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May 28, 2020

How rural and urban hospitals can team up to combat Covid-19

Daily Briefing

    As rural hospitals prepare for an expected increase in Covid-19 cases, they should be looking to partner with larger urban hospitals that can provide a financial cushion. Rural hospitals, already struggling financially, know the risk their organizations face if their communities suffer an outbreak. If more rural hospitals are forced to shut down, it could exacerbate health disparities between rural and urban areas.

    Your Covid-19 checklist to expand capacity

    That's why it's crucial for rural hospitals to assess all their options as they prepare for their own Covid-19 surges. In previous blogs, we've covered how rural hospitals can address workforce shortages and secure PPE. This time we'll focus on partnering with larger urban institutions.

    2 ways rural and urban hospitals can partner to treat Covid-19 patients

    As rural providers work to manage persistent and emergent health challenges and worsening economic conditions, many have merged with larger health systems or entered into partnerships. Rural hospitals that are part of a larger system have better finances on average; however, merging is not a short-term solution to combat Covid-19. Instead, partnerships are a viable solution to address critical needs. 

    There are two key ways rural and urban hospitals can form partnerships to respond to Covid-19: 

    1. Increase testing capabilities by leaning on larger organizations with lab capacity.

    Widespread testing is key to understanding the prevalence of Covid-19 in communities and mitigating its spread. But for many rural hospitals testing remains an uphill challenge. That's why rural hospitals should look to their urban counterparts to meet the demand for Covid-19 tests.

    For example, Indiana University of Pennsylvania partnered with Indiana Regional Medical Center (IRMC) to increase rural patients' access to same-day testing. The chair of IU-Pennsylvania's biology department stepped forward to offer IRMC the university's lab for processing patients' test, shortening the turnaround time for them to get results. The partnership also helps IRMC save on PPE that clinicians would have used while waiting for test results and treating patients under investigation (PUI). The idea is catching on—Augusta University Health is also serving rural providers in Georgia and South Carolina by offering their lab services for Covid-19 testing.

    2. Ease capacity in hard-hit areas by sharing the patient load.

    These partnerships should be bidirectional. Rural and urban hospitals in hard-hit areas can work together to increase capacity by transferring Covid-19 patients. For example, University of Maryland Shore Medical Center at Easton, a rural hospital, is accepting patients from more populous—and more infected—parts of the state.

    There's some local concern that bringing Covid-19 patients to an area where it's not prevalent could put the community at risk. However, Talbot County Health Officer Freida Wadely said that the health system's ability to spread the case load across the state will preserve access and ensure optimum care. She told The Star Democrat, "Maybe we should be asking ourselves, 'If I were infected with Covid-19 and Shore hospitals were overwhelmed with cases, would I want a hospital in another area to find a bed for me?'"

    Hospitals provide mutual support in a time of need

    When urban and rural provider organizations come together to support one another, it creates win-win partnerships. These organizations can better serve their communities by sharing capacity and spreading caseloads to meet patient needs and ease the financial strains. 

    In our next blog post, we'll review how rural hospitals can use telehealth capabilities to respond to Covid-19.

    Is your rural hospital implementing strategies to combat the impact of Covid-19? Email Darby Sullivan at to share your experience.

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