Tennessee rural health in jeopardy

Published 9:24 am Tuesday, March 12, 2024

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To the Editor:

In an ominous warning preceding Jellico’s hospital closure, the Chartis Center for Rural Health recently reported that 41% of rural hospitals in Tennessee are at risk of closure – making Tennessee one of the states most vulnerable to losing additional rural hospitals.

At the same time our rural hospitals are fighting for survival in a complex and rapidly changing environment. Tennessee’s Certificate of Need (CON) proposes to further tip the scales in favor of venture capital and out-of-state interests.

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The CON program protects local access to a full range of healthcare services for patients. With CON protections gone, more patients than ever will be sent away from their rural communities to urban centers, further damaging an incredibly delicate system of care and restricting access to persons who are low-income, uninsured, expecting mothers, and seniors.

By drastically changing the competitive environment, Tennessee’s 40 rural Prospective Payment System (PPS) Hospitals, 17 Critical Access Hospitals, and 17 Medicare Dependent Hospitals, could be forced to close services or their doors. Freestanding emergency departments, imaging centers, and other providers will selectively pick profitable services away from rural hospitals and clinics, placing further strain on their operations.

Meanwhile, 24 rural counties do not have access to the Uninsured Adult Safety Net – Tennessee’s answer to not expanding Medicaid. These counties have Critical Access Hospitals, PPS Hospitals, and federally designated Rural Health Clinics who bear the brunt of uncompensated care and have been denied participation in the Uninsured Adult Safety Net (as well as other state programs) because of their “for-profit” tax status.

Rural Health Association of Tennessee and our 800+ members appreciate Governor Lee’s attention to rural health in his budget. We would like to call attention to the fact that CON reform was not a proposed solution by the Rural Health Taskforce. Given the delicacy of the rural health infrastructure, our members insist more attention should be given to community needs – not less. Policies that do not directly help rural communities are only harming them.

Respectfully, Jacy Warrell, MPA; CEO Rural Health Association of Tennessee


Jacy Warrell

Decaturville, TN