Study Finds 250 Rural Hospitals Could Lose Critical Access Status

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																			April 20, 2015

A new study from the School of Public Health (SPH) finds more than 250 hospitals nationally could lose critical access status because of a minimum distance requirement, which requires the hospital to be located at least 15 road miles from the next nearest hospital. These critical access hospitals had higher patient volume, were more financially stable, were more likely to publicly report quality data, and had better quality performance than critical access hospitals located farther from other hospitals.

Photo: Ryan Smith/CC BY-SA 3.0
Photo: Ryan Smith/CC BY-SA 3.0

The study findings, published today in the April issue of Health Affairs, also found loss of critical access hospital status and cost-based reimbursement from Medicare would have considerable negative impacts on these hospitals and the rural communities that depend on them for health care.

“Currently there are more than 1,300 critical access hospitals located in 45 states, and these hospitals serve a high proportion of Medicare patients,” said Michelle Casey, lead author of the study and deputy director and senior research fellow in SPH’s Rural Health Research Center . “A substantial reduction in financial support from Medicare could lead to additional rural hospital closures and increased travel time for emergency, inpatient, and outpatient care for rural residents.”

Casey and co-author Ira Moscovice, director and principal investigator in the Rural Health Research Center, in collaboration with colleagues at the University of North Carolina-Chapel Hill, compared hospitals that could lose their critical access status due to a minimum distance requirement with the remaining critical access hospitals in terms of organizational characteristics, quality, and financial performance, and examined the financial impact of losing cost-based reimbursement.

They concluded current policy proposals to establish a minimum distance requirement for critical access hospitals may actually harm the rural health care system and reduce access to quality health care for rural residents.

“Our research shows that cost-based reimbursement from Medicare can help ensure that high-quality rural hospitals are able to continue providing care to their communities,” said Casey.

Moscovice said, “A hospital’s ability to retain critical access certification should not be based solely on geographic distance to another hospital. Other factors such as clinical expertise, physician distribution, the availability of technology, sufficient volume to maintain key services, the availability of other health care providers, and the needs of special and underserved populations should be considered.”

~ Post derived from a Research Snapshot by Matt DePoint, AHC media team

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