COVID Worsened Shortages of Doctors and Nurses. Five Years On, Rural Hospitals Still Struggle

Posted on by lad3

Even by rural hospital standards, Keokuk County Hospital and Clinics in southeastern Iowa is small.

The 14-bed hospital, in Sigourney, doesn’t do surgeries or deliver babies. The small 24-hour emergency room is overseen by two full-time doctors.

CEO Matt Ives wants to hire a third doctor, but he said finding physicians for a rural area has been challenging since the covid-19 pandemic. He said several physicians at his hospital have retired since the start of the pandemic, and others have decided to stop practicing certain types of care, particularly emergency care.

Another rural hospital is down the road, about a 40-minute drive east. Washington County Hospital and Clinics has 22 beds and is experiencing similar staffing struggles. “Over the course of the last few years, we’ve had not only the pandemic, but we’ve had kind of an aging physician workforce that has been retiring,” said Todd Patterson, CEO.

The pandemic was difficult for health workers. Many endured long hours, and the stresses on the nation’s health care system prompted more workers than usual to quit or retire.

Read more.

Report: 100 Rural Hospitals Have Closed Labor and Delivery in 5 Years

Posted on by lad3

From Becker’s Hospital Review

Labor and delivery services have ended or are set to end at 100 rural hospitals since the end of 2020, highlighting a growing maternal health access crisis across the U.S.

The findings come from the Center for Healthcare Quality and Payment Reform’s most recent report on rural maternity care. Since the beginning of 2025, Becker’s has also reported on 13 maternity service closures, with four alone closing in Maine.

The report also revealed that 42% of U.S. rural hospitals still provide labor and delivery services, with less than one-third offering the services in 10 states. Over 130 rural hospitals that still deliver babies lost money in the last two years and could be forced to close the services to maintain financial sustainability.

Travel time to access labor and delivery services in rural areas has also increased. In many urban areas, the services are often accessible in less than 20 minutes, but in rural areas, travel times can take as much as 30 to 50 minutes.

“Rural maternity care is in a state of crisis, and more women and babies in rural communities will die unnecessarily until the crisis is resolved,” the report said. “Federal and state government officials and private employers must take immediate action to ensure that all health insurance plans are paying adequately to support high-quality maternity care in every community.”

Below are 10 states from the report that have seen heightened levels of labor and delivery unit closures since 2020. Their drive time to hospitals with labor and delivery services along with the number of rural hospitals with no labor and delivery services in 2025 are also listed, per the report.

CHQPR’s full report can be accessed here.

1. Alabama

  • Labor and delivery unit closures since 2020: Three
  • Rural hospitals with no labor and delivery services in 2025: 36
  • Median drive time to hospitals with labor and delivery services: 45 minutes

2. Connecticut

  • Labor and delivery unit closures since 2020: One
  • Rural hospitals with no labor and delivery services in 2025: One
  • Median drive time to hospitals with labor and delivery services: 31 minutes

3. Florida

  • Labor and delivery unit closures since 2020: Two
  • Rural hospitals with no labor and delivery services in 2025: 20
  • Median drive time to hospitals with labor and delivery services: 50 minutes

4. Idaho

  • Labor and delivery unit closures since 2020: Three
  • Rural hospitals with no labor and delivery services  in 2025: 14
  • Median drive time to hospitals with labor and delivery services: 39 minutes

5. Illinois

  • Labor and delivery unit closures since 2020: Four
  • Rural hospitals with no labor and delivery in 2025: 58
  • Median drive time to hospitals with labor and delivery services: 32 minutes

6. Indiana

  • Labor and delivery unit closures since 2020: 11
  • Rural hospitals with no labor and delivery services in 2025: 29
  • Median drive time to hospitals with labor and delivery services: 30 minutes

7. Maine

  • Labor and delivery unit closures since 2020: Six
  • Rural hospitals with no labor and delivery services in 2025: 13
  • Median drive time to hospitals with labor and delivery services: 41 minutes

