Hospitals across the country continue to raise concerns about their struggles to stay afloat. A forum Monday night, "Hospitals in Critical Condition," a Fluence Forum with Blois Olson on WCCO Radio will focus on struggles felt by the country's health systems.
Hundreds of rural hospitals across the country are facing closures after years of funding problems, but that struggle is also being felt by hospitals in the core of the largest U.S. cities as well.
That is highlighted by the fight for Hennepin County Medical Center to stay afloat in Minneapolis. That system is facing closure unless state funding is granted through the Minnesota Legislature.
HCMC is the state's premier level one trauma center, that treated patients following last year's Annunciation Church shooting, and is frequently the first stop for the most dire of emergency situations in the state.
The head of the hospital board, Hennepin County Commissioner Jeffrey Lunde, says they were able to find $50 million dollars in cuts in order to survive the first quarter of the year - but they still have to find $125 million more to cut by the end of the year, a massive number they say isn't survivable.
"We just want to be clear to everyone that the situation at HCMC is dire," Lunde says.
The issue was compounded last summer by the Trump administration’s massive cuts to Medicaid, the government’s safety net for low-income Americans, whose reimbursements have long helped hospitals meet their bottom lines.
One of the experts joining the forums is United Hospital District CEO Rick Ash, who tells the WCCO Morning News with Vineeta Sawkar that OBGYN and delivery programs in rural Minnesota have been hit especially hard.
"About 11 years ago when I first got here, we had OB in every county around us," says Ash. "Today, 19 programs across Minnesota have closed, and patients are driving 60-plus miles to give birth. And not to get into too much detail, but we've had a couple of occurrences where it's been nip-and-tuck for babies. Fortunately we were here."
Outcry over the funding cuts prompted Republican lawmakers to create $50 billion in new rural health grants, but critics say that funding is intended for innovative health care delivery solutions — not propping up hospitals buckling under current pressures.
“It won’t pay to keep the lights on. And it won’t turn the lights back on once they’ve been turned off,” said Dr. Ben Young, an infectious disease specialist and policy expert with public health advocacy group Wellness Equity Alliance.
Administrators say the new $50 billion fund is not meant to shore up ailing rural hospitals or maintain the status quo, but to transform rural health care through tech, workforce and other innovations. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz in a December video said it “gives states the tools to design solutions that last, not Band-Aids that fail.”
However, Ash says the crisis is becoming so widespread, he believes every hospital in the state is feeling the financial strain, with a shocking admission of significant loss coming off as a positive in his eyes.
"We are fortunate that we've been doing fairly well," Ash says of United Hospital, where he works. "We've only lost $1 million so far this year, and we've been able to find ways to cover that. But it's going to continue to get worse. I know hospitals colleagues that are trying to make payroll, trying to get short-term financing just to make payroll."
Cuts to Medicaid funding vary by state. In Minnesota, the state is looking at a 15% cut, which amounts to approximately $19 billion over the next decade, and that's money hospital systems can't come close to making up.
As for that $50 billion coming from the Trump administration to rural hospitals? It amounts to just over $193 million.
Cuts by state
AP graphic
Significant number of hospitals across the country facing financial distress
Minnesota hospitals, and many across the U.S., are facing a severe financial and operational crisis.
Nearly 25% of the hospitals in Minnesota are in financial distress, with many, including major urban safety net facilities like Hennepin Healthcare, at risk of closing.
But why? What's happened?
There are a number of factors at work like those federal funding cuts, which will eventually slash billions of dollars in health care funding.
Also, government programs like Medicaid often don't reimburse hospitals at the same cost of the care. This is compounded by a growing number of uninsured patients or even underinsured patients, leaving hospitals with huge amounts of debt and uncompensated care.
It’s also costing more to operate a hospital. Inflation is driving up the cost of supplies, services, faculty maintenance, and the cost of labor with widespread staff burnout since the COVID-19 pandemic.
