Leopards Ate My Face

As a primary factor, running a clinic with a population of 806 with the current payout structure of Medicare, Medicaid, and insurance companies is frankly unsustainable. It's not wrong to say the Medicaid cuts are not the primary factor, just the last straw in an already broken model. Giving service to a community that small and spread out takes state subsidies or the regional health care system eating the losses. It sounds likely this crew would be hostile to the former and are mad that the nonprofit can't continue to afford the latter as the Medicaid cuts squeeze them more.

Much of these services are offered primarily to avoid 30 day readmission penalties that CMS hits hospitals with after discharging people to areas with no follow up care. It essentially externalizes the cost of providing this care into regional health systems. But eventually they'll find other avenues, like very targeted home visits and increasing nursing home admissions, as the costs get unsustainable. And then the costs of this lack of access are externalized right back onto the community.