By Brandon Moseley
Alabama Political Reporter
Rural hospitals have really felt the impact of the economic downturn that has hit the state of Alabama (and the country as a whole) since early 2008. Many rural hospitals are struggling to retain doctors and stay open. The latest casualty is the Chilton County Hospital which announced its closing on Monday.
Rep. Kurt Wallace (R) from Maplesville wrote on Facebook, “Many of you know this by now…but this is a really sad day for Chilton County. The notice went out today that the Chilton County hospital is being closed. There have been literally dozens of people working night and day to keep the doors open. Senator Cam Ward and myself have been working with the Governor’s staff to do anything we could to keep it open. The Chilton County Hospital Board has worked tirelessly to keep it open. But, unfortunately our efforts were not enough. I had conversations with the Director of Alabama Department of Public Health, the Director of the C.O.N. board, and the Governor’s staff today. I am confident that in the near future we will be re-opening the hospital. Sometimes things just don’t turn out the way we want them to. Please keep the hospital staff in your prayers. Many families will be adversely affected by the events of this day.”
Rep. Wallace said on Facebook, “Based on the conversations I had today, the hospital can apply for a new C.O.N. And there are other hospitals that are interested in buying and operating the hospital. We will pursue these options going forward.” “I also want you all to know the downfall of this hospital rests solely with the ownership and not the current management staff. Ted Chapin and his staff have worked miracles with very few resources. It is amazing that it has survived this long under these circumstances.”
To operate a hospital in the state of Alabama you have to obtain a Certificate of Need from the state of Alabama Certificate of Need Board which regulates Alabama hospitals. When the state revokes the Certificate of Need a hospital can not operate.
During economic downturns people lose their jobs and most people’s health benefits are associated with their jobs thus hospitals get both fewer patients and more patients without the ability to pay. Costs associated with implementing new regulations with the Patient Protection and Affordable Care Act have also affected hospitals operating margins. Since the largest payer of medical bills in the country is Medicare and Medicaid what hospitals can charge for those patients is set by the government, thus cash strapped hospitals can not raise their rates to fit their economic circumstances. Additionally individual hospitals have to accept negotiated prices with private insurers like Blue Cross Blue Shield of Alabama, United Healthcare, Healthsprings, and Humana to remain in those insurers’ provider networks. Large urban hospitals are able to make up for these economic pressures by increasing the volume of patients. Small rural hospitals lose patients as more and more specialists are moving their practices to the larger hospitals in and around urban centers of the state to achieve larger patient volumes necessary to operate economically in this environment. Patients from rural Alabama are having to drive farther and farther distances to obtain services especially for things like knee replacements or births.