Rural hospitals say health-reform bill is 'too urban'

Urban teaching hospitals are among the biggest benefactors of Medicare reimbursements, but in as Congress debates health-care reform, rural lawmakers are pushing to change the disparity, Susan Milligan reports for The Boston Globe.

Government policies pay more to big hospitals associated with medical schools for maintaining things such as trauma centers and burn units, and providing training for future doctors. But that rationale is being tested by lawmakers with rural constituents who say the bill is ‘too urban’ and neglects the impact and challenges of rural hospitals. Alan Morgan, chief executive of the National Rural Health Association, told Milligan that rural hospitals serve higher percentages of elderly and low-income patient populations, and therefore rely more heavily on government reimbursement.

Opponents say stripping Medicare money from teaching hospitals could have a big impact on the medical field, especially in hospital-rich states like Massachusetts. Nationally, about 18 percent of patients are referred to teaching facilities, but in Massachusetts that figure is closer to 50 percent. John Erwin, executive director of the Conference of Boston Teaching Hospitals, said it is important to see what teaching hospitals bring to the table. He argues that they provide crucial services for the entire country and not just regions, and not only train physicians, including those who go to smaller communities to practice, but conduct research and cutting-edge medical procedures that help everyone. A bill that ‘levels the playing field’ could have some “real, unintended consequences,” Erwin warned. “It could have the impact of stifling innovation.” (Read more)