Abstract for: How might a rural hospital adapt to prevent closure? (Best Poster Award Winner)

Rural hospitals are closing where patient populations are most vulnerable. As a result, rural patients and rural economies suffer. When hospitals cite the factors that provoke a closure, they look outward, to factors beyond their control: low patient volumes; high number of uninsured patients; low reimbursement rates; difficulty in getting payment from private insurance providers; and low Medicaid and Medicare rates. We built a model to understand what a hospital could control, and the role innovation and efficiency could play in supporting the stabilization of a rural hospital’s finances. Our results indicate that a hospital can adapt to balance a loss of earnings, but only to a point. When losses fall by 30% per user per month, our hospital no longer has a realistic mitigating mechanism via innovation. This lends support to the necessity of government intervention to improve earnings per patient (through Medicaid expansion for example) to save rural hospitals from closure.