Below is a reprint of an article that recently ran in the Journal Record newspaper. The article was written by Bob Henger, Northwest Medical Center CEO and it outlines some of the challenges faced by rural hospitals, but more importantly, explains the tremendous value our hospital provides to the community and the importance of the hospital's survival.
The Economic Value of Rural Hospitals
By Bob Henger, CEO Northwest Medical Center
The Alabama Daily News Digest recently featured an article by columnist Matthew Stokes. In the article he writes about “The Hamilton Project,” a significant initiative by the Brookings Institution. The project examines the vitality index of every county in America, weighing factors including median household income, poverty rate, unemployment rate, life expectancy, home vacancy rate and prime-age unemployment to population ratio. To no one’s surprise, almost every county in Alabama ranks low on this vitality index.
The article goes on to say that rural industries leave an area for a variety of reasons and, in time, rural residents with higher degrees and training leave the area as well due to a lack of job opportunities and the amenities offered by larger cities. When they leave, they take with them their money, civic energy, organizational know-how and leadership. Put crudely, this phenomenon causes many of our rural areas to suffer from a significant brain drain.
The decline of rural industry and closing of factories has led to a massive migration of educated Americans to cities. A look at the State of Alabama on the Hamilton Project reveals strong vitality numbers in Autauga, Baldwin, Madison and Shelby counties while the rest of the state flounder from bad to worse. The problem is that too many of our state’s best and brightest are increasingly congregating in intense clusters, leaving the rural and even some suburban areas bereft of the human capital that could enrich them. While this situation has been occurring nationwide, it is worse for a state that is experiencing a stagnant population.
The Hamilton Project’s vitality index is a measure of a location’s economic and social well=being. The indicators and their relative weights are as follows:
- Median household income (45%)
- Poverty rate (24%)
- Life expectancy (13%)
- Prime-age employment-to-population ratio (9%)
- Housing vacancy rate (5%)
- Unemployment rate (4%)
Counties with a vitality rate index that is above zero are doing better and those with vitality scores below zero are doing worse. The Hamilton Project’s vitality index scores compare Marion County, Alabama, to the State of Alabama and to the national index scores.
|Level||Vitality Index||Median Household Income||
Employment Rate (age 25-45)
|Housing Vacancy Rate||
What can be done to stem the decline of rural America, in particular, rural Alabama? All rural counties seek to bring in new industry and secure current companies and jobs. In order to attract new industry to a rural area, at least two quality institutions must be in place; a highly regarded education system and a hospital. We are fortunate to have in Marion County excellent education systems and two hospitals on either end of the county.
Unfortunately, rural hospitals in Alabama are disappearing one by one due to out-migration of populations and poor reimbursement to rural hospitals. Beyond the fact that our citizens would not have access to local healthcare and would need to drive an hour or more to the closest hospitals or emergency service, what would it mean to the local economy and social well-being of Winfield and Hamilton without our hospitals? A hospital is a major industry in any rural town, employing hundreds of people in higher-paying jobs. Without a hospital in place, it’s almost impossible to attract physicians to rural towns. As an example, Northwest Medical Center in Winfield employees ten physicians and five nurse practitioners, while 11 other internal medicine and family practice doctors have their individual practices in the Winfield area, and they employ an additional five nurse practitioners. A total of 21 physicians and ten nurse practitioners would probably not be living in this community without the hospital. Furthermore, ten out of the twenty-one doctors and most all of the nurse practitioners were born and raised in this area and have come back home after medical training to serve our hospital and community. These are highly-educated professionals with six-figure jobs. The Hamilton area has a similar story to tell.
Besides physicians, hundreds of nurses are employed by the two hospitals and physician practices. Other high-paid professionals working in hospitals include pharmacists, dietitians, radiology and lab technicians, cardiopulmonary technicians, physical therapists, occupational therapists, speech therapists, audiological therapists, social workers, IT specialists, accountants, business office specialists, executive and middle managers, skilled maintenance workers, medical records specialists and several other specialists.
Our hospital campus has also attracted several other medical facilities and services, such as the Cancer Center, Wellness and Rehabilitation Center, Sports and Occupational Clinic, Dialysis Center and assisted living facilities. Without the hospital as the hub of medical services, ambulance service, hospice, home health agencies, pharmacies and rehabilitation therapists might not exist in the community.
The impact of losing these professionals would be devastating to the local economy and businesses. From a social well-being standpoint, many elderly people and uninsured citizens might go without proper healthcare. Our civic and social clubs as well as churches would experience a great void in membership and leadership. I have always been impressed with the number of great families that live in Winfield and from one generation to the next their children set high standards and performance in our school system and later go on to become the human fiber of what makes Winfield such a unique community.
Without adequate reimbursement for the services rendered in our two hospitals, it will be difficult to survive. And, the only way we will survive is for our communities to believe in our hospitals and utilize our services. The combination of poor reimbursement and our citizens seeking their healthcare elsewhere simply means our rural hospitals will not survive. Remember, the very people who work in our hospitals are your family members, friends and neighbors. Put your trust in them and receive your healthcare locally. I can tell you without any doubt, the physicians, healthcare professionals and managers we employ at Northwest Medical Center provide outstanding care and service and can meet or exceed any hospital elsewhere.