8. Ohio

  • Labor and delivery unit closures since 2020: Eight
  • Rural hospitals with no labor and delivery services in 2025: 38
  • Median drive time to hospitals with labor and delivery services: 30 minutes

9. Pennsylvania

  • Labor and delivery unit closures since 2020: Four
  • Rural hospitals with no labor and delivery services in 2025: 31
  • Median drive time to hospitals with labor and delivery services: 39 minutes

10. Wyoming

  • Labor and delivery unit closures since 2020: Three
  • Rural hospitals with no labor and delivery services in 2025: 11
  • Median drive time to hospitals with labor and delivery services: 60 minutes

PHC4 Releases New Reports, Displaying Utilization Insights, at a County-Level

Posted on by lad3

The Pennsylvania Health Care Cost Containment Council (PHC4) published a new set of County-Level Utilization Reports today, displaying the overall total number of inpatient hospitalizations and ambulatory/outpatient cases for Pennsylvania residents.

The information reflects outpatient data from hospital outpatient departments and ambulatory procedure data from freestanding ambulatory surgery centers in Pennsylvania from Quarter 3 of 2024. Also reflected is inpatient data for the same time period from acute care, long-term acute care, rehabilitation, psychiatric, and specialty hospitals, presenting a spectrum of focused data, at a county-level.

Barry D. Buckingham, PHC4’s Executive Director, believes that these reports provide a wealth of insight for stakeholders. “Providing these quarterly County-Level Utilization Reports supports a consistent supply of fact-based data. These insights represent a vast range of facility data and are amongst the timeliest reports available to stakeholders.” The reports are updated every quarter and show the number of cases for each county, with breakouts by patient age, sex, and payer.

These quarterly reports portray the current climate of public health in Pennsylvania and provide focus and perspective. The County-Level Utilization Reports are valued resources for local communities, health care professionals, and policymakers. By fostering a data-driven approach to health care, PHC4 envisions a healthier, more resilient society where resources are allocated effectively, and lives are improved. PHC4 aims to continue to serve its mission of empowering Pennsylvanians through transparency.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.

For more information, visit phc4.org or access the reports here.

States Ranked by Potential Coverage Losses under Medicaid Work Requirements

Posted on by lad3

From Becker’s Hospital Review

California is projected to experience the largest potential losses in Medicaid coverage if federal work requirements are enacted, according to an analysis released by the Urban Institute on April 14.

Approximately five million adults across the country could lose Medicaid coverage next year under a possible federal mandate requiring adults aged 19 to 55 in Medicaid expansion states to work. At least 10,000 adults in nearly every expansion state could lose coverage, with the largest losses occurring in the most populous states.

These coverage reductions are likely to stem from a lack of awareness or confusion about the new policy, rather than from enrollees failing to work. The extent of the losses could also vary depending on the final policy and how each state implements the work requirements.

The study examined a proposal that would withhold federal funds for adult Medicaid enrollees in expansion states who do not report working at least 80 hours per month, or who do not meet exemption criteria such as being a student, caregiver, or having a disability. Similar legislation has been proposed in several states this year.

States ranked by potential coverage losses under Medicaid work requirements:

