Rural hospitals are closing at a record pace, and many of the reasons why could have been avoided.


By Robert Thorn, MBA, FACHE

Director, Pinnacle Healthcare Consulting


Last week, in Part Three of this six-part series on “Six Things Every Rural Hospital CEO Must Do,” we examined Topic #3, Strategic Planning.  This week, in Part Four, we will look at Telehealth, how it has become more commonplace due to the COVID-19 pandemic, and how it can remain a routine and relied-upon part of rural healthcare.

Part Four: Telehealth

With the introduction of COVID-19 into our world, providers have been scrambling to develop alternatives to people coming into the office to be seen.  The government cleared a lot of hurdles to allow providers and patients to see one another via video platforms.  Medicare even changed its restrictions for reimbursement; state licensure has at least been temporarily waived, as well.  Regardless of whether these changes are temporary or permanent, having a solid plan to provide safe alternatives for patients and doctors to use in getting together will be required to navigate the “new normal.”  Moving forward, it is the patients’ expectation that providers offer convenient, effective and secure telehealth options. So, where do you start?

In my previous post, Part Two, “Physician Demand Analysis,” I wrote about the need to assess your medical community and identify where there may be opportunities for an increased presence of specialists.  While there can be an argument made that nothing is better than for a doctor and a patient to be in the same room at the same time, there is also an argument that can be made as to whether having a doctor and a patient in the same room is always a good idea.  Besides the COVID-19 pandemic, patients living in rural communities have other factors to consider, such as driving long distances, sometimes in questionable weather, and often having multiple appointments requiring multiple trips.  Therefore, if you have not done so already, it is time to assess your community’s medical staffing needs; and, based on these needs, determine which physician specialties are needed, and can they be supported through a virtual presence?  Do they need a face-to-face exam, or will data (medical test results, remote patient monitoring, images, etc.) prove to be more meaningful to the physician? Furthermore, where do opportunities lie for recurring treatments, such as dialysis?  Can they be coordinated and safely offered in a setting previously considered unacceptable because the specialist is not routinely physically present?  Telehealth has opened the door for rural hospitals to provide diagnostic and therapeutic services that could both benefit the patient through increased local access, and the hospital through an ability to offer services and retain the revenues that were going to another community.  It can also help position the hospital for value-based models of care, allowing the hospital to better manage its risk by addressing chronic conditions proactively and cost-effectively, rather than reactively and costly.  After all, telehealth is more than two-way video that has come into the limelight as a result of the COVID-19 pandemic.  It is yet another tool providing valuable information that providers can use to assess, treat and manage care, driving a more responsive approach and, in many cases, a higher quality outcome for the patient.  If you have not considered telehealth as a viable option for you community, or if the specialists to whom your physicians refer patients have not, please contact me and I would be glad to discuss options with you.  I may be reached at

In next week’s edition of this six-part series, we will explore Topic #5 of the “Six Things Every Rural Hospital CEO Must Do.”  I hope you will join me.  Should you have any questions in the meantime, please feel free to contact me at or (720) 598-1443.