COVID surge in Midwest testing rural hospitals

DES MOINES, Iowa — With COVID-19 still ravaging Iowa, hospitalizations have been increasing.

The situation comes as rural health-care systems in the U.S. struggle to survive.

Among Midwestern states, Iowa isn’t alone in seeing the virus infect more people, but it still is near the top nationally in weekly cases per capita.

Brock Slabach, senior vice president of the National Rural Health Association, said a big concern now is rural areas, where community spread has been hard to control. Making matters worse, it’s been difficult for residents in these areas to access care.

“When someone is experiencing anxiety due to physical conditions that are very troubling, these delays can be very, very impactful and create lots of problems in their well-being,” Slabach cautioned.

He said rural providers are seeing “fractures” being widened in these communities. He cites staffing, supplies and lack of reimbursements as critical problems for hospitals. Despite the higher hospital numbers, Gov. Kim Reynolds said Iowa’s facilities are equipped to handle the surge.

Nationally, 15 rural hospitals have closed in the U.S. this year. None have been in Iowa, but Slabach said many systems in smaller communities face a severe cash crunch, leaving room for doubt about their future.

He pointed to a pause in elective surgeries at the start of the pandemic and slow reimbursement payments, while adding it will be hard for them to improve their outlook in the near future.

“This will exacerbate, I think, some of the problems that have already existed for a long time in rural communities,” Slabach asserted.

He said part of the problem is treating COVID patients can be very expensive, placing an even greater financial burden on facilities struggling to stay afloat.

To get a handle on the immediate problem, he said increased testing and contact tracing in rural areas can help with case management, and potentially reduce demand for hospitalizations.