NRHA outlines new Rural Emergency Hospital model
Alex T. Olson
Rural hospital closures are at crisis levels with over 135 rural hospitals closing since 2010 and more than 450 identified as vulnerable to closure based on performance levels. When a rural hospital closes, the mortality rate in that community increases, the local economy declines, and disinvestment in the community ensues.
Rural closures increase travel times for patients and lead to outmigration of health care professionals’ postclosure, which severely dismembers patients’ access to care and exacerbates health disparities. Despite insufficient patient volumes and resources to support inpatient services, access to emergency services and higher-level outpatient services remains necessary.
Section 125 of the Consolidated Appropriations Act of 2021 created the Rural Emergency Hospital (REH) model as a new Medicare provider type. The designation is effective as of January 1, 2023. The REH model will offer the opportunity for current CAHs and rural PPS hospitals with fewer than 50 beds to convert to REH status to furnish certain outpatient hospital services in rural areas, including emergency department and observation services.
NRHA has long advocated for a new service delivery and payment model that would enable small rural hospitals to sustain access to vital health care services for their patients. Although many questions remain regarding the implementation of the REH model, NRHA applauds Congress for creating this new provider type.
NRHA believes the REH model will be an opportunity for vulnerable rural communities to maintain an essential access point for health services. It will be critical for NRHA membership to engage in the REH implementation process, including monitoring CMS' development of the conditions of participation and calculations of payment methodologies.
We encourage NRHA members and rural stakeholders to communicate the need for this model in your rural community directly with your representatives.
View NRHA's full outline of the Rural Emergency Hospital model to learn and disseminate more information.