Rural Healthcare
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Rural Healthcare in Wisconsin
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Rural Healthcare in Your State
Jennifer Foschia
Rasmussen College
Financial Management of Healthcare Organizations
8/13/2023
Rural Healthcare in Wisconsin
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Rural healthcare in seems to be a bigger problem than ever before. The rise for
families to live in Urban America is at a greater demand than it was 30 years ago.
Families want to live close to the cities because it makes it easier to commute back and
forth to work and to do activities such as shopping, dining out, or simply just being in a
neighborhood that makes life easier for their children. Healthcare needs are huge in the
cities, making it easier to find the healthcare wanted when it is needed. However,
healthcare needs are seemingly harder to find than ever before in rural areas due to
rising costs in healthcare expenses and the money it takes to keep the medical offices
and hospitals open due to paying salaries.
This is the start of declining healthcare
needs in certain rural communities. The problem becomes horrendous when the needs
of sick people are not met and this tends to cause an uprise of poor health outcomes in
smaller communities.
This seems to be the problem for the “Northwoods” of Wisconsin.
Ascension is a
healthcare company provider in Wisconsin, that signed an agreement to transfer the
ownership of its care sites to Aspirus
(Ellichipuram, 2021)
. Ascension had to start selling
some of their hospitals and medical facilities due to the never ending of cost and
despair that came from the Covid pandemic and being rural had troubles being able to
afford their staffing needs and keeping up with the uprise in price with medical supplies
and needs to keep the doors open.
Aspirus is a non-profit rural healthcare organization that now owns 13 hospitals in
the state of Wisconsin and 4 in the state of upper Michigan. However, do not be fooled
just because they own a few hospitals in Wisconsin, most of these are rural and seem
Rural Healthcare in Wisconsin
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to be harder and harder to keep their doors open in some of their communities. Aspirus
in Eagle River, Wisconsin is home to about 1,630 people and only can offer 14 staffed
inpatient beds at this facility. This is not a lot to offer, especially since most of their
hometown are retirees that have boughten land over the years to settle down away from
the city. What would happen if even 1/8 of their town had a pandemic happen and the
residents got sick? People would have to pray that they could make it to another 20
some miles to the next rural town in Rhinelander, Wisconsin and hope to get a bed
there in their facility to be able to attend to their medical necessity. However, for a small-
town hospital they do offer some wonderful care. They are equipped to treat a wide
range of inpatient and outpatient services such as: 24/7 Emergency care, Trauma care,
Family and Internal Medicine, Breast Center with Mammography, Orthopedics,
Laboratory services, Physical Medicine and Rehab, Surgery Center, and a Paramedic
Ambulance team that also contains a Medical Air Transport Team to transport critical
care patients to the nearest trauma center of the patient’s choice or best practice of care
(Aspirus, 2021).
Some of the challenges that Aspirus in Eagle River must face is not having the
income to expand and make the hospital and medical center bigger for more patients to
be able to come in and be treated when the time would arise. Even if they had the funds
to be able to expand another challenge the hospital would face is being able to find the
staff to be able to support the added space and beds needed. This is one of the most
significant problems that rural healthcare systems face is an insufficient number of staff to
support the patient’s basic needs and necessities. This in fact causes more people to
travel to bigger cities to get the care they need or seek, causing companies such as
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Aspirus to go under due to losing patients in their facilities. Even if they had the funds to
be able to expand another challenge the hospital would face is being able to find the
staff to be able to support the added space and beds needed. The patients would not
have all the medical attention required for their healthcare needs to be met properly.
This in fact, could cause even more health problems for not only the patients admitted,
but the stress on the current staff to be overloaded and mistreat or misdiagnose a
patient. Potential patients are traveling to other cities and states now due to the lack of
specialty doctors that are needed in each clinic or hospital setting, causing companies
to maintain their money that is needed to support hiring new staff and suppling older
facilities with expansions to improve their facilities.
Increasing costs in healthcare expenses and longer turn around reimbursement
times also plays apart in the financial challenges with Aspirus. Patients have limited
resources of income limits in rural communities due to unemployment rates as well as
lower income guidelines than larger cities have. Government insurances are also not
paying full coverage for services as other insurances can cover and pay out, which in
the long run can make rural hospitals and clinics run out of money and they are forced
to sell or shut their doors forever, forcing the rural communities further in financial ruin.
