As rural hospitals continue to take financial hits, 59% of critical access hospitals in Nebraska are losing money on operations, according to a Nebraska Hospital Association fourth-quarter report shared with Becker's.
"The previous quarter for our critical access hospitals at the end of Q3 showed about 41% of our critical access hospitals at that point were running a negative margin. So, a pretty dramatic increase," Jeremy Nordquist, president of the Nebraska Hospital Association, told Becker's.
The report also pointed to inadequate Medicaid rates, with only 40% to 60% of costs being reimbursed by Medicaid. This, combined with medical inflation, is part of what NHA suggested has forced state hospitals to reduce or eliminate crucial services, particularly in rural areas.
"What we've seen over the course of the last year is closures of labor and delivery units. We've seen hospital nursing homes that the hospital just can no longer subsidize close, as well as other services like behavioral health services," Mr. Nordquist said.
Along with tackling hospital financial challenges, Mr. Nordquist also pointed to a challenge in the healthcare workforce.
"In Nebraska, almost 20% of our nurses are over the age of 60," he said. "We have a workforce crisis today that we have to grow our way out of in the next decade. That's such a big driver of the financial condition of our hospitals as well."
To combat these challenges, NHA is pointing to Legislative Bill 1087, the Hospital Quality Assurance and Access Assessment Act.
"We are focused on a piece of legislation that would allow us to establish what's called Medicaid directed payment program and basically create a provider assessment that allows us to access additional federal funds into our Medicaid program that will enhance rates for all of our hospitals across the board," Mr. Nordquist said.
On a federal policy level, Mr. Nordquist said it's important to remove the ongoing burden placed on the state's smallest hospitals.
"We need to really look at that 99%-of-cost-based reimbursement that we're down to now in trying to advocate to go back to the 101% that critical access hospitals were previously reimbursed at, but sequestration has taken it down to 99%," he said.