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NRHA warns Capitol Hill about modifying rural hospital programs

NRHA sent the following communication to Capitol Hill offices this morning. Please contact NRHA Government Affairs at (202) 639-0550 with any questions. "Elimination of rural hospital designations will annihilate the rural health care safety net and access to care in rural America.  Recent recommendations to the Joint Select Committee on Deficit Reduction erroneously claim that these designations and their accompanying payment formulas discourage efficiency and value in health care.  This is simply untrue.  Many rural counties where Critical Access, Sole Community and Medicare Dependant Hospitals are located rank in the bottom quartile in Medicare spending. Furthermore, hospitals carrying these designations care for 16.4% of all Medicare hospital patients while receiving only 12.4% of the total Medicare hospital budget in payments (note that these figures are adjusted for case complexity to reflect net patient days). "The true purpose of these payment formulas is to prevent hospital closures.  During the 1980s and early 1990s, 360 rural hospitals closed and rural Americans lost access to health care.  These hospitals struggled to maintain financial stability under the urban-centric Medicare Prospective Payment System because of their small size and unpredictable patient mix. In response, Congress created the Critical Access Hospital (CAH) designation. This designation was designed to prevent hospital closures by allowing CMS to pay CAHs for inpatient and outpatient services on the basis of reasonable costs.  This allows for more flexible staffing options relative to community need, simplifying billing procedures and creating incentives to develop local integrated health delivery systems, including acute, primary, emergency and long-term care. Sole Community Hospital and Medicare Dependant Hospital designations were created for the same reasons. "Forcing rural hospitals into a  prospective payment system modeled on care in urban environments is completely unsuitable for the rural delivery system, will lead to hospital closures, and will compromise access for millions living in rural areas.  This is an unacceptable result. "NRHA and its 22,000 hospital, physician, practitioner and patient members call on you to protect the rural health care safety net.  It is vital that you oppose any and all efforts to decimate the rural delivery system."

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