The COVID-19 pandemic disrupted everyday life in the U.S., and it wreaked havoc on our healthcare system. Hospitals lost revenue and were forced to lay off workers, a consequence of fewer visits to the emergency department and the postponement of non-urgent procedures.

The American Hospital Association has estimated that U.S. hospitals are seeing a $50 billion-per-month negative impact from COVID-19 as costs rise and revenues plummet. Hospital operating margins, already ultra-thin at an average of 2% prior to the pandemic, have also taken a hit. According to a report from Kaufman Hall, hospital operating margins fell 96% in the first seven months of 2020 compared to the same period in 2019.

For rural hospitals, which generally exist on thin margins even in the best of times, the situation has only grown more dire. Just last year, at least 14 rural hospitals have closed in the U.S. This has incredibly adverse effects on population health and patient outcomes, as a 2019 study found that “death rates in the communities increase by nearly 6% after a rural hospital closes.”

Since 2010, 133 rural hospitals across 34 states have closed, and 21% of the nation’s 430 rural hospitals were already at high-risk of closure prior to the pandemic without improvements to their financial situations, according to Navigant Health. And just since the start of the pandemic, these safety net hospitals have reported a 20-30% loss in revenue, according to America’s Essential Hospitals.

Often the first point of contact in the health care system for Americans, many rural hospitals provided the necessary critical care close to home, even as their limited resources were taxed further as some urban hospitals sought help to transfer COVID-19 patients to rural facilities where beds were available. While providing quality healthcare to rural areas has never been easy, the challenges have increased over the last few years and the pandemic only exacerbated these problems.

Approximately 60 million people – about one in five Americans – rely on rural healthcare, and the challenges for these hospitals have intensified to the point that it must be addressed. So, in 2019, the American Hospital Association (AHA) gathered rural hospital and healthcare leaders to create the Future of Rural Health Care Task Force, which released its recommendations last month for addressing this crisis.

One of the Task Force’s recommendations is for rural hospitals to form strategic partnerships and affiliations. Several members of the Task Force noted that forming strategic alliances, “helped their organizations respond more effectively and efficiently to the pandemic.”

For example, many rural hospitals remain unequipped to treat certain patients. A partnership with an urban facility could provide access to technology and expanded services. However, in these scenarios, which are becoming more and more common, patients generally must be transported to more advanced facilities, such as trauma centers, that are better equipped to treat their conditions.

In that case, rural hospitals can serve as an entry point for larger hospital systems, which the Task Force suggests can result in “synergies that benefit both entities and the populations they serve.”

To make these synergies possible air ambulances often serve as flying emergency rooms with lifesaving equipment and highly trained staff treating critical patients in the air while transporting them to facilities offering more advanced care. Air Methods is proud to be part of rural communities throughout the U.S. and partner with both rural and urban hospitals to provide that connection point and extend access to more advanced healthcare in rural America.

The State of Rural Healthcare in the U.S.