In the past decade, the volume of Medicare inpatient discharges increased at urban hospitals and decreased at rural hospitals. Decline in inpatient volume can have very real financial consequences for rural hospitals and the communities they serve. The project goals were to compare the decline in inpatient volume of rural hospitals to urban hospitals, to assess whether decline in inpatient volume has been greater in rural hospitals that serve disadvantaged communities, and to investigate whether decline in inpatient volume of rural hospitals has been associated with changes in net patient revenue from outpatient services, profitability, financial distress, and hospital closure.

Decline in inpatient volume can have very real financial and community consequences for rural hospitals. This reality has prompted MedPAC and others to state that the inpatient-centric basis of current rural hospital payment model needs to be revised. This study provided a better understanding of how decline in inpatient volume may pose potential threats to rural hospital financial viability and the communities served by them.

Publications

• Decline in Inpatient Volume at Rural Hospitals
  Journal Article
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 12/2020
  This study examined inpatient volume in rural hospitals between 2011 and 2017. Patient population and the organizational and geographic characteristics of hospitals that were significant predictors of inpatient volume included census region, Medicare payment type, ownership type, total margin, and percent of the population in poverty.