A report recently presented to the General Assembly’s Joint Commission on Health Care found that while rural hospital closures have remained relatively rare in Virginia, many hospitals have steadily reduced inpatient care, eliminated labor and delivery services and become increasingly reliant on outpatient treatment as financial pressures mount. “The key issue is therefore not only whether hospitals stay open, but how the composition of services changes within them,” commission staff stated in the report. “This shift towards outpatient care prevents closures, but narrows access to services.” The study examined the financial and operational conditions of Virginia’s 36 rural hospitals after lawmakers directed commission staff last year to investigate growing concerns about rural health care access. Researchers identified several rural hospitals in Virginia facing the hi…

While larger hospital systems can offset losses through high-volume specialty services, many rural hospitals lack the patient base and negotiating leverage needed to generate similar revenue. Since 2005, more than 100 rural hospitals have closed nationwide. Virginia has lost two rural hospitals during that period, while another closed and later reopened under a more limited service model. Researchers found that service reductions have become more common than outright closures. Among the seven highest-risk hospitals in Virginia, patient days declined between roughly 34% and 60% over the past decade while staffed beds were reduced and obstetric services largely disappeared, according to the report. Some hospitals eliminated surgical services entirely, while emergency department utilization remained stable or increased.