HJAR Jul/Aug 2020

34 JUL / AUG 2020 I  HEALTHCARE JOURNAL OF ARKANSAS POLICY prevent our healthcare facilities from be- ing overwhelmed. The state began gradually easing restrictions on elective procedures on April 27. The temporary suspension of elective procedures, in combination with other disruptions related to the pandemic, had a major impact on hospitals’ finances. An interim financial impact study conducted by the Arkansas Hospital Association in late April among nearly 80 hospital mem- bers estimated that business disruptions in March andApril resulted in lost revenue for the hospitals totaling $271 million. Several health systems have announced emergency cost-cutting measures, including furloughs for some workers. Every hospital in the state has been COLUMN POLICY A SUBCOMMITTEE of the Arkansas Gen- eral Assembly’s public health committee was formed to study the issue. Then came the pandemic, which has added to rural hospitals’ difficulties, and highlighted the need for new strategies to ensure that access to healthcare does not become a privilege available only toArkansans living in urban areas. Gov. Asa Hutchinson declared a public health emergency in response to the pan- demic on March 11. On April 3, state Sec- retary of Health Dr. Nate Smith, in consul- tation with the governor, ordered a halt to elective medical procedures in the state. The move was, I believe, appropriate, as part of a carefully crafted effort to slow the spread of the novel coronavirus, and affected, but hospitals in rural areas were operating on thin margins even before the pandemic. These hospitals struggle tomain- tain aging facilities and overcome workforce recruitment challenges. And acquiring and adjusting to new technology, including tele- medicine, which has become especially im- portant during the pandemic, is more dif- ficult for rural hospitals than for their urban counterparts. This, in part, is why Congress allotted funds specifically for rural hospitals from the Provider Relief Fund created under the Coronavirus Aid, Relief, and Economic Security Act. A key factor in the financial challenges facing rural hospitals is that Arkansas, like other states, is experiencing significant shifts in its rural-urban divide. Well before the COVID-19 pandemic began, healthcare leaders and policymakers in Arkansas were voicing concerns about the financial challenges facing the state’s rural hospitals. RURAL ARKANSAS HOSPITALS WERE ALREADY STRUGGLING; ThenCame the Pandemic