Telehealth Potential In-Patient Volume Lifeline for Rural Hospitals in East Tennessee

Date of Award

Spring 2023

Document Type


Degree Name

Doctor of Healthcare Administration (DHA)

Committee Chair

Cynthia Smoak

Committee Member

Jennifer Sheinberg

Committee Member

John Suozzi


Currently, rural hospitals account for thirty percent of all hospitals in the United States (U.S). However more of these facilities have experienced closure in the last decade than any time in U.S. history. Typical reasons for this occurrence are financial distress stemming from shrinking patient volume, physician departure, and reimbursement reductions. Currently the state of Tennessee has experienced several rural hospital closures to date. Finding opportunities to grow in-patient census while expanding substantial revenue generation is paramount to slow the closure trend. Covid-19 has caused a recent rise and demand for telehealth services in the healthcare industry. Is now a time for rural hospitals to improve telehealth resources to capture greater patient volume and potential improvement in revenue reducing financial burdens? A descriptive causal design utilizing secondary data from four rural hospitals in east Tennessee will determine if telehealth has increased in-patient volume over a four-year period of time. Diagnosis related groups (DRG) will be tested with Pearson’s Chi-square with year over year group comparisons for improvement before, during, and since the pandemic. As telehealth use has grown during Covid- 19, have rural hospitals leveraged benefits to care for specialty diseases (i.e., neurology, nephrology, pulmonology) that before may have not been an option? Can comparing hospitals to understand if less or greater telehealth is performed in each studied facility influence in-patient volume? Using Medicare payment codes consideration for this research maybe used in other geographic regions to perform similar analysis in the future.