How a GoFundMe Page Aims to Keep a Rural Hospital Open

When financial troubles turned dire, leaders of a rural hospital turned to a popular source of funding to support their efforts to get back on their feet: GoFundMe.

Crowdfunding platforms like GoFundMe are popular among individuals looking for help paying their medical bills. NORC reports that over 8 million Americans have started a crowdfunding campaign for themselves or a household member to cover medical expenses. What’s more, one in five Americans have donated to a healthcare-related campaign.

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Bucktail Medical Center, a critical access hospital in Renovo, Pennsylvania, is using its crowdfunding campaign for a similar purpose. The hospital has been losing between $100,000 and $150,000 a month since the COVID-19 pandemic as operating expenses add up and the challenges of rural healthcare mount.

“Providing healthcare in rural America is much more expensive than providing healthcare in urban areas,” Tim Reeves, the former administrator and CEO of Bucktail Medical Center, recently shared. Reeves set up Bucktail Medical Center’s GoFundMe page, hoping to raise awareness and support for the hospital. Shortly after our conversation, Reeves resigned as CEO after nearly a decade in the role, but the GoFundMe page continues.

The page raises awareness about the challenges facing rural healthcare. Low patient volumes mean staffing an emergency department 24 hours a day, 7 days a week typically means a loss for the hospital, which may only see four people that day versus the hundreds walking through the doors in urban areas.

Add that to falling reimbursement rates, challenges recruiting and retaining staff, and aging infrastructure, and rural hospitals are coming up in the red. They simply cannot compete with large insurance companies who don’t want to raise reimbursement rates.

Crowdfunding to prevent a hospital closure is unique, but the Bucktail Medical Center “is determined to turn over every rock and exhaust every opportunity,” according to a Dec. 4th update on the page.

Bucktail Medical Center, like many rural hospitals, is on the brink of closure. There have been 148 rural hospital closures and conversions since 2010, according to UNC’s Cecil S. Sheps Center for Health Services Research. And researchers at the Center are still counting. Rural hospital closures have accelerated over the last decade as these providers face falling reimbursement rates, staffing shortages, low patient volumes, and financial troubles. These challenges have forced many hospitals to close their doors despite existing and severe access to care challenges for rural communities.

But for hospitals like Bucktail Medical Center, closing isn’t an option—at least one they want to avoid at all costs. The next closest hospital is nearly 29 miles away, and that facility itself recently changed its designation from an acute care hospital to an outpatient emergency department, meaning it gave up all its inpatient services, including surgeries.

These new designations can help rural hospitals make ends meet and maintain access to care in remote communities. This year, CMS established the Rural Emergency Hospital, a new provider type that aims to address rural hospital closures. These hospitals only provide emergency services, observation care, and some medical and health outpatient services in exchange for an additional 5 percent over the Hospital Outpatient Prospective Payment System rate for the selected services.

Converting to a Rural Emergency Hospital may not make sense for every rural hospital on the brink of closure though. Reeves, for example, said Bucktail would only break even despite the payment boost. Plus, their conversion would have left the community with no inpatient beds for miles. It was more important to keep the additional services local than convert and shut down service lines.

Closing a rural hospital may even mean shutting down industry in a community. Oftentimes, rural hospitals are some of the largest employers in a community. Without them, people, as well as community dollars, go elsewhere.

What are hospitals like Bucktail Medical Center to do? Some of the initiatives Reeves stood up in addition to the GoFundMe page included purchasing the hospital’s first CT scanner and an ambulance. Investing in these services aims to bring patients and revenue to the rural hospital.

These investments haven’t been a magic pill. In fact, there are still many pills to swallow. Private insurance companies, for example, continue to be an issue for rural hospitals. Their reimbursement rates rarely cover the costs of providing care and rural hospitals aren’t in a position to negotiate higher rates. It comes down to a difficult question: Do rural hospitals continue to hemorrhage money or do they leave the negotiation table, becoming an out-of-network provider? It’s not an easy decision, Reeves said, but one rural hospitals grapple with every day.