Compared to their urban counterparts, rural hospitals serve a population that tends to be older, sicker, uninsured and have less income. Rural hospitals provide a lot of uncompensated care and run on more narrow profit margins.
To stay open, these hospitals depend on special federal designations that give them a higher rate of reimbursements from Medicare and Medicaid. For example, when a hospital designated as a critical access hospital, Medicare reimbursements can make up to a third of its entire revenue.
The U.S. Supreme Court will likely rule on the fate of the federal health care reform law this Thursday. That ruling could affect provisions of the law aimed at improving health in rural America.