CHARLESTON, W.Va. — The state of healthcare in West Virginia puts the future of small, rural hospitals in the state in doubt.

Joe Letnaunchyn, president and CEO of the West Virginia Hospital Association, said there are daunting challenges which lie ahead for those facilities.

“You can’t just keep buying hospitals with the population staying the same and having the same number of hospitals treating fewer people, that math just doesn’t work,” he said in a recent appearance on MetroNews “Talkline” from the state capitol.

During 2019 the Ohio Valley Medical Center in Wheeling closed its doors and last month Thomas Health Systems was forced put it’s two hospitals in Kanawha County into bankruptcy protection to see if they could ride the tide until better time prevail. Other smaller hospitals have been forced to seek a lifeline with partnerships with larger hospital systems like WVU Medicine, Mon General, CAMC and other larger umbrella organizations.

Among the myriad of problems for those hospitals is the loss of commercial insurance carriers among patients. Currently 70 to 75 percent of patients in West Virginia are covered by Medicare, Medicaid, or PEIA. Letnaunchyn added the Medicaid expansion was a positive in that it allowed many West Virginians to finally get healthcare coverage they needed and they were able to get healthier with that coverage. However, it wasn’t financially helpful to hospitals who are forced to treat patients with the coverage at whatever rate the payer plans to pay.

“The good news is they were covered, the bad news is the payment for all of those is below cost and we have no negotiating ability,” he said.

Letnaunchyn said until now, hospitals in West Virginia had accepted that system because it was the community mission to help those who are sick get well. But the financial strain is starting to become more than some small hospitals are able to bare.

“There are others on the bubble. We could be hearing news sometime this month, next month. I keep hearing there’s going to be some news coming out of these hospitals,” he said.

He didn’t offer any names of hospitals teetering on the bring of bankruptcy or takeover, but given the climate it is likely any of them or all of them.

“I think there’s a combination of economic development opportunities in West Virginia so that we’re getting people moving back into West Virginia rather than leaving West Virginia. Otherwise, we’re going to see more hospitals facing difficult challenges,” he said.