The Consolidated Appropriations Act of 2021 established the rural emergency hospital to tackle the growing concerns over the closures of rural hospitals.
The rural emergency hospital is an important mechanism to preserve vital access to health care services at rural hospitals which are vulnerable to closure.
The aim is to streamline financial resources to only outpatient and emergency services as a way to ensure health care access in rural communities. A core set of outpatient services will be preserved including primary care, maternal care, and mental health, ultimately improving health outcomes. Additional payments can be used to expand access to unavailable outpatient services including preventive screening mammography or colonoscopy.
However, patients requiring inpatient hospital services will need to be transferred to larger centres. Patients may in fact benefit from this as they would be treated at a specialised centre for more dedicated expertise. For example, for complex cancer conditions, this opportunity may lead to better quality of care. However, capacity constraints in rural hospitals is a long-standing issue; rural emergency hospitals may find it an issue to identify an accepting hospital with sufficient capacity.
Rural emergency hospitals may also preserve jobs for local health care workers and an increased reimbursement for outpatient services may even expand practices for outpatient clinicians. On the other hand, it may be more of an issue to recruit and retain clinicians who can provide a broad range of services required in rural communities. For example, it may be more difficult to recruit general surgeons who can perform a range of procedures without available inpatient services that are usually required in their practice.
There is strong potential for rural emergency hospitals to maintain health care access to people in rural areas. However proactive monitoring for unintended consequences will be needed, as well as ample resources to ensure hospitals can provide intended services.
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