Per Ostmo, Grand Forks

There are 37 Critical Access Hospitals (CAHs) in the state of North Dakota. The CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. It is not uncommon for small rural hospitals to operate on margins of less than 1%, and nearly 50% of rural hospitals across the country operate in the red.

New research from Chartis, a research institution that specializes in rural health, examined the impact that Medicaid has on rural hospital finance. The key findings should be alarming to all policy-makers and rural residents.

First, at the median, Medicaid represents $3.9 million to a rural hospital’s bottom line — more than 9% of total hospital net revenue. It is inconceivable that small rural hospitals could make up for this lost revenue. Hospitals are often the largest contributor to small town economies, and hospital closures can be the death knell for small communities.

A second key finding of Chartis’ research helps illustrate this point. A 15% loss in Medicaid revenue is equivalent to more than 21,000 full-time hospital employees across the country. In rural America, the loss of a single primary care provider can result in hospital closure, because that hospital may no longer meet minimum staffing requirements to remain operational.

Make no mistake, cuts to Medicaid will result in loss of service, increase preventable deaths, and destroy rural economies.