Mikael Wood | (TNS) Los Angeles Times

It would’ve been weird enough for Justin Timberlake, of all people, to open his new album with a sob story about the high price of fame. But one in which he frames the pain he’s endured as a byproduct of his devotion to his Tennessee hometown? That’s truly unhinged.

Yet it’s just what Timberlake does with “Memphis,” the first song on “Everything I Thought It Was,” which came out Friday, more than half a decade after the release of his previous LP. Over a bleary, slow-mo trap beat, the singer and former boy-band star, now 43, laments the isolation he experienced and the sacrifices he made on his way up — a wild choice given the critique that’s coalesced in recent years of Timberlake as a man long permitted to glide by troubles that damaged the women around him (including his ex-girlfriend Britney Spears and his onetime Super Bowl halftime partner Janet Jackson).

It’s also a baffling aesthetic approach: By rooting his struggles in his connection to an African American cultural capital — “I was way too far out in the world, but I still put on for my city,” he insists in his well-practiced blaccent — Timberlake is flaunting his proximity to Blackness at a moment when pop seems to have little of the use it once did for white guys doing R&B. Consider the disappearance of Robin Thicke; consider Justin Bieber’s apparent reluctance to jump back into the game.

Or consider that much of the discourse surrounding this year’s Super Bowl halftime performance, by Usher, had to do with the sorry fact that it took this Black superstar as long as it did to reach pop’s biggest stage while Timberlake was invited to headline six years ago — and after having taken part in the 2004 “wardrobe malfunction” that derailed Jackson’s career.

None of this is to doubt Timberlake’s genuine love of R&B nor to diminish his undeniable skill for making it: Though it’s larded with glib disco-funk tracks and morose, One Republic-style pop-rock tunes, “Everything I Thought It Was” contains a handful of gems in “Love & War,” a Prince-ish ballad with his prettiest falsetto singing, and the spacey slow jam “What Lovers Do”; “Selfish,” the album’s coolly received lead single, is another highlight, this one with echoes of Bieber’s underrated “Changes” from 2020.

Timberlake’s enthusiasms were also on display last week at the Wiltern, where he played an intimate free concert meant to drum up attention for the new music and for a world tour he’ll launch next month. His 2006 ballad “Until the End of Time” was soulful and unhurried — watch him do it with similar finesse in a just-released NPR Tiny Desk Concert — and he seemed sincerely amped to bring out Coco Jones, the up-and-coming R&B singer, for a duet on her slinky “ICU,” which he called one of his favorite songs of the last five years.

Jones wasn’t Timberlake’s only guest at the Wiltern: Near the end of the show, he reunited the members of ’N Sync to perform a medley of several of the band’s vintage hits, including “Gone,” probably its most impressive downtempo moment, and “Girlfriend,” which the group did as a raunchy mash-up with Too Short’s classic “Blow the Whistle.” (Less happily, the members also perched on five carefully arranged stools to offer the live debut of “Paradise,” a maudlin new ’N Sync song featured on “Everything I Thought It Was.”)

For most of the nearly two decades since ’N Sync’s initial breakup, Timberlake has appeared ambivalent about a comeback, even sitting out a much-hyped cameo by the group during Ariana Grande’s performance at Coachella in 2019. Here, though, he looked gratified to have his old pals by his side — and eager, perhaps, to revisit a time when his privilege promised unlimited mileage.

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©2024 Los Angeles Times. Visit at latimes.com. Distributed by Tribune Content Agency, LLC.

Jazmin Orozco Rodriguez | (TNS) KFF Health News

In a little more than two years as CEO of a small hospital in Wyoming, Dave Ryerse has witnessed firsthand the worsening financial problems eroding rural hospitals nationwide.

In 2022, Ryerse’s South Lincoln Medical Center was forced to shutter its operating room because it didn’t have the staff to run it 24 hours a day. Soon after, the obstetrics unit closed.

Ryerse said the publicly owned facility’s revenue from providing care has fallen short of operating expenses for at least the past eight years, driving tough decisions to cut services in hopes of keeping the facility open in Kemmerer, a town of about 2,400 in southwestern Wyoming.

South Lincoln’s financial woes aren’t unique, and the risk of hospital closures is an immediate threat to many small communities. “Those cities dry out,” Ryerse said. “There’s a huge sense of urgency to make sure that we can maintain and really eventually thrive in this area.”