Aspirus in my opinion is vulnerable because it has taken a lot of risks by them
purchasing a lot of smaller rural hospitals to try to turn a profit and make the
organization bigger faster. This to me is a mistake due to the lack of evidence behind
the rural organizations being able to turn a profit when you do not have the staffing or
ability to have patients to continue to travel to these rural locations. If you have a limited
number of people living in the town and surrounding communities, it makes it harder for
Rural Healthcare in Wisconsin
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companies to afford to continue to keep those doors open in the “smaller” facilities, even
if it does help the older communities be able to get to their local doctor’s office or
hospital. If the number of people continue to grow in these smaller communities then I
do believe that Aspirus would have a chance to grow their patient panels generating
more revenue which in turn gives the organization more profit and earnings to be able to
employee more staffing such as specialty doctors, nurses, emergency medical service
drivers, and overall will make the community a better place to not only live in but drive
other patients into their doors making the travel to other cities minimal. Other challenges
are that certain insurance providers do not cover some locations and this makes it
harder for patients to want to continue their care with Aspirus. Which in turn causes the
patient to travel elsewhere or they are forced to pay higher premiums and since they do
not have the money to afford these services, the patient will default on their bill causing
the company to have to litigate those debts costing even more money by having to turn
the owed debt to collection companies.
I believe that Aspirus does have the ability to grow and be productive if they
continue to grow in the right direction. They just signed a merger with
St. Luke’s Duluth
in Minnesota. These two systems merging would staff approximately 14,000 people,
which would include 1,300 employed physicians and advanced practice clinicians,
across its 19 hospitals and 130 outpatient locations in northeastern Minnesota, northern
and central Wisconsin, and Michigan’s Upper Peninsula
(Muoio, 2023)
This would help
patients be able to have home health and hospice care, pharmacies, critical care, and
medical goods operations of both. Aspirus Health System would bring to the table a
Rural Healthcare in Wisconsin
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useful health insurance company for patients to be able to use and medical
transportation services to more communities, while St. Luke’s would contribute its two
ambulatory surgery centers, helping more patients to be able to get elective and critical
surgeries in a timely manner
(Muoio, 2023). This merge would help the local
communities get the care they need and still not have to travel as far.
I would implement a policy to
deliver high-quality,
cost-effective care
to ensure
that patients could afford the services provided however making sure that it was quality
care
(Healthcare Financial Transformation: 5 top strategies, 2023).
This would ensure
patient satisfaction and they would want to continue coming back to our facilities. Word
of mouth works the best today, so if your mom gets her care at Aspirus and the staffing
was adequate and care was great and prices are fair, and you tell your friends they will
share those stories making it a much better facility monetary wise. I would also create a
way to continue the cash flow by going through the data and analytics to boost revenue
through improved financial performance and reimbursement. Making sure that the
books are up to date including reducing the number of outstanding bill holder accounts
and this can reduce the debt the company maintains. Making better and easier
opportunities for patients to pay their bills, eases the mind of not only the patients, but to
the company’s debt to ratio numbers. I would create an easier more suitable way for
patients to be able to pay their bills whether it be online or in person. Implementing a
health care wellness institutive. This would create more people to want to go to the
doctors to get more routine testing, which in turn helps keep the community healthier
and in turn driving the cost of insurance and medical care down, all while giving the
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organization more money in the long run. The larger amount of healthy people we have
in a community, the longer they live and the longer they continue to maintain their care
through their local organization. Using the government programs that are readily
available can help maintaining keeping the budget and costs of medical supplies and
needs down as well.
In conclusion, the rural communities either make or break the healthcare setting.
If smaller communities continue to work together to implement a better healthcare
setting, then the costs can be lower helping more people to be healthier and this in turn
helps the smaller health care facilities to keep their doors open. But it is a rising
concern, and I hope that through state grant programs and communities that can help
support the rising medical costs, we can come together to help keep these local clinics
open for ease of care for all.
Rural Healthcare in Wisconsin
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References
Aspirus Health. (n.d.).
Aspirus Eagle River Hospital
. Find a Location | Aspirus Health
Care. https://www.aspirus.org/find-a-location/aspirus-eagle-river-hospital-533
Ellichipuram, U. (2021, August 3).
Aspirus assumes ownership of hospitals and clinics
from Ascension Wisconsin
. Hospital Management.
https://www.hospitalmanagement.net/news/aspirus-ascension-wisconsin/
Healthcare Financial Transformation: 5 top strategies
. Health Catalyst. (2023, January
23). https://www.healthcatalyst.com/insights/healthcare-financial-transformation-5-
top-strategies
Muoio, D. (2023, July 12).
Aspirus Health, St. Luke’s Duluth unveil plans to form 19-
hospital midwest nonprofit system
. Fierce Healthcare.
https://www.fiercehealthcare.com/providers/aspirus-health-st-lukes-duluth-unveil-
plans-form-19-hospital-midwest-nonprofit-system#:~:text=Aspirus%20and
%20St.,value%20for%20patients%20and%20employers.%E2%80%9D
Levinson, Z. (2023, February 23).
Rural Hospitals Face renewed financial challenges,
especially in states that have not expanded Medicaid
. KFF.
https://www.kff.org/health-costs/issue-brief/rural-hospitals-face-renewed-financial-
challenges-especially-in-states-that-have-not-expanded-medicaid/
Rural Healthcare in Wisconsin
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