Hospitals Are Closing Across the South: What You Need to Know

For millions of Americans, especially those living in rural communities like those throughout the South, quality health care, including cancer care, may be hard to find.

It’s not that good doctors don’t practice in rural counties or remote towns. On the contrary, competent and caring clinicians practice in some of the smallest, most remote towns in America. But in many rural communities, hospitals are closing at an alarming rate, leaving behind so-called “health care deserts” and forcing residents to travel many miles to get basic care and find specialized care for diseases such as diabetes and cancer.

Since 2005, 195 hospitals in rural communities across America have closed. According to Becker’s Hospital Review, another 432 hospitals are at risk of closing in coming years.

According to U.S. News & World Report, five of the 10 states with the most hospital closures since 2005 are in the South. They include:

• Georgia
• Tennessee
• North Carolina
• Florida
• Alabama

The University of North Carolina Gillings School of Global Public Health reports "in the Southern United States, the region with the greatest share of hospital closures in the past decade, approximately 10% of rural counties lost one or more hospitals to a closure between 2007 and 2018.”

In this article we’ll explore:

• What’s Causing Rural Hospital Closures?
• What’s the Impact to the Community?
• Where Are Hospital Closures Occurring?
• How Does This Affect Cancer Patients?
• What Cancer Patients May Do if Their Hospital Closes

If you or a loved one has been diagnosed with lung cancer and are looking for a second opinion, call us 24/7 at 877-524-4673.

What’s Causing Rural Hospital Closures?

Hospitals are businesses with payrolls to meet, specialized and expensive equipment to purchase and complex infrastructures to maintain.

In rural communities with small populations, some hospitals simply don’t have high enough patient census numbers to bring in the revenue required to stay in business. According to the health care consulting firm Chartis, nearly half of all rural hospitals across the country are operating at a deficit.

Other reasons hospitals close are:

• Reimbursements from Medicare, Medicaid or private insurance companies may not be high enough to cover costs
• Rural communities may have high levels of poverty, making it difficult to residents to pay medical bills
• Rural hospitals may have a difficult time attracting doctors and other qualified clinicians and staff
• Aging hospitals may become difficult to maintain or require expensive upgrades
• Increased regulatory requirements may impose additional financial burdens

What’s the Impact to the Community?

When a hospital closes in a community:

• People have to travel longer distances to get health care
• Doctors and clinicians may leave the community to find employment elsewhere
• Specialize care, such as cancer care, may be harder to find
• Wait times increase and surrounding hospitals, clinics and doctors’ offices and appointments may be harder to get

And it’s not just the lack of care that hits a community where a hospital has closed. Residents in rural health care deserts often don’t get regular checkups, fail to address symptoms of potential disease, lack education on disease prevention and may not get screening recommendations or advice they need to catch conditions, such as heart disease or cancer, early.

“Decreased access to health care can certainly lead to decreased screening, which can result in missing early detection of cancer in place of more advanced cancer that can be more difficult to treat,” says Jeffrey Metts, M.D., M.P.H., chief of staff at City of Hope^® Cancer Center Atlanta. “The top two causes of death are heart disease and cancer. Smoking is the No. 1 preventable risk factor for both. In communities with decreased access to health care and education we see a rise in both, along with premature mortality.”

Rural communities in which hospitals have closed tend to have large ethnic populations and/or high rates of poverty. So, hospital closures in some rural communities may also contribute to health care disparities among the poor, elderly and certain ethnic groups, such as African Americans or Native Americans, which already have higher incidence and mortality rates for cancer and other diseases.

Where Are Hospital Closures Occurring?

Rural hospitals are closing across the country, but a large percentage of hospitals that have closed or are at risk of closing are in the South. 

How Does This Affect Cancer Patients?

According to the Chartis report, residents of rural communities already have higher rates of death from diabetes, cancer and heart disease. When a hospital closes in a rural community, it further increases the risk for premature death from these conditions.

And even if a rural hospital remains open, it may cut crucial services because of a lack of staff or specialists, such as gynecologists, oncologist or surgeons.

The Chartis report reads: “Access within rural communities to chemotherapy is also dwindling across the country. Between 2014 and 2023, our research reveals 424 stopped providing chemotherapy services. This represents 21% of all rural hospitals offering chemotherapy.”

Between 40% and 50% of the hospitals in southern states have stopped offering chemotherapy.

What Cancer Patients May Do if Their Hospital Closes

Whether you’ve been diagnosed with cancer or another condition or are simply concerned about long-term health care needs for yourself or your family, it’s important to be proactive upon getting word about your community’s hospital closing.

Here are some suggestions:

• Ask the hospital about any plans to close, including its timetable and whether the facility is transitioning to another provider.
• Contact all your current doctors to ask about their plans and get suggestions and recommendations about what to do next.
• Do your own research into what other hospitals, doctors and health care centers are available nearby.
• If you have cancer, make sure you work with your doctor on a plan to ensure your treatments, consultations and follow-up scans are not interrupted.
• Ask about telehealth services and whether they are an option for checkups and consultations. “We need to leverage technology like telehealth to get into patient living rooms and decrease the need for them to travel when that is prohibitive to care,” Dr. Metts says. “This can allow us to treat diabetes, cancer and heart disease before patients have advanced stages of disease requiring expensive ER visits or ICU level of care.”
• Ask about medical records and how they will be archived or transferred to a new provider. Ask if you can access your records.
• Get involved in community efforts to attract a new health care provider and to make sure your elected representatives are aware of the impact on your community.
• Find out where to go in an emergency.

“We always counsel patients to call 911 for emergencies,” Dr. Metts says. “However, emergency response times can more than double in rural areas due to the increase in distance as well as problems with reception and not enough EMS responders to meet the need. This places a higher burden on patients and caregivers to seek care emphasizing the importance of an advanced emergency plan. It is imperative to know where to go and how you will get there assuming you are unable to drive yourself.”

If you or a loved one has been diagnosed with lung cancer and are looking for a second opinion, call us 24/7 at 877-524-4673.