Changing suburban demographics impact hospital systems

An article by Kaiser Health News, "Losing A Hospital In The Heart Of A Small City" reveals a growing and challenging trend. 

The trend is one of hospitals closing their doors in communities they have served for years if not generations.  In this case it's the Cleveland suburbs and the hospital is Lakewood, a part of the Cleveland Clinic heralthcare system.  Lakewood Hospital has reportedly lost money since 2005 and the expectation is that it will close within two years.  To be clear, it will be replaced by a small clinic and emergency room that Cleveland Clinic says will make it a sustainable point of care.

Lakewood is experiencing something that is increasingly common across the country -

The hospital, like others, has fewer patients and they aren’t staying as long – which can cut into revenues. Who is using the hospital is also a factor - there are fewer privately insured and more Medicare and many more Medicaid patients.  As many as 16% of Cleveland population live at the poverty level, up from 2% reported in 2002.

The trend of hospitals closing because of the inability to sustain revenues is a particular problem in rural areas.  Kaiser Health News article, "Georgia Weighs Medicaid Experiment (But Not Expansion)," cites a novel yet not guaranteed approach by the State of Georgia to shore up its rural healthcare. 

While to article unfolds within the politics of the Affordable Care Act and a state that has opposed the law's Medicaid expansion, it highlights the same issue of hospitals not able to sustain a presence where populations are withouht private insurance and reliant on Medicaid -

"Dozens of rural hospitals face funding shortfalls so acute that they threaten access to care for tens of thousands of Georgians across the state. Since 2001, eight rural hospitals have closed and more than a dozen are considered financially fragile."

From a related NAHAM News post ("When a hospital closes"), we find one significant difference in the closure of a rural hospital versus the closure of an urban hospital -

"Rural closures can be devastating when the hospital is the only one in the region."  In an urban area, patients arguably have an easier time finding and getting to alternative care settings.

Since 2010, 50 rural hospitals have closed, 16 of them last year, according to the N.C. Rural Health Research Program.