It’s increasingly difficult for rural hospitals to make ends meet. Many have had to freeze or cut salaries, said Danne Howard, chief policy officer with the Alabama Hospital Association. Some have eliminated services, like obstetrics and gynecology. Howard said others partner with outside groups or bigger health systems to take some of the financial pressure off.

“It’s clear to see that we’ve got a number of hospitals that may not survive in the current financial environment,” she said.
In the past decade, seven rural hospitals have closed in Alabama, and of those that remain, 88% operate in the red.

But Howard said Medicare is throwing the state a lifeline. The federal health insurance program, primarily for senior citizens, recently approved a plan to start paying rural hospitals a little more money. Read more.