In an effort to control the spread and have enough resources to effectively treat the anticipated surge in critically ill patients as a result of the COVID-19, State and Federal officials have strongly recommended the postponement of all elective surgical procedures across all hospitals and surgical centers in the U.S.
At the same time, leaders of the response effort in Washington, DC have noted that the impact of COVID-19 may be drastically different based upon the geographic area of the country they are talking about. Specifically, Dr. Anthony Fauci made reference to the fact that restrictions could be lifted on a regional basis based upon the incidence and prevalence data being reviewed on an hour by hour basis.
Most hospitals in rural America operate on razor thin margins. The National Rural Health Association (NRHA) estimates that close to half of the hospitals in rural communities have negative operating margins. With the postponement of elective procedures for the foreseeable future, this critical income stream has been eliminated and no amount of increased traffic in the emergency rooms or use of critical care beds can make up for this volume loss due to the fact that ER operations and critical care are usually negative margin services in rural healthcare.
While this pandemic is a threat to human life, it may also create a “tipping point” for rural health providers in their ongoing battle to keep their doors open. Major funding from the relief package passed by Congress last night will need to be channeled to our rural healthcare providers if we are to avoid a second disaster as a ripple effect of COVID-19.
Should rural healthcare providers be allowed to continue operations as usual based upon updated incidence and prevalence data in their service areas? Is it better practice to initiate blanket restrictions on a State by State basis or use more accurate testing and epidemiological data to be more precise in the issuance of restrictive guidance? We are walking a fine line. We need more aggressive testing and trending data to avoid winning the battle but losing the war.