Dive Brief:

• The Portland Planning Commission approved Maine Medical Center's $512 million expansion, making it possible for construction to begin in May, according to the Portland Free Press. The hospital has the only Level 1 trauma center in Maine.
• The project will unfold in three phases during a five-year period, and the first phase will include increasing one tower by two floors and adding three levels to the center's parking garage, according to the Bangor Daily News. The hospital's plan, in addition to moving its helipad, will add 64 new rooms for cancer patients and 225 new parking spaces. Work on the parking garage will be complete by the end of the year, and the tower is scheduled for completion in 2019.
• The second and third phases of the project will include construction of a 270,000-square-foot building that will also serve as the hospital's new entrance. Future construction will add 19 new operating rooms and 128 new single patient rooms.

Dive Insight:

The expansion of Maine Medical Center, according to the Portland Press Herald, is partly in response to demand from rural residents who are willing to travel hours to major hospitals. In Maine, rural hospitals, taken together, operated at a $50 million deficit in 2016 while Maine Medical Center ended the year $61 million in the black.

This is not an issue specific to Maine, however. The National Rural Health Association reported in June 2017 80 rural U.S. hospitals had closed since 2010 and that 673 others were at risk of being shut down. That is more than 30% of the country's rural hospitals. The association chalks up the closures to cuts in hospital payments, which have created "medical deserts" all over the nation, sacrificing jobs, hurting local economies and leaving residents without local medical options.

On the flip side, however, major medical systems and big urban hospitals are expanding in order to provide state-of-the-art care to more patients.

For example, the Providence Tarzana Medical Center in Tarzana, California, last week secured the initial approval necessary to start a $542 million expansion, according to the Los Angeles Daily News. If the hospital can win approval from the Los Angeles City Council, it will build a new wing that includes a pediatric intensive care unit, a parking facility and increased surgical capacity.