Exploring telehealth adoption and financial outcomes for rural hospitals during the COVID‐19 public health emergency

Purpose To examine factors associated with rural hospital telehealth adoption during the COVID‐19 public health emergency (PHE), and evaluate its relationship with rural hospital financial performance before and during the PHE. Methods This panel study used retrospective data (2017–2021) from the Am...

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Bibliographic Details
Published in:The Journal of rural health Vol. 41; no. 2; pp. e70038 - n/a
Main Authors: Karim, Saleema A., Tilford, J. Mick, Bogulski, Cari A., Hayes, Corey J., Eswaran, Hari
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01.03.2025
Subjects:
access
Adoption of innovations
Bivariate analysis
Clinical outcomes
COVID-19
COVID-19 - epidemiology
Disadvantaged
Financial performance
Health care
Health care expenditures
Health care industry
Health services
Health status
Hospitals
Hospitals, Rural - economics
Hospitals, Rural - organization & administration
Hospitals, Rural - statistics & numerical data
Humans
Information services
Information sources
Information systems
Information technology
Investments
Medicaid
Medical technology
Medicare
Public finance
Public Health
Retrospective Studies
Rural areas
Rural communities
Rural health care
rural hospital
SARS-CoV-2
Statistical analysis
Subgroups
Telecommunications
telehealth
Telemedicine
Telemedicine - economics
Telemedicine - organization & administration
Telemedicine - statistics & numerical data
United States - epidemiology
United States
rural hospital
access
COVID‐19
telehealth
ISSN:0890-765X, 1748-0361, 1748-0361
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Summary:Purpose To examine factors associated with rural hospital telehealth adoption during the COVID‐19 public health emergency (PHE), and evaluate its relationship with rural hospital financial performance before and during the PHE. Methods This panel study used retrospective data (2017–2021) from the American Hospital Association Annual Survey, the Centers for Medicare & Medicaid Services Healthcare Cost Report Information Systems, and the Area Health Resource File. Rural hospitals were categorized as persistent adopters, persistent nonadopters, or switchers based on telehealth adoption status. Bivariate analyses assessed differences in subgroup means and frequencies, while a difference‐in‐difference model estimated the impact of telehealth adoption on rural hospital financial performance. Findings Telehealth adoption varied among rural hospitals. Before the PHE, 75% (751) of rural hospitals had adopted telehealth, while 25% (247) were nonadopters. Despite efforts to promote remote care delivery during the PHE, 58% (144) of pre‐PHE nonadopters did not adopt telehealth. Among the 42% (103) that did adopt telehealth during the PHE, no statistically significant effect was observed on operating or total margins. Conclusion Rural hospitals in economically disadvantaged and sparsely populated areas, which stand to benefit the most from telehealth adoption, often face substantial barriers that limit their ability to adopt this technology. Financial constraints and limited resources continue to hinder adoption, underscoring the need for targeted policies and investments to expand telehealth access and improve health care outcomes in rural communities.
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ISSN:0890-765X
1748-0361
1748-0361
DOI:10.1111/jrh.70038