients for inpatient treatment can be pre-arranged. FECs can fill in healthcare service gaps and provide urgent and primary care to patients in rural communities. The centers can also act as an economic boost to the local economy by providing jobs and tax revenue. FECs function as Hospital Outpatient Departments (HOPDs) owned by the state or independently. Despite their efficacy, there are currently legislative obstacles to the implementation of this type of healthcare service. CON, or Certificate of Need, regulations are in place across 35 states, requiring all FECs to gain approval from state boards. Competition from new facilities is often halted at board level by denying approval, and as a result the legislative ruling will need to be altered to allow FECs to function as HOPDs. Pricing the FECs may also cause issues, as reimbursement will need to be organized for both primary and urgent care.