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COVID-19: Beyond Tomorrow
June 10, 2020

Sustaining Rural Hospitals After COVID-19: The Case for Global Budgets

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
  • 2Harvard Kennedy School, Cambridge, Massachusetts
  • 3Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
JAMA. 2020;324(2):137-138. doi:10.1001/jama.2020.9744

The coronavirus disease 2019 (COVID-19) pandemic is a financial stress test for US hospitals.1,2 Revenues have declined from the suspension of elective procedures and nonessential services, and many hospitals have experienced a surge of critically ill patients. These circumstances have created an unprecedented challenge for rural hospitals, many of which entered the crisis in poor financial condition due to the loss of patients to regional referral centers and rural depopulation.3 Of the 4663 acute care hospitals in the US, approximately 47% are located in rural areas across 49 states.4 The added financial strain of COVID-19 has the potential to accelerate the closure of rural hospitals, draining health care resources and jobs from rural communities that have lost 130 hospitals since 2010.5,6

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