The financial crisis for rural healthcare delivery has been building for years. Cash-strapped rural hospitals in the U.S., which tend to run on thinner margins and see a lower volume of patients than metro-area hospitals, have been hurt by reimbursement cuts, staffing constraints, inflation, an older and sicker population, and rising interest rates, to name a few. While these dedicated providers may find some financial relief through new operating and care coordination models, Medicaid expansion, and potential mergers and acquisitions, closures and service cuts are expected to increase next year.
Already, fewer than half (45%) of rural hospitals currently offer labor and delivery services, and in 10 states, less than one-third do. Over the past decade, more than 200 rural hospitals have stopped delivering babies. Nearly 200 rural hospitals have shut down since 2005, and over 300 are at immediate risk of closing due to severe financial challenges.
Fifteen percent of Americans living in rural areas face a disproportionate burden of health disparities compared with their urban counterparts. Most rural hospitals are at least a half-hour drive from the nearest alternative hospital, and many communities have no alternate sources of healthcare. Patients are at greater risk for poor outcomes; these providers need new approaches that expand patient access to vital healthcare services.
A broad array of digital health solutions, which include HIPAA secure texting, two-way conversational chatbots, and secure patient texting with virtual visits, can quickly help rural hospitals achieve new levels of performance, relieve staff, and increase patient satisfaction – all at an affordable cost. Digital patient engagement strategies integrated into clinical workflows, for example, are closing population health equity gaps in care and helping organizations thrive in value-based care arrangements.
No matter their geographical location, healthcare consumers across the country ─ including those in rural settings ─ expect a convenient, retail-like online experience, which they have grown accustomed to in other areas of their lives, including e-commerce. Their frustration with the country’s healthcare system is mounting, and many believe digital health solutions can help. A 2021 summary of survey findings identifies consumers’ pain points, such as:
Unquestionably, the value of the patient’s experience at a rural hospital has a much bigger impact on the bottom line. The low population density often results in a decreased patient volume, bringing in patients on Medicare, Medicaid, or the uninsured. Though overall hospital labor costs have started to ease since spiking in 2022, rural facilities have been slower to recover, given that recruiting doctors and nurses to their communities is harder.
Federal assistance during the pandemic has also ended, leaving many rural facilities facing forced closings. Among the top concerns in 2024 are the relatively low Medicare Advantage reimbursement rates and payment denials claimed to be crippling rural hospitals.
Given these concerns, a digitally enabled patient experience that is positive, convenient, and reasonably priced can help attract and retain healthcare staff and patients. This is especially true for the elderly and those with complex chronic needs, who are particularly vulnerable and may lack transportation to commute long distances to larger healthcare locations and see a provider in person.
A positive patient experience is broadly defined as healthcare delivery that patients highly value. One of the simplest and best definitions hails from the University of Utah Health’s patient experience team.
Fifteen years of evolving qualitative analysis based on hundreds of thousands of patient voices has culminated in the Five Elements of Patient Experience:
When all five elements are present, patients describe an increase in confidence and trust in their care team, along with loyalty to the healthcare system.
Because rural hospitals are considered the heart of the community, increasing patient satisfaction is integral to preserving their reputation. Services provided by small rural hospitals are also important for residents of urban areas, who rely on the nation’s food supply and energy production, which comes from rural communities. Farms, ranches, mines, drilling sites, wind farms, and solar energy facilities cannot function without an adequate, healthy workforce, and people are less likely to live or work in rural communities without adequate healthcare services.
Because hospitals in a rural setting are a focal point of the community, a positive patient experience that enhances the hospital's reputation also encourages patients to seek care locally. Satisfied patients are more likely to share their positive experiences with others, leading to increased trust and a better overall reputation for the hospital.
Research reveals that 5% of all Google searches are health-related and 94% of patients use online reviews to evaluate providers, and 84% of consumers trust reviews as much as personal recommendations. In the digital age, a strong healthcare marketing strategy that intersects with digital strategies, e.g., campaigns targeting selective population groups, is essential to educate, retain, engage, and motivate potential, existing, and new patients.
A positive patient experience increases the likelihood that patients will choose or return to the same hospital for future healthcare needs. Retaining patients is important for the financial sustainability of the rural hospital, as repeat business reduces the need for costly marketing efforts to attract new patients.
In rural areas, there often are limited healthcare options. With the expansion of telehealth, patients may have more choices to seek care elsewhere. Focusing on a convenient and positive patient experience encourages patients to choose the local facility over other options.
Rural hospitals and clinics can improve financial performance by delivering a superior patient experience.
A recent Accenture survey shows that strengthening patient engagement correlates to 50 percent higher hospital margins.
Patients who have positive experiences are more likely to follow through with prescribed treatments and attend follow-up appointments. This can lead to better health outcomes, reduced complications, and more efficient use of healthcare resources, especially for patients with chronic conditions.
A positive patient experience is often closely tied to the attitudes and behaviors of healthcare staff. When staff members see satisfied patients, it boosts morale and job satisfaction, contributing to staff retention and creating a positive work environment.
Regulatory bodies increasingly emphasize patient-centered care and satisfaction as essential indicators of healthcare quality. Compliance with these standards can positively impact the hospital's performance on incentive metrics whether they be related to HCAHPS scores or measures tied to value-based care contracts.
Digital services support a positive patient experience on top of the patient’s healthcare journey by enhancing access, convenience, engagement, health equities, and health outcomes, increasing preventive care and promoting continuity of care.
Given the limited resources available to rural health systems, it is critical to move beyond point solutions to a digital, artificial intelligence (AI)-powered system that is affordable and flexible to address multiple needs, can go live quickly, and deliver immediate results. For guidance on selecting an efficient, high-performing digital system, click here.
Ultimately, delivering a positive patient experience in a rural hospital is crucial to building trust, maintaining a good reputation, ensuring patient retention, and contributing to the overall health and well-being of the community it serves.
Bobbi is a lifelong learner who is passionate about enabling healthcare transformation. She has 20+ years of healthcare experience in care delivery, consulting, healthcare IT, and market strategy.
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