Rural ND Hospitals Prepare for Increase in Covid-19 Cases

North Dakota hospitals are preparing for an increase in covid-19 cases in rural parts of the state. This week, Governor Burgum and rural health care providers discussed what is needed for hospitals outside of our metro areas. As the pandemic overwhelms our health care systems in urban hot-spots, rural hospitals have faced prolonged challenges to meet the need.

According to Brad Gibbens, the Deputy Director of the Center for Rural Health, the hospitals are “calm and deliberate” in their approach. They’re putting in place plans for potential surges in patients needed care. Pallets of personal protective equipment (PPE) have been distributed by the ND Hospital Association to these rural hospitals.

Listen: Brad Gibbens, Deputy Director of the Center for Rural Health talk about Covid-19 Preparedness

Yet, the two biggest challenges consistently facing rural hospitals are workforce and finances. Those challenges weren’t created by covid-19, but maybe accelerated by the virus. More needs to be done.

Some legal requirements have been waived during this national emergency. What was waived by the federal government? Capacity requirements for those hospitals that allow for more patients and more hours of treatment. Also, the ability of physicians to work across state lines has been granted. This means a person licensed and operating in South Dakota will be allowed to operate in North Dakota during this time. Additionally, plans are being made to “call back” retired physicians, nurses, and respiratory therapists to fill the workforce need. Will it be enough?

Financially, rural hospitals wonder how they’ll be reimbursed for treatment. Will they get equal reimbursement for telehealth consulting? Will the federal dollars be procured through Medicaid and Medicare? What about those potentially losing insurance because of unemployment?

Many of ND’s rural hospitals were given a lifeline when the 2013 Legislature approved Medicaid Expansion. Its passage surprised many because it was a part of the disliked “Obamacare” plan. That decision to approve expansion is proven right every single day in the state.

Something troubling is lurking behind the scenes when it comes to hospital finances. The Supreme Court has agreed to take up the lawsuit to repeal all of Obamacare including Medicaid Expansion. It is entirely fair to ask what happens to those necessary payments to our rural hospitals if the Court strikes the law down. In fact, Congress needs to layout a practical plan of what happens in case the law is struck down.

At a time they’re ramping up to do their job to assist patients, medical expenses will increase. Our friends, family, and neighbors on the front lines are stepping up during this unprecedented challenge. We don’t know how long this crisis will last. Many important steps have been taken to assist hospitals. More needs to be done to help those risking their lives to help us.

Tyler Axness
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