When smaller hospitals in rural areas seek relief in tough economic times, they usually have to resort to merging with larger systems to stay afloat while continuing to serve the rural communities in which they are located. For one troubled tiny 15-bed facility in western Minnesota, the road to eventual acquisition by the largest system in neighboring North Dakota was a long and bumpy one. Fraught with a saga involving three rotating physicians over a period of fifteen years and the involvement of one of them resorting to whistleblowing the federal government to investigate protracted shady Medicare billing practices, the acute facility is ready to simply “move on”.

“The fact is that medicine is practiced differently in rural areas than urban areas,” said Hill,^[1] executive director of the national Rural Health Resource Center in Duluth. “In the Twin Cities, you can be practically anonymous as a doctor, but not so in small cities. There, if you make a mistake by under-treating a patient — say you send 91-year-old Mr. Jones home alone and he falls and dies — everybody in town knows about it.

It’s a great read — and one which gives serious thought to the issue of what constitutes appropriate reimbursement for appropriate medical care in very rural areas as opposed to even moderately-sized suburban populations, and how far one facility will go to stay in business for the sake of the community it serves. | LINK

1. Terry Hill — a rural health expert [↩]

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