  • California: 1 to 1.2 million
  • New York: 743,000 to 846,000
  • Illinois: 193,000 to 220,000
  • Pennsylvania: 174,000 to 198,000
  • North Carolina: 171,000 to 195,000
  • Arizona: 166,000 to 189,000
  • Ohio: 158,000 to 180,000
  • Michigan: 145,000 to 165,000
  • Washington: 121,000 to 138,000
  • Kentucky: 120,000 to 136,000
  • Louisiana: 116,000 to 132,000
  • New Jersey: 115,000 to 131,000
  • Indiana: 102,000 to 116,000
  • Virginia: 98,000 to 111,000
  • Maryland: 95,000 to 109,000
  • Colorado: 95,000 to 108,000
  • Massachusetts: 86,000 to 98,000
  • Oregon: 83,000 to 95,000
  • New Mexico: 75,000 to 86,000
  • Connecticut: 74,000 to 85,000
  • Missouri: 69,000 to 78,000
  • Minnesota: 67,000 to 76,000
  • Arkansas: 62,000 to 70,000
  • Nevada: 59,000 to 67,000
  • Oklahoma: 47,000 to 53,000
  • West Virginia: 38,000 to 44,000
  • Iowa: 34,000 to 39,000
  • District of Columbia: 26,000 to 30,000
  • Rhode Island: 25,000 to 29,000
  • Hawaii: 24,000 to 27,000
  • Montana: 23,000 to 27,000
  • Utah: 20,000 to 23,000
  • Idaho: 17,000 to 20,000
  • Delaware: 17,000 to 20,000
  • New Hampshire: 17,000 to 19,000
  • Nebraska: 13,000 to 15,000
  • Maine: 11,000 to 13,000
  • Alaska: 10,000 to 11,000
  • South Dakota: 8,000 to 9,000
  • Vermont: 7,000 to 8,000
  • North Dakota: 5,000 to 6,000

Share of US Adults Who Are “Unable to Afford or Access Quality Health Care” Reaches Record High

Posted on by vfl5083

According to a recent Gallup poll, the number of U.S. adults unable to afford or access quality health care has risen by 3 percentage points since 2021, reaching a record high of 11%, or about 29 million people. The steepest increases were seen among low-income and minority groups: Hispanic adults rose 8 points to 18%, Black adults rose 5 points to 14%, and those earning under $24,000 annually rose 11 points to 25%. Over the same period, the share of adults considered “cost secure” dropped significantly, especially among Hispanic adults (down 17 points to 34%) and Black adults (down 13 points to 41%). These shifts underscore the widening gap in health care access and affordability since 2021 – and the important role of CHCs.

Need Data on Medicaid and SNAP?

Posted on by vfl5083

The Pennsylvania Department of Human Services publishes data on Medicaid and SNAP enrollees by county and congressional district. As of February 2025, PA had 3,009,860 individuals accessing Medicaid which is 23.17% of the population. In 2015, Pennsylvania implemented Medicaid Expansion, part of the Affordable Care Act that allows low-income people to obtain health care coverage. The SNAP data includes an interactive map by county and age group. The United States Department of Agriculture’s Economic Research Center found that for every $1 issued in federal SNAP benefits, it helps grow our economy by $1.54 Click here to access the PA Department of Human Services Dashboard.

Provider Groups Calling for Congress to Bolster Visa Waivers

Posted on by vfl5083

More than three dozen healthcare associations and organizations wrote a letter calling on House and Senate leaders for action on a bill bolstering foreign-born physician recruitment to underserved areas. The letters speak to the Conrad 30 Waiver program and support a pair of bills introduced last month that would increase the number of waivers allotted per state, among other “common sense changes.” Read more.

Providing Oral Health Care in Rural Areas

Posted on by vfl5083

This distance from places like dental offices and grocery stores makes it challenging for patients in rural areas to have good oral health. Dr. Jessica Robertson, DMD, shares patients are only coming to town once a month to get their groceries. So, their perishables will be done and over within the first two weeks. And then the next two weeks are just ultra-processed foods, which are high in sugar and salt. Read more about Dr. Robertson’s efforts to improve oral health in rural areas Voices from the Field.

Final Recommendation Statement: Primary Care Behavioral Counseling Interventions to Support Breastfeeding

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The U.S. Preventive Services Task Force released a final recommendation statement on primary care behavioral counseling interventions to support breastfeeding in JAMA. Clinicians can help improve the health of babies by providing interventions that support breastfeeding. Visit the April 8 online issue of JAMA to view the recommendation, the evidence on which it is based, and a summary for clinicians.