A new study finds that Iowa has closed more medical facilities than it has opened, and the state’s mental health center closure rate is at its highest in a decade.
This discovery Report The report on Iowa’s health care environment was released this week by the Common Sense Institute of Iowa, a nonpartisan, pro-free enterprise economic research and policy think tank. The nonprofit examined the economics of the state’s health care sector, including health care costs, insurance rates and the workforce.
“We may be in a better position than other states, but we still have some very significant hurdles we need to overcome in order to improve our economy and our health,” said Chelsea Lensing, a health and wellness researcher at the Common Sense Institute Iowa and lead researcher on the report.
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More than 600 health care facilities closed between 2008 and 2023, according to the report. This includes hospitals, home health care facilities, clinics, senior care facilities and other medical centers overseen by the Iowa Department of Inspection and Appeals.
Fewer than 450 facilities opened during that period, and 250 health centers closed in Iowa.
“This is definitely something that’s a concern going forward, especially as we try to understand how we can help the populations that are most affected by these shutdowns,” said Lensing, who is also a professor at Coe College.
Mental health centers have seen a massive overall decline of 94% since 2008. Researchers found that a total of 180 facilities have closed, including 92 centers that closed between 2020 and 2023. Since 2008, only 11 mental health centers have opened.
The report found that aged care facilities, which include nursing homes, assisted living facilities and residential care, had the most openings and closures from 2008 to 2023. Researchers counted 219 openings statewide, as well as a total of 262 closures, including 88 that occurred in the past three years.
Report highlights financial, workforce challenges facing healthcare industry
The Common Sense Institute Iowa report also noted that Iowa hospitals are increasingly financially vulnerable, with more than half of the state’s hospitals expected to operate at a loss by 2022, after average hospital expenses increased 66% from 2009 to 2022.
“Starting in 2022, hospitals in the state will be operating at a net loss for the first time,” said Ben Murray, policy and research director for the Common Sense Institute Iowa.
The report, citing data from the Center for Healthcare Quality and Payment Reform, estimated that 28 of Iowa’s hospitals only have enough financial reserves to cover six to seven years of losses, while 10 hospitals lack the funds to cover more than three years of losses.
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Additionally, the report noted that current health care workforce trends “suggest that severe labor shortages will occur in the coming years” as demand for workers continues to outstrip supply. The researchers concluded that a major driver of this shortage is health care workers aging out of the workforce.
“Iowa’s health care workforce has strengths, but policymakers and industry must continue to explore ways to fill the health care worker pipeline so younger workers can meet current demand and fill holes left by retiring professionals,” the Common Sense Institute Iowa report states.
The institute says recent legislation could be the solution
Despite the challenges outlined in the report, researchers at the Common Sense Institute Iowa said they believe state lawmakers have passed some policies that could help address them.
The report points to a number of policies passed in recent state legislative sessions, including a law capping damages in medical malpractice lawsuits and one expanding Medicaid coverage to postpartum women in Iowa.
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Murray noted that it will take time for the new law to have an impact on the health care sector, and that Common Sense Iowa will continue to evaluate the sector, and that the latest report will be a benchmark against which future legislation will be measured.
“Policymakers have made significant efforts to address some of these issues, but we need to continue to monitor the data to see whether these issues are impacted,” he said.
Michaela Lamb covers health care for the Des Moines Register. Contact her at Email:(319) 339-7354 or on Twitter Michael Lamb.
