Nathan Deal's plan to save struggling rural hospitals

Gov. Nathan Deal is backing a new health structure for rural health systems to help stabilize failing hospitals. But it may be too late for some of the 15 rural health systems already facing dire financial turmoil.

The report from the governor's rural health committee, which can be found here, calls for a "hub and spoke" model to try to relieve pressure on overworked emergency departments. The state Department of Community Health will oversee a four-site pilot program to test the new model. Deal is backing a $3 million budget request to launch the test sites and pay for other infrastructure.

The committee also urges lawmakers to preserve the certificate-of-need regime that regulates the number of hospitals. That system is regularly under scrutiny by healthcare advocates and rival medical systems who call for more inclusive rules.

And it recommends expanding the duties nurse practitioners and physician assistants. Such a move could give them broader leeway to write prescriptions and perform procedures once exclusively reserved for doctors. Fights over so-called "scope of practice" changes are among the fiercest in the Legislature.

"With a growing physician shortage, it was determined that these expansions could help bolster healthcare resources in rural communities," said the report, which didn't elaborate on specific changes.

Deal formed the committee in April after a spate of rural hospitals shuttered. He advocated for a "step down" plan to allow struggling hospitals to scale back their services to help keep them afloat. But few, if any, took that approach.

A series by the Atlanta Journal-Constitution's Misty Williams exposed the glaring deficiencies in the state's network of rural health systems. It found that nearly two-thirds of Georgia’s 61 remaining rural hospitals lost money in the year for which they most recently reported results. Some 21 suffered budget shortfalls for five years running. Only seven made a profit each year.

The committee found that eight hospitals have closed or attempted an overhaul within the last three years. It said another 15 rural facilities are considered "financially fragile" with six operating on a day-to-day basis.

The fate of the hospital systems became a part of the wider political debate last year, with Deal's opponent, Democrat Jason Carter, highlighting a struggling hospital in Montezuma as a case study for expanding the Medicaid program under the Affordable Care Act. Deal has long resisted an expansion, saying it's too costly in the long run.

The committee's proposal would turn larger regional hospitals into communication hubs that will help direct patients in a rural network to the most appropriate places for care. The idea for the "hub and spoke" system is to relieve the burden for facilities that now struggle to offer a wide range of costly medical services.

It aims to offer more ambulances and school clinics equipped with teleconferencing capabilities and WiFi to access medical experts, as well as more coordination with public health departments and local physicians. Under the plan, the four proposed pilot hubs would be Union General, Appling Health System, Crisp Regional and Emanuel Regional Medical Center.

The governor said in a statement he would take immediate actions to implement the proposals.

“Just as a medical emergency can’t wait, neither can we wait to act upon these recommendations,” said Deal. "It is my hope that these efforts are not a temporary fix, but rather the beginning of a long-lasting road to recovery for our rural health systems.”

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About the Author

Greg Bluestein
Greg Bluestein
Greg Bluestein is a political reporter who covers the governor's office and state politics for The Atlanta Journal-Constitution.