A recent report examined how some rural Tennessee hospitals have managed to stay afloat despite financial challenges.

The report includes interviews from staff at five different rural hospitals, which range in size from 25 to 125 beds.

Judy Roitman, executive director of the Tennessee Health Care Campaign, said some of the hospitals are drowning in uncompensated care. She explained as part of their research, they did an interview with a CEO from a rural hospital in Kentucky who expressed the importance of Medicaid expansion.

"Kentucky has expanded its Medicaid program and Tennessee has not," Roitman pointed out. "He said that's the key to our stability is actually having the funds coming in to treat these patients. And the CEOs and others in Tennessee hospitals said it would make a huge difference to have that federal funding."

Roitman added the federal government is offering Tennessee a nine-to-one match. If Tennessee were to expand Medicaid, at least 330,000 people would gain access to coverage.

Roitman pointed out the report suggested further steps hospitals could take, including examining how they are reimbursed for services provided. She noted private insurance plans tend to provide the highest reimbursement rates, and said more funding is needed to support TennCare, which does not cover enough of the cost.

"TennCare is all managed by managed-care organizations," Roitman explained. "They negotiate with every hospital about how they're going to reimburse and the big hospitals have some leverage to demand better payment and the smaller hospitals are just, they're just not getting paid."

Roitman added the report credited strong community engagement and effective hospital leadership as key factors in staff retention. Robust management and maintaining an engaged workforce significantly affect a hospital's viability, according to the report.


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Seven cases of H5N1 avian flu have been reported in Michigan since Dec. 16. The first case was discovered at a poultry facility in Ottawa County.

Avian flu circulates in wild birds and can infect poultry, causing illnesses classified as highly or low pathogenic. Michigan's first cases in 2022 introduced a highly pathogenic strain.

Dr. Kimberly Dodd, dean of the College of Veterinary Medicine at Michigan State University and an infectious disease expert, explained why the initial outbreak was unique.

"Generally, once it comes to wintertime the number of cases drop off and sometimes that's all we see at the outbreak, and it's resolved," Dodd noted. "In this case, the outbreak continued over the winter and spread across the entire country."

The recent outbreak has affected more than 340,000 birds. Early findings showed the virus also infecting wild mammals, especially young carnivores and scavengers, later spreading to marine mammals near infected waterfowl.

As of now, avian flu has been detected in 30 dairy cattle herds across Michigan. The initial case, reported in March 2024, marked the first instance of avian flu in dairy cattle in the U.S. Since then, the virus has spread to additional herds around the state. Dodd pointed out dozens of domestic and wild cats were also infected after the virus spread to dairy cattle.

"We think this is primarily due to the fact that these barn cats may have access to raw milk on the farm," Dodd emphasized. "We know that raw milk contains high levels of virus."

The Centers for Disease Control and Prevention has reported 67 confirmed human cases of avian flu in the United States, with one death reported in Louisiana. However, the CDC views the situation as a low health risk to the public.


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The Medicaid and CHIP programs are vital to rural Missouri, according to a report that says reliance on this safety-net health coverage is much higher in small towns than in cities - especially for children.

The Georgetown University report says proposed federal cuts threaten rural communities, where nearly 41% of children rely on Medicaid, compared to 38% in metro areas.

Dr. Shanon Luke, a pediatrician at a Federally Qualified Health Center in rural Missouri, said her clinic is essential to a community where the nearest hospital is 45 minutes away.

"The clinic being open is incredibly important to these kids receiving healthcare," said Luke. "Having Medicaid allows them to come in for their well-child checks, and for us to do some monitoring and treating of things before they get to scary points."

The report says to stay afloat, many rural hospitals have already been forced to close less profitable units. In 2022, 52% eliminated their maternity wards, compared to 36% of urban hospitals.

The report also reveals disparities, with about 40% of American Indian and Alaska Native people more likely to live in non-metro areas without access to adequate healthcare.

Joan Alker is the executive director and co-founder of the Center for Children and Families at Georgetown University. She said Medicaid helps recipients through much-needed preventive care.

"People wind up sicker and then, they're in the emergency room," said Alker, "and children can't get their asthma inhalers and they miss school."

Statistics show Medicaid helps prevent medical debt, covers most nursing home residents, and funds a significant portion of births and maternal care - issues Dr. Luke said her patients are familiar with, firsthand.

"For our families, both financially and medically, as well as mentally," said Luke, "it's really important to know that they have that coverage."

Just over 24% of Missouri's population lives in rural areas.

This month is National Blood Donor Month, and blood donor groups are making sure people know the importance of giving blood.

Blood can't be manufactured, so people need to donate blood at their local blood bank. Nearly 400 people a day donate blood to the American Red Cross in the DMV metro area.

Bethany Bray Patterson, communications director of the National Capital and Greater Chesapeake Region of the American Red Cross, said donor blood is used in a variety of medical situations.

"Donated blood," said Patterson, "goes to people who are heading into surgery, fighting cancer, newborn babies in the NICU and people who are living with sickle cell disease and other chronic illnesses."

Patterson added that someone in the U.S. needs a life-saving blood transfusion every two seconds.

However, only 3% of eligible donors donate each year. According to America's Blood Centers, if just 1% more of Americans donated, blood shortages would be alleviated.

Patterson said the blood supply in the country is stable, but organizations like the Red Cross are also on the look out for universal donors.

"There is an increased need right now for type O blood donation, and platelet donations," said Patterson. "Type O blood is always in demand. It's often going out to hospitals faster than it's coming in through blood donation, because it is the universal blood type. It's used the most by hospitals."

You can find blood donation locations and schedule an appointment at RedCrossblood.org.




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