A recently released report from the health analytics and consulting firm Chartis paints a clear picture of the grim reality Ryerse and other small-hospital managers face. In its financial analysis, the firm concluded that half of rural hospitals lost money in the past year, up from 43% the previous year. It also identified 418 rural hospitals across the U.S. that are “vulnerable to closure.”

Mark Holmes, director of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina, said the report’s findings weren’t a surprise, since the financial nosedive it depicted has been a concern of researchers and rural health advocates for decades.

The report noted that small-town hospitals in states that expanded Medicaid eligibility have fared better financially than those in states that didn’t.

Leaders in Montana, whose population is nearly half rural, credit Medicaid expansion as the reason their hospitals have largely avoided the financial crisis depicted by the report despite escalating costs, workforce shortages, and growing administrative burden.

“Montana’s expansion of Medicaid coverage to low-income adults nearly 10 years ago has cut in half the percentage of Montanans without insurance, increased access to care and preserved services in rural communities, and reduced the burden of uncompensated care shouldered by hospitals by nearly 50%,” said Katy Mack, vice president of communications for the Montana Hospital Association.

Not one hospital has closed in the state since 2015, she added.

Hospitals elsewhere haven’t fared so well.

Michael Topchik, national leader for the Chartis Center for Rural Health and an author of the study, said he expects next year’s update on the report will show rural hospital finances continuing to deteriorate.

“In health care and in many industries, we say, ‘No margin, no mission,’” he said, referring to the difference between income and expenses. Rural hospitals “are all mission-driven organizations that simply don’t have the margin to reinvest in themselves or their communities because of deteriorating margins. I’m very, very concerned for their future.”

People living in rural America are older, sicker, and poorer than their urban and suburban counterparts. Yet, they often live in places where many health care services aren’t available, including primary care. The shorter life expectancies in these communities are connected to the lack of success of their health facilities, said Alan Morgan, CEO of the National Rural Health Association, a nonprofit advocacy group.

“We’re really talking about the future of rural here,” Morgan said.

Like South Lincoln, other hospitals still operating are likely cutting services. According to Chartis, nearly a quarter of rural hospitals have closed their obstetrics units and 382 have stopped providing chemotherapy.

Halting services has far-reaching effects on the health of the communities the hospitals and their providers serve.

While people in rural America are more likely to die of cancer than people in urban areas, providing specialty cancer treatment also helps ensure that older adults can stay in their communities. Similarly, obstetrics care helps attract and keep young families.

Whittling services because of financial and staffing problems is causing “death by a thousand cuts,” said Topchik, adding that hospital leaders face choices between keeping the lights on, paying their staff, and serving their communities.

The Chartis report noted that the financial problems are driving hospitals to sell to or otherwise join larger health systems; it said nearly 60% of rural hospitals are now affiliated with large systems. South Lincoln in Wyoming, for example, has a clinical affiliation with Utah-based Intermountain Health, which lets the facility offer access to providers outside the state.

In recent years, rural hospitals have faced many added financial pressures, according to Chartis and other researchers. The rapid growth of rural enrollment in Medicare Advantage plans, which do not reimburse hospitals at the same rate as traditional Medicare, has had a particularly profound effect.

Topchik predicted sustainability for rural health facilities will ultimately require greater investment from Congress.

In 1997, Congress responded to a rural hospital crisis by creating the “Critical Access Hospital” designation, meant to alleviate financial burdens rural hospitals face and help keep health services available by giving facilities cost-based reimbursement rates from Medicare and in some states Medicaid.

But these critical access hospitals are still struggling, including South Lincoln.

In 2021, Congress established a new designation, “Rural Emergency Hospital,” which allows hospitals to cut most inpatient services but continue running outpatient care. The newer designation, with its accompanying financial incentives, has kept some smaller rural hospitals from closing, but Morgan said those conversions still mean a loss of services.

“It’s a good thing that now we keep the emergency room care, but I think it masks the fact that 28 communities lost inpatient care just last year alone,” he said. “I’m afraid that this hospital closure crisis is now going to run under the radar.”

“It ends up costing local and state governments more, ultimately, and costs the federal government more, in dollars for health care treatment,” Morgan said. “It’s just bad public policy. And bad policy for the local communities.”

(KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.