A new case study of seven states in the Upper Midwest, released by the Bipartisan Policy Center, has argued that many critical access hospitals in rural America cannot be supported by waning local populations, and should thus be converted to provider facilities that provide cost-effective services more in line with their communities’ most pressing healthcare service needs.

Although most residents of small communities view their hospitals as critical infrastructure and are thus reluctant to consider closing them, hospitals with low in-patient volumes often need to charge more for services than their suburban and urban counterparts do, just to stay afloat. That, the study’s authors said, is wasteful and, ultimately, more harmful to rural population health than closing the hospital would otherwise be.

The study’s authors suggested more small communities should consider converting their low-volume hospitals to primary care facilities, freestanding ERs, or ambulatory surgical centers, to maintain critical access without the expense of staffing and running full hospitals.

Read more here in the report by NPR.