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Hospital service closures in Miami County raise concern for rural health access

Premier Health

When two health care units closed in Miami County early this year, it raised concerns about health care access in the rural region.

In February, Premier Health closed its labor and delivery unit at Upper Valley Medical Center, and Kettering Health closed its emergency unit in Piqua.

With the closure of the Premier Health unit, no hospital in Miami County offers labor and delivery services.

“This means that anyone that's pregnant in Miami County is going to have to drive at least 15 miles to have to deliver a baby,” said Miami County Commissioner Gregory Simmons, one of the local leaders who has raised concerns on behalf of their residents about the status of health care in the county following these closures.

Premier Health cited a number of reasons for the closure of the birthing unit. In a statement, the hospital pointed to declining local birth rates and challenges around physician recruitment.

“All specialties are a challenge right now to recruit, but OB-GYNs are especially challenging,” said Kevin Harlan, president of Upper Valley Medical Center. “That is really why we saw the precipitous drop in deliveries between 2022 and 2023, and we fully anticipated that to drop even more from 2023 into 2024.”

Data provided by Premier Health shows deliveries have dropped steadily from about 700 births in 2015 to about 300 last year. The closure of the Upper Valley Medical Center maternity unit comes nearly two years after Premier Health shut down another delivery unit at Miami Valley Hospital South in Centerville.

“We have job opportunities in Miami County. Miami County is a great place to live. And we attract young families. But, we're afraid that the young families won't want to come if we don't have a full-service hospital.

In Piqua, Kettering Health has closed its emergency department.

In a statement shared with WYSO, the health care provider said that financial sustainability and fewer emergency cases are the reasons for the closure.

The health network said its Troy location, which is 8 miles away from Piqua, will continue to provide emergency care. In 2020 Kettering Health also closed the ICU and operating rooms at Greene Memorial Hospital in Xenia.

Simmons said these closures will affect not just patients but the local economy.

“We have job opportunities in Miami County. Miami County is a great place to live. And we attract young families,” Simmons said. “But, we're afraid that the young families won't want to come if we don't have a full-service hospital.

Brock Slabach, from the National Rural Health Association, echoed this concern, especially as a health care facility in a rural area can account for 20% of the rural economy.

“There is quite an alarm that goes off in (rural) communities when they find out that their hospitals and their related health systems are closing services, because it really is not just a matter of access, it's also a matter of economic development for small rural communities,” Slabach said. The association also is lobbying Congress to address the issue of rural access to health care and hospital closures. They said reimbursements are not adequate to sustain these facilities with their low staff volumes and high unit costs.

The Center for Healthcare Quality and Payment Reform found in a study that at least 40% of rural U.S. hospitals are at risk of shutting down in the near future. It said a key reason is that current cost-based payment systems don’t cover the full costs of running rural hospitals.

Data from the American Hospital Association shows that even though rural populations account for 14% of the population, only 10% of physicians in the United States practice in rural areas. The hospital association found that nearly 70% of the primary care Health Professional Shortage Areas are located in rural or partially rural areas.

Last year, the Rural Physician Workforce Production Actwas introduced by U.S. Rep. Henry Cuellar, D-Texas. Lobbyists say this will improve Medicare reimbursements and enhance the current structure of the Medicare-funded graduate medical education program to bring more medical residents and doctors to rural areas.

“There’s a tremendous workforce crisis going on all over the United States, not just in rural areas, but it impacts rural areas in a disproportionate way,” Slabach said. “It's extremely difficult to find the staffing that is needed in an affordable way to maintain a lot of the work that these facilities do.”

Premier Health said gynecological surgery will continue at Upper Valley and the hospital will open its new Women’s Imaging Center there in March.

In a statement, Kettering Health said it expects to expand its primary care presence in the northern part of the Miami Valley over the next year.

Ngozi Cole is the Business and Economics Reporter for WYSO. She graduated with honors from Columbia University’s Graduate School of Journalism in New York and is a 2022 Pulitzer Center Post-Graduate Reporting Fellow. Ngozi is from Freetown, Sierra Leone.