EDITORS/NEWS DIRECTORS:
Hundreds of rural hospitals across the country are facing closures after years of funding problems. The issue was compounded last summer by the Trump administration’s massive cuts to Medicaid, the government’s safety net for low-income Americans, whose reimbursements have long helped hospitals meet their bottom lines.
Outcry over the funding cuts prompted Republican lawmakers to create $50 billion in new rural health grants, but critics say that funding is intended for innovative health care delivery solutions — not propping up hospitals buckling under current pressures.
“It won’t pay to keep the lights on. And it won’t turn the lights back on once they’ve been turned off,” said Dr. Ben Young, an infectious disease specialist and policy expert with public health advocacy group Wellness Equity Alliance.
Administrators say the new $50 billion fund is not meant to shore up ailing rural hospitals or maintain the status quo, but to transform rural health care through tech, workforce and other innovations. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz in a December video said it “gives states the tools to design solutions that last, not Band-Aids that fail.”
The White House echoed that Wednesday, saying the fund is intended to fund “big ideas” to improve rural health care access long-term.
Rural Americans’ health care worries reflect broader national concerns about access and rising prices of care as the cost of living spikes — anxieties that could prove pivotal in this year’s midterm elections.
This guide includes access to grant funding proposals for each state and resources for identifying at-risk hospitals in your community.
___
READ AP'S STORY
A $50b rural health fund ‘won’t pay to keep the lights on’ at struggling hospitals
___
FIND YOUR STATE: FUNDING APPLICATIONS
Each state had to apply for its portion of Rural Health Transformation Program grant funding, explaining to the federal government how it planned to spend the funds in ways that transform rural health care.
Most states have made their application, or at least a descriptive section of it known as the Project Narrative, public on their websites. AP has collected PDFs of these proposals and collected them in a folder here.
Alternatively, to find these and other relevant documents online, search your state name with “Rural Health Transformation Program” or look on your state's health department website.
___
FIND YOUR COMMUNITY: AT-RISK HOSPITALS
Several organizations have conducted their own analyses of rural hospitals that are especially at risk of closing or reducing their services as a result of the Medicaid cuts.
Exploring these analyses and the databases that power them can be a good way to find hospitals that may be worth further reporting.
A few potential resources include the Center for Healthcare Quality and Payment Reform, which monitors hospital financial status; the University of North Carolina at Chapel Hill’s Cecil G. Sheps Center for Health Services Research, which maps hospital closures; and Public Citizen, a progressive group that recently put out a report that includes an interactive map identifying at-risk hospitals and other hospitals.
___
CONSIDER THESE REPORTING THREADS
— Read through your state's Project Narrative to see what the state is proposing be done with the funds. How much, if any, of the funding will go toward helping rural hospitals? Are there other proposed projects worth deeper reporting?
— As you explore potential hospitals to feature in your coverage, consider their proximity to other places to get comparable care. A rural hospital's closure may be felt more deeply if nearby residents need to drive a long way to find such care anywhere else.
— Find voices for your story. Once you locate a hospital to report on, you can use a variety of reporting tools to find sources in the area who may be affected by its financial challenges. These can include patients who rely on the hospital or people who are employed by it. Search community Facebook groups and Reddit forums for anyone who may be talking about the hospital. Contact local advocates and community leaders to find people in their networks to interview. Get in touch with local politicians. Consider trying labor unions whose members may be employed at the hospital. Finally, contact the hospital's leadership to get their perspective on its financial status and next steps.
— Seek input from state hospital associations and state lawmakers. Has anyone in your state legislature been raising concerns about this issue? Are lawmakers responding to the federal funding shortfall with their own solutions to fill the gap?
___
READ ADDITIONAL AP COVERAGE
How an empty North Carolina rural hospital explains a GOP senator's vote against Trump's tax bill
Rural hospitals brace for financial hits or even closure under Republicans' $1 trillion Medicaid cut
FACT FOCUS: Rural hospitals are expected to lose money from Trump's bill, despite RFK Jr's promise
Trump administration rolls out rural health funding, with strings attached
___
Localize It is a resource produced regularly by The Associated Press for its customers’ use. Questions can be directed to the Local News Success team at localizeit@ap.org. View guides published in the last 30 days here.
