Reimagining the Role of Maine’s Rural Hospitals: Preparing for the Future

Abstract

Maine’s rural hospitals struggle with workforce shortages, high operating costs, inadequate reimbursement, and patients bypassing their local hospitals to access services outside of the community. Since 2013, four Maine acute care hospitals have terminated inpatient operations. Evolving challenges include a declining need for inpatient beds, growth in Medicare Advantage and value-based payment plans, escalating healthcare costs, and the Reconciliation Act (HR 1), which contains provisions expected to harm rural hospitals, providers, and residents. To partially offset the anticipated negative impact of the bill, HR 1 also provides $50 billion in funding for a five-year Rural Health Transformation Program (RHTP). This paper reimagines the role of rural hospitals to focus on the delivery of comprehensive primary care and essential services, proposes regionalizing services to maintain access to care, discusses the role of the state in supporting rural hospitals and applying for RHTP funds, and offers a Rural Community Health Transformation Collaborative model to engage communities in planning for and supporting their local and regional hospitals and delivery systems.