rural-hospital-photoUSA Today ran a great series on recent closures of rural hospitals, more than 40 of them in all, predominantly in the South.

In total, the closures add up to less than two thousand beds, which is not a big number. Medium and big urban hospitals are often licensed for hundreds of beds in a single facility.

But rural hospitals fill a vital niche — usually more than 35 miles or more from the nearest health care facility. Many of them are known as “critical access,” which means that they qualify for enhanced payments for services due to the rural demand they meet and their remoteness.

The thing is, it’s tough to compete with bigger, regional hospitals and medical centers. Economies of scale allow bigger places to purchase expensive technologies (think MRI machines and surgical robots) that further enhance their marketing power. And the whole hospital industry is undergoing massive consolidation as hospitals join networks of even larger holding companies or non-profit networks. Smaller and rural hospitals just don’t fit in this brave new world.

I was lucky to interview one the authors of the series, Laura Ungar, who is the national/regional health enterprise editor for USA Today, and the Gannett-owned [Louisville, KY] Courier-Journal.

If you’re interested, you can stream it here.