Considerations of hospital viability in rural Texas

The rural hospitals in Texas face the same situation as rural hospitals throughout the country. Unfortunately, little data are available to define the scope or possible duration of the problem. However, rural hospital administrators currently believe that their facilities are being hurt by increased government regulation and that today's figures on average daily census indicate that the problem could threaten their hospital's long-term viability. Initial investigations have shown that the problem of casualty is a complex one; multiple factors interact to exacerbate the situation, such as more stringent enforcement of Medicare certification standards, review of claims and quality of care by PROs, and the use of PPS. Other factors cited include the economic recession, the exodus of young people from rural areas to urban areas, the high cost of technology, and the preadmission review by insurance companies. A study that will both sample and survey rural hospital viability using financial ratio analysis and service utilization data is presently being undertaken to provide some responses to these concerns. Further, it will later examine how rural hospital administrators are responding to the problem of decreased hospital viability. It is possible that new coping strategies may be developed from the study results that will change present modes of health care delivery and result in regional networks and more diversified health care services.