LA VISTA, Neb. —
Nebraska hospital leaders shared concerns about the $177 million coming to support rural healthcare in the state. They are thankful for the Rural Health Transformation Program, but there needs to be a plan for the future.
One of the hospitals impacted is Pender Community Health in northeast Nebraska. Pender isn’t just a hospital; it’s also a daycare and a nursing home, but CEO Laura Gamble said that might not last.
“We’re going to start having talks with our community of whether we can’t do this ourselves,” Gamble said. “We can’t sustain this as a hospital system.”
Pender is one of dozens of hospitals affected after the Medicaid cuts enacted by the One Big Beautiful Bill. The legislation cut $1 trillion in funding, but allocated $50 billion to offset that loss. That money will be divided amongst all 50 states over the next five fiscal years.
Even with the incoming money, Nebraskan hospitals continue to suffer.
“About 30% of our rural hospitals are still losing money on operations,” Jeremy Nordquist, president of the Nebraska Hospital Association, said.
Gamble just received funding from the program, which she’s using for hospital updates. The renovations will move administration and allow Pender to take in even more patients, hopefully increasing their revenue.
She said while the funding will help, it isn’t enough.
“This money, maybe it’s a band-aid,” Gamble said.
Related coverage: Nebraska legislative committee probes impacts of cuts to Medicaid
The program supports hospitals by giving money for modernization, expanded care access and increased staffing and retention.
“If they stay for five years, they will receive some retention dollars for being and working in a rural area,” CEO of Great Plains Health, Ivan Mitchell, said.
However, Mitchell said that money isn’t solely for traveling staff or transplants. Even people who have worked in the same hospital for years can still apply for the bonuses. He felt the money is only being used for short-term solutions.
“I do not see how that is going to help keep a service line open in a rural community,” Mitchell said. “I don’t see how it’s going to help your hospital stay open.”
The Nebraska Hospital Association said care is always needed, even after the money goes away.
“We should be helping [the hospitals] with their financial situation and then making investments that will put us in a better spot when these dollars go away in five years,” Nordquist said.
After the Medicaid cuts from the One Big Beautiful Bill, hospitals only have two options to save money: shift costs off to someone else or cut services to save money, according to Nordquist.
Related coverage: Officials say thousands of Nebraskans would lose Medicaid coverage under proposed spending bill cuts
Because of the Medicaid cuts and changes, fewer people have coverage. Nordquist said so far roughly a thousand Nebraskans have lost coverage, but he’s said that number could climb to tens of thousands.
“The bottom line is we’re going to see more people show up at our hospitals without health coverage,” Nordquist said.
Mitchell said there are good ideas and innovators out there trying to solve the problem, but the hospitals aren’t being included in the decision-making.
“[Money is] going to things that seem to be maybe more pet projects or things that aren’t really going to directly help your rural hospitals,” Mitchell said.
“Health systems felt like we had some really good ideas and we could have helped move those forward,” Gamble said. “We just didn’t feel like we got listened to very well.”
Nordquist said he anticipates the state could receive up to $200 million each year until the program is up in fiscal year 2030.
“Let’s move on. Let’s make it better for two, three and four so that we can really make a difference with this money,” Gamble said.
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