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Health Care Reform and Rural Hospitals: Opportunities and Challenges under the Affordable Care Act

Parisian, Esther Elizabeth
http://rave.ohiolink.edu/etdc/view?acc_num=osu1313596532

Abstract Details

2011, Master of Science, Ohio State University, Rural Sociology.
Rural hospitals have long faced a set of challenges, due to the unique demographic characteristics of the populations they serve, which sets them apart from their urban and suburban counterparts. On average, rural residents tend to be older, poorer and sicker than urban counterparts, require more care, and are more likely to be uninsured than non rural residents. This means that the higher cost of providing care to this population is more likely to go unpaid and, as a result, many rural hospitals struggle to remain viable financially; providing uncompensated care at such high levels makes it difficult to break even, let alone turn a profit. Because rural hospitals are central to rural communities, in terms of both the important health services they provide and their significant contribution to the local economy, their financial vulnerability is of particular concern to rural residents. Recently, the March 2010 passage of the Affordable Care Act (ACA), a health care reform law which increases access to and lowers the cost of health care for many Americans, has offered renewed hope to rural hospitals. Major rural health organizations have suggested that the ACA may relieve a significant portion of the financial burden faced by rural hospitals by providing a large percentage of the rural uninsured with free or affordable health insurance. However, a critical flaw in this thinking is the assumption of homogeneity among rural hospitals. The ACA, if implemented as planned, will in fact expand health insurance coverage to many previously uninsured Americans, a disproportionate number of whom reside in rural areas. Nonetheless, the potential benefits of the legislation will be felt differentially by rural hospitals depending upon their size, ownership type, and the demographics of patients served. It is possible that small or isolated rural hospitals and those that serve a disproportionate number of undocumented workers may fail to experience the kind of financial relief predicted for rural hospitals in general. The objectives of this analysis are to a) assess systematically and critically the expectations/predictions regarding the impact of the ACA; b) evaluate factors that apply specifically to rural hospitals given their current difficulties and the characteristics of the populations they serve; and c) identify factors not considered in the existing policy research that need to be addressed to more accurately predict and control the relative impact of the ACA on rural hospitals.
Cathy Rakowski, PhD (Advisor)
Joseph Donnermeyer, PhD (Committee Member)
Public Policy; Sociology

Recommended Citations

Citations

  • Parisian, E. E. (2011). Health Care Reform and Rural Hospitals: Opportunities and Challenges under the Affordable Care Act [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1313596532

    APA Style (7th edition)

  • Parisian, Esther. Health Care Reform and Rural Hospitals: Opportunities and Challenges under the Affordable Care Act. 2011. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1313596532.

    MLA Style (8th edition)

  • Parisian, Esther. "Health Care Reform and Rural Hospitals: Opportunities and Challenges under the Affordable Care Act." Master's thesis, Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1313596532

    Chicago Manual of Style (17th edition)

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© 2011, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.