Hospital revenue has declined slightly since the onset of the coronavirus pandemic, but doctors say the major source of economic distress in the healthcare field is rising costs. Staffing, transportation, food and other essential services hospitals must provide have all been affected by inflation or shortages, and experts say those costs may not recede any time soon. “It’s kind of been a domino effect over the past two-and-a-half to three years,” says Dr. John Cross, President of the Mississippi State Medical Association. He says small hospitals across the state are strained. “Medicare has cut some of their reimbursement rates, Mississippi Medicaid has been forced to cut some of their reimbursement rates,” says Dr. Cross. “There’s increased numbers of uncompensated care, that’s uninsured patients that come in. And there’s even increased cost to the private paying patients. And so all these things have kinda all come together.” Many doctors and healthcare advocates have called on the state legislature to aid these hospitals through various avenues, with a major pathway being an expansion to Medicaid under the Affordable Care Act. Dr. Cross says that’s not the only option, and the state should be investigating ways to create sustainable and comprehensive healthcare in rural areas.