JACKSON, Mississippi (AP) — More than half of Mississippi’s rural hospitals are at risk of closing immediately or in the near future, according to the state’s top public health official.
dr Daniel Edney, the state health commissioner, spoke Monday at a hearing with state senators about the financial pressures on Mississippi hospitals. Edney said 54% of the state’s rural hospitals – 38 – could close. The potential closures threaten to worsen poor health outcomes in one of the poorest states in the country.
“This is a situation that is unsustainable from an economic perspective — losing 54% of our hospitals in the state — let alone from an access-to-care perspective,” Edney said.
Rural hospitals were under economic pressure before the COVID-19 pandemic, and problems have worsened as the cost of providing care has risen. The high number of low-income people in Mississippi who are uninsured means hospitals are looking to provide more free care. At the same time, labor costs weigh on hospitals as they struggle to pay competitive wages to retain staff.
“The cost of an income statement for a hospital has skyrocketed,” said Scott Christensen, chair of the Mississippi Hospital Association board of governors. “Liabilities on the balance sheets of hospitals across the state have reached unsustainable levels given what lies ahead.”
At the heart of the problem Mississippi hospitals are facing is that revenues have not kept pace with rising costs, Christensen said.
The strain is most acute in the Mississippi Delta region, an agricultural plain where poverty is entrenched. Greenwood Leflore Hospital has been cutting costs by cutting services and reducing its workforce for months. But the medical facility failed to avert the risk of an impending closure. Hospital leaders say they will be out of business before the end of the year without a cash injection.
Maternity wards at Greenwood Leflore and other hospitals across the state have been on the chopping block. Mississippi already has the highest fetal mortality rate, the highest infant mortality rate, and the highest rate of preterm birth in the country, and is one of the states with the worst maternal mortality rates.
About 60% of Mississippi births in 2020 were funded by Medicaid, according to the Kaiser Family Foundation.
Healthcare deserts are emerging in the delta, but financial pressures are also on hospitals in more affluent areas of the state, experts said at the hearing. But hospitals in poor areas often treat patients who are uninsured and cannot afford to pay for out-of-pocket care. Expanding Medicaid coverage would reduce the costs associated with unpaid care.
Gov. Tate Reeves and other Republican leaders have rejected proposals to expand Medicaid, which primarily covers low-income workers whose jobs don’t offer private health insurance. Opponents of the expansion say they don’t want to encourage reliance on government aid for people who don’t need it.
As a short-term solution, the Mississippi Hospital Association has proposed that the state Medicaid department work with federal officials to raise the Medicaid reimbursement rate ceiling to a higher level. The move would reduce the cost of care for people already covered under the state’s current Medicaid plan.
Democratic Senator Hob Bryan, who called the hearing, said the financial outlook for Mississippi’s hospitals is a “market failure” that deserves full attention.
“What we need is someone somewhere in the state government tasked with figuring out what healthcare should look like now and five and 10 years from now,” Bryan said. “Unless I’m terribly confused, there is no one in your state government who has this charge.”
This story has been corrected to show that the number of closed rural hospitals accounts for 54% of all rural hospitals, not all hospitals.
Michael Goldberg is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that brings journalists into local newsrooms to cover undercover topics. Follow him on Twitter at twitter.com/mikergoldberg.
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