Mississippi’s struggling rural hospitals haven’t improved their financial outlook much over the past quarter, a newly updated report shows.

A report from the Center for Healthcare Quality and Payment Reform shows that about a third of Mississippi’s rural hospitals are still at risk of closure, and over a half of those still at risk of immediate closure. 

The report, which the organization updates every three months, shows 27 hospitals are currently at risk of closure in Mississippi, with 20 of those at risk of immediate closure. 

The January version of the report previously showed that 28 of Mississippi’s 74 rural hospitals were at risk of closure. Of those, 19 were at risk of closing immediately.

Only four other states — Oklahoma, South Carolina, Alabama and Connecticut — have poorer statistics regarding immediate closure risk, while Mississippi and Tennessee are tied for fifth place. In both states, 27% of overall rural hospitals are at risk of immediate closure.

Harold Miller, CEO of the center behind the report, said the situation is largely due to low payments from private health insurance companies. His organization advocates for hospital payment reform. 

READ MORE: Lawmakers approved $104 million for Mississippi hospitals. Some say it’s not nearly enough.

The center judges closure threat by how long hospitals can continue operations while losing money. The center says hospitals are at risk when they can sustain losses for six to seven years, and at immediate risk when they can offset those losses for only two to three years. 

More than half of Mississippi’s rural hospitals are losing money serving patients, according to the report.

Many of the state’s hospitals were already financially vulnerable, and during the pandemic, the cost to run hospitals went up — supplies and labor became more expensive, but hospital profit did not increase.

The situation siphoned money out of the state’s struggling hospitals, and now the state’s health care infrastructure is crumbling.

When rural hospitals close, it can be disastrous to their communities. Residents are forced to drive longer distances for what is sometimes life-changing care. It’s a thorny situation in a state with already some of the country’s worst health outcomes.

Hospitals are taking different approaches in an effort to stay open. Some are closing certain departments to cut costs, such as Singing River’s Gulfport hospital, while others are applying for a new federal designation to bring in more money, such as Alliance Healthcare System in Holly Springs.

This year, state lawmakers passed a plan to send millions in grant money to hospitals, and a change in Medicaid supplemental payments brought in slightly more money. The influx of money, along with a big credit line, has helped Greenwood Leflore Hospital stay open.

But that money is temporary, hospital administrators have stressed, and isn’t a long term solution to the state’s health care crisis.

While experts agree it’s not a silver bullet, Medicaid expansion would bring an influx of millions to Mississippi’s struggling hospitals. Though a majority of Mississippians support Medicaid expansion, Republican state leadership has adamantly opposed the idea and blocked serious debate about it. 

“Many of these hospitals could be forced to close in the near future if they don’t receive payments that are adequate to cover their costs,” Miller said.