JACKSON, Miss. (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 chief public health official.
State health official Dr. Daniel Edney spoke to state senators during a hearing Monday about the financial strain on Mississippi hospitals. Edney said 54% of the state’s rural hospitals – 38 – could be closed. The potential closure threatens to worsen poor health outcomes in one of the nation’s poorest states.
“It is a situation that is intolerable from an economic perspective – losing 54% of our hospitals in the state – much less from a 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 rises. The high number of low-income people in Mississippi means hospitals are on the hook for more uncompensated care. At the same time, labor costs weigh heavily on hospitals as they struggle to pay competitive wages to retain staff.
“The costs on the hospital’s income statement have skyrocketed,” said Scott Christensen, chairman of the Mississippi Hospital Association Board of Governors. “Liabilities on the balance sheets of hospitals across the state have reached some of the unsustainable levels we are facing.”
Christensen said the crux of the problem facing Mississippi’s hospitals is that revenues haven’t kept pace with rising costs.
Tensions are most acute in the Delta region of the Mississippi, an agricultural flatland where poverty persists, Greenwood LeFlore Hospital has been cutting costs for months by reducing services and reducing its workforce. But the medical facility has not been able to avert the risk of imminent closure. Hospital chiefs say they will be out of business before the end of the year without cash infusion,
At Greenwood LeFlore and other hospitals across the state, maternity care units are on the chopping block. Mississippi already has the nation’s highest fetal mortality rate, highest infant mortality rate and highest pre-term birth rate, and is one of the worst states for maternal mortality.
According to the Kaiser Family Foundation, about 60% of births in Mississippi in 2020 were funded by Medicaid.
Experts at the hearing said a growing number of health care deserts are emerging in the Delta, but hospitals in more affluent areas of the state are under financial pressure. But hospitals in poor communities often treat patients who don’t have insurance and can’t afford the care out of pocket. The expansion of Medicaid coverage would reduce the costs that result from uncompensated care.
Gov. Tate Reeves and other Republican leaders have killed proposals to expand Medicaid, which primarily covers low-income workers whose jobs don’t provide private health insurance. Opponents of the expansion say they do not want to encourage dependence on government aid for those who do not need it.
As a near-term solution, the Mississippi Hospital Association suggests the state’s Medicaid department work with federal officials to raise the Medicaid reimbursement rate cap to a higher level. The move would lower the cost of providing care for people who are already covered under the state’s existing Medicaid plan.
Democratic Sen. Hobb Bryan, who convened the hearing, said the financial outlook for Mississippi’s hospitals is a “market failure” that needs full-time attention.
“We need someone, somewhere in state government, who is charged with taking the health care that we want to see down five and 10 years from now,” Bryan said. “Unless I am very confused, there is no one in your state government who has this charge.”
This story has been corrected to reflect that the number of rural hospitals closing is 54% of all rural hospitals, not all hospitals.
Michael Goldberg is a core member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a non-profit national service program that places journalists in local newsrooms to report on undercover issues. follow him on twitter twitter.com/mikergoldberg,