In rural America, critical access hospitals (CAHs) play a crucial role in providing essential healthcare to underserved communities. These facilities are often the first point of care for individuals in need of emergency treatment or routine medical procedures. However, many CAHs face challenges when it comes to offering specialized services such as general surgery and orthopedic surgery. The question arises: Is it viable for CAHs to provide these surgical services, and what benefits could this bring to both patients and hospitals?
Access to Care
One of the most pressing concerns for rural populations is access to timely and effective healthcare. Patients in remote areas often face long travel times to reach surgeons in urban centers. For individuals needing emergency or elective procedures such as appendectomies, gallbladder removal, or orthopedic surgeries, the absence of in-hospital surgery services can result in delayed care, worsened health outcomes, or even financial hardship due to travel costs.
By establishing general surgery and orthopedic surgery services, CAHs can reduce the need for long-distance travel and allow patients to receive care closer to home. In fact, studies show that patients in rural areas are more likely to seek care when services are available locally, leading to earlier intervention and better clinical outcomes.
Financial Sustainability for CAHs
Operating general surgery and orthopedic services may also provide financial benefits to critical access hospitals. CAHs are funded by Medicare under specific reimbursement rates, which are typically higher than those for larger hospitals. Offering surgical services can increase hospital revenue, which is vital for maintaining operations in rural settings. Surgeries—especially those in high-demand fields like general and orthopedic surgery—are typically reimbursed at a higher rate than other types of care, allowing hospitals to offset costs associated with maintaining their facilities and staff.
Moreover, the ability to attract and retain a specialized workforce can be a significant advantage for CAHs. Offering comprehensive services helps hospitals differentiate themselves from other rural healthcare providers, potentially drawing more patients and encouraging local healthcare professionals to establish their practices in these areas.
Improved Patient Outcomes
The benefits of having surgery available locally extend beyond convenience; they also significantly affect patient outcomes. Critical access hospitals that provide timely and high-quality surgical services can improve the speed and efficiency of treatment, reducing the risk of complications that may arise from delayed interventions.
For instance, orthopedic surgeries for trauma patients—whether from falls, accidents, or sports injuries—require immediate attention to prevent long-term disability. General surgeries for conditions such as acute appendicitis also require prompt action to prevent dangerous complications like perforation or sepsis. The ability to perform these surgeries in-house allows CAHs to treat patients quickly and effectively, improving long-term health outcomes and reducing the need for costly follow-up treatments that might arise if patients were referred to faraway hospitals.
Building Community Trust and Resilience
When rural communities have access to essential healthcare services like surgery, they not only improve their physical health but also their mental well-being. Patients are more likely to feel confident in their healthcare system when they know that their hospital can provide a wide range of services. This fosters trust and helps to build community resilience.
Additionally, the availability of surgical services can contribute to local economic growth. For instance, local hospitals that expand their services often see an increase in demand for jobs within the community. Healthcare workers, such as surgeons, nurses, anesthesiologists, and surgical technicians, are more likely to stay in rural areas when they can work in a comprehensive healthcare setting, which also helps to address the broader issue of workforce shortages in rural healthcare.
Reducing Healthcare Inequities
One of the most compelling reasons for CAHs to offer surgical services is the role they play in reducing healthcare inequities. Rural America faces stark disparities in health outcomes compared to urban areas. Access to quality healthcare—including surgical care—helps level the playing field for rural residents who may otherwise experience worse health outcomes due to lack of timely care.
By offering general and orthopedic surgery services, CAHs can ensure that rural populations are not left behind in the modern healthcare landscape. The ability to receive care locally means that these communities are less reliant on travel and the associated challenges, such as financial strain and time off work, that often disproportionately affect low-income and elderly patients.
Overcoming Challenges
While the benefits of offering surgical services in critical access hospitals are clear, there are challenges to consider. Staffing is one of the most significant obstacles—finding qualified surgeons and support staff to work in rural areas can be difficult. In fact, over the last two decades, the number of General Surgeons practicing in the rural setting has decreased by 29%. The financial investment required to establish and maintain these services can also be daunting.
From upgrading surgical equipment to ensuring the availability of post-operative care, CAHs must carefully plan for the long-term sustainability of these services. However, with the right strategies, including collaboration with state and federal funding programs, these hurdles can be addressed.
A Promising Future for Rural Surgery Services with Rural Physicians Group
If starting, or enhancing, your surgical services is something you desire, Rural Physicians Group can help. Our surgeons provide on-site hospital and clinic coverage, on either a full-time or part-time basis, delivering the highest level of care. Our surgeons are skilled experts, have a robust scope of practice, and understand what it takes to help a CAH thrive. Before we get started, we perform a comprehensive evaluation of your surgical facilities, staffing, and equipment and provide recommendations on how to succeed with your general surgery or orthopedic surgery service line. For rural communities, local surgical services can be the key to a healthier, more resilient future—one where access to timely, high-quality care is a reality, not a rarity. It is a way to keep local patients local!
Blog Author: Michael Patterson, CEO – RPG
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