rural hospitals

As someone interested in Oklahoma health care, I read KTUL’s April 11 headline with widened eyes: Tulsa nonprofit seeks community support as 42 rural hospitals are at risk of closing.

The lede intrigued further:

More families are forced to travel to the Tulsa area as more rural hospitals are at risk of closing. Oklahoma’s budget deficit could shut down 42 rural hospitals or change the status to an outpatient facility, ER or triage clinic.

The rest of the story, however, offered no other details about those 42 hospitals. No citation, no source, no hyperlink.

Was this figure accurate? Who had floated that number? What was the rest of the story?

Tracking down the original source

My voicemail to KTUL’s Franque Thompson requesting details went unreturned. I scanned her bio to determine the potential credibility of the report:

Growing up, I was a very shy girl with extremely low self-esteem. I thought I would never see the day where I could turn on a television and see myself on the screen.

Instead of hiding in the shadows for several years, I finally took a chance on faith and stepped into the light. I won my first beauty pageant at the age of 16, and from then on I began to see my potential and purpose in life. The adrenaline of pageantry and onstage presentation peaked my interest in journalism.

Since homophones always “pique my interest,” I tried to investigate further. I asked health care contacts if they had heard of a report on the topic of Oklahoma rural hospitals facing closure. For several days, people said they had not. I read Brianna Bailey’s excellent hospital story on NewsOK, but no such numbers or reports were included. Perhaps they didn’t actually exist?

April 18, however, I caught a break. The Oklahoma Hospital Association was having its lobby day at the Capitol, begging lawmakers to value Medicaid reimbursement rates and other state funding for health care.

Susie Wallace with the OHA said she knew where the “42 hospitals” number had come from. While she was unable to find the report itself, she recalled the company that had published it. I left that company a voicemail. Within the hour, their report had landed in my inbox.

Zeroing in on the data

Or so I thought. Scrolling through iVantage’s Rural Relevance 2017 assessment of American health care (below), I could find no reference to Oklahoma nor its rural hospitals.

Fortunately, iVantage’s marketing director had also sent me a two-page chart titled Rural Health Policy Impact — Oklahoma (below). It features all of the state’s hospitals and numbers concerning their revenue, bad-debt reduction and operating profit margin/loss percentages.

Upon further request, I was finally able to obtain the company’s 2016 Oklahoma Snapshot that listed the 42-hospital figure. Wallace had come through with the key document.

So there it was, three numbers in three boxes and a giant “N” to signal Oklahoma has thus-far said “No” to Medicaid expansion. That was circa 2016, but 2017 is no different in terms of expanding coverage for low-income Oklahomans and drawing down hundreds of millions of federal dollars for state health care.

OHA president: State’s health care in ‘crisis’

rural hospitals
Oklahoma Hospital Association president Craig Jones speaks at the Make OK Better press conference to support a proposed cigarette tax last week at the State Capitol. (Provided)

At the Make OK Better press conference to support a proposed cigarette tax last week, OHA president Craig Jones said the state’s health care system was in a “crisis.” He said failure to pass the tax could cause Medicaid reimbursement to be cut by about 26 percent. That, he said, would cause “over a dozen” Oklahoma hospitals to close.

Depending on whether you trust 2016 numbers from iVantage or 2017 estimates from Craig Jones, between 12 and 42 hospitals in Oklahoma face potential closure.

What a spread.

At what point, if any, will lawmakers and Gov. Mary Fallin admit that the decision to refuse federal money for Medicaid expansion (or InsureOklahoma expansion) has jeopardized the financial stability of the state’s health care entities?

In Kansas, it has taken the impending closure of a hospital in the state capital of Topeka to push lawmakers toward the policy. That state’s conservative governor, however, has already vetoed the proposal. Not enough votes exist (as of yet) to override him.

Perhaps if journalists would report that, say, 43 hospitals might close, the Legislature would perk its ears up on the issue.