About half of Tennessee’s rural hospitals have dropped chemotherapy over the past decade

It’s gotten much harder for rural Tennesseans to get chemotherapy.

Nearly half of Tennessee’s rural hospitals dropped their chemotherapy programs from 2014 to 2022. That’s according to a report from health care consulting firm Chartis that looks into financial pressures on rural safety net hospitals. The report ranks Tennessee fourth in the nation for these losses.

The drop in chemotherapy services is especially concerning because of Tennessee’s high cancer rates. The American Cancer Society estimates more than 43,000 Tennesseans will get a diagnosis this year.

Hospitals cancel services to save money, and since COVID-19 hit, it has only gotten more expensive to provide care. There have been shortages — and price hikes — for labor, equipment and medications. Some services can become so expensive the hospital can’t afford to keep offering them.

The Tennessee Hospital Authority told WPLN last year that costs are rising, but their payments aren’t keeping up. One reason: multi-year contracts with insurers.

Hospitals and insurance companies enter contracts that lay out how much insurers will pay hospitals for their services. They tend to be long-term contracts, spanning two or three years — sometimes longer. So when the cost to deliver services surged during the pandemic, the payments for those services stayed the same.

Chemotherapy is one of several services that hospitals tend to shutter during tough financial times. Labor and delivery is another.

The state’s hospital authority reported that more than half of the state’s hospitals were either cutting back on services or eliminating them altogether in 2023.