The health care industry continues to face financial challenges, as evidenced by more chapter 11 bankruptcy filings and closures by hospitals and other providers, including long-term-care facilities.

The Supreme Court handed a major procedural victory to hospitals in its June 3, 2019, opinion in Azar v. Allina Health Services.[1] By a 7-1 majority, the Court found that the government’s imposition of controversial Medicare payment calculations without a public notice and comment period violated the Medicare Act.

It is well established that health care businesses are confronted with significant financial challenges, including lower reimbursement rates, constant changes in the delivery of services, increased competition and the need for expensive capital improvements to adopt the latest technology. Recent political uncertainty and heightened government scrutiny has only exacerbated these challenges.

Rural hospitals in America are closing at a rapid pace, and many others are experiencing severe challenges. The statistics reflecting the closings and financial challenges facing rural hospitals are readily available, but that is not the focus of this article.