July 18, 2015
Rural hospitals are more important than ever. And they are struggling harder to keep their doors open than ever before. Ten Alabama hospital closed their doors in the past three years; 17 statewide since 2000, reported a recent AL.com article. Fewer than 100 acute care hospitals remain viable in the state now, 50 of which meet federal criteria to be considered rural, according to the Alabama Hospital Association. These hospitals treat 110,000 patients annually and deliver 10,000 babies every year. In a recent study called ‘Rural Hospitals at a Crossroads,’ AHA offers many reasons why rural hospitals are the lifeblood of the state: • They provide emergency medical care to those in need • They provide preventative health care to rural communities • They employ thousands and drive local economies • They help attract and keep local businesses because most major employers won’t locate in a community without a hospital In other words, rural hospitals are essential in a state like Alabama where 40 percent of the population lives outside an urban area. Fortunately for the 130,000 people living in the communities of Marshall County and the surrounding area, the two hospitals here remain healthy and viable. Marshall Medical Centers are modern, efficient hospitals. Marshall North and South are community-owned, not-for-profit hospitals which make it their mission to provide world-class health care locally. The goal is to offer the health care people need close to their home so they don’t have to travel to a large city to get it. Having to travel for medical attention is a large cause of people going without health care. Citizen’s Bank & Trust President Mike Alred is chairman of the Marshall County Healthcare Authority, which is the governance board responsible for the hospitals. He credits Marshall Medical Centers' staying power to its ability to maintain the small hospital atmosphere while staying competitive in the ever-changing world of medicine. “We’ve kept that smaller community touch you don’t always get in a big-city hospital,” Alred said. “At the same time, the quality of the medical care we provide is at least equal to, if not better than, the services you would get in Huntsville or Birmingham. We don’t try to do everything, but the things we do, we do them very well. We have excellent physicians, dedicated staff and modern equipment and facilities. And, it’s provided right here, at home, by people you know.” Convenient access to healthcare is not only beneficial, but at times can be crucial, especially in emergencies like natural disasters. At such times when treatment must be immediate, rural hospitals can save lives. Sometimes, this may mean stabilizing the patient for transportation to a trauma center or facility with more specialized services. Other times it means caring for someone until their family can be reached. Marshall has helped bring many new medical specialties to the community in recent years. Oncology, vascular surgery, pulmonology and dermatology are just a few. However, primary care remains the backbone of any medical community. “Primary care is at the core of what we do,” said Gary Gore, CEO of Marshall Medical Centers. “We are blessed to have the quality and number of great primary care doctors in this area. Our goal is to maintain a balance of primary care and specialties appropriate for the size of our community”. Many causes are responsible for the fact that 45 percent of rural hospitals operate in the red. Alabama’s rural hospitals average an operating margin of 1.1 percent, according to the AHA. The state has the lowest revenue-per-discharge rates in the country. The result is that when reimbursements do not cover the costs of hospital services cuts have to be made. Hospital budgets are being hit hard from three areas: • No Medicaid expansion in Alabama • $220 billion in Medicare cuts to hospital services • Alabama’s low wage index which helps determine Medicare reimbursement rates. Regrettably, these factors compound the difficulty of trying to keep a hospital going against the odds. It’s often simply impossible to successfully provide health care in a rural environment. But the leadership of Marshall Medical Centers is proud that it has been embraced and supported by a community that recognizes the importance of nearby medical services. As the second-largest employer in Marshall County and with a $140 million budget, the economic impact of two hospitals with 1,200 employees is extremely important. “A community focus is very important,” Gore added. “We may not be perfect and we may not be able to do everything, but you can be assured that we are going to do everything possible to make Marshall Medical Centers the best it can be. We live here too and there’s no greater motivator than that.”