As financial distress persists in rural markets, Caitlin Carroll and coauthors use national hospital data from the period 2008–18 to examine how often unprofitable hospitals in predominantly rural markets close or merge, and to what extent predominantly rural markets consolidate over time.

The authors find that many hospitals survived financial stress despite poor financial performance. In some cases, hospitals returned to profitability as well.

The results of their research "suggest that the process of consolidating may be slow, giving policy makers more time to act, but also that rural hospital markets are far from stable."

"Consolidation was more common in markets that had more competitors at the beginning of the study period," the authors report. "As the number of competitors in rural markets decreases, policy makers will need a regulatory framework for areas that can support only limited hospital competition."

Carrol discusses the research and findings in greater detail on this week's episode of A Health Podyssey, which you can listen to here.

Today in Forefront, Andrew Twinamatsiko and Zachary Baron argue that the recent Texas ruling on preventive services and the Affordable Care Act would open a new "Wild West" where insurers and employers pick and choose benefits to cover and associated financial obligations.

Sarah Duffy challenges the "six month minimum" recommendation of pharmacotherapy for opioid use disorder, arguing that, although more evidence is needed, treatment duration should start with a minimum of a year.

Richard Hughes IV and coauthors argue that, while the Braidwood v Becerra decision leaves coverage of preventive care uncertain, real policy solutions are available, including installing oversight by government leaders and exercising administrative solutions to increase the US Preventive Services Task Force’s accountability.

Read more on Forefront and learn more about how you can contribute to the publication.

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