Tuesday, October 20, 2009

Rural lawmakers push for critical access hospitals

Several senators from rural districts are pushing to make it easier for hospitals to get the funding boost that comes with a "critical access" designation, and are the same senators pushing hardest to hold the line on the cost of health-care reform, Eric Pianin and Mary Agnes Carey of Kaiser Health News report.

Critical-access hospitals, designed to ensure access to care in the country's most isolated areas, are allowed to collect 101 percent of their costs from Medicaid for a maximum 25 beds rather than the usual 95 percent. Half of all rural hospitals and a fifth of hospitals nationwide have the critical-access designation. The number ballooned until 2006, when states could no longer waive the rule that a critical-access hospital had to be 35 miles from another hospital. Congress, faced with rising Medicaid costs, ended the waivers, slowing the increase to only a few dozen new critical access hospitals in the last three years.

Maggie Elehwany of the National Rural Health Association told the reporters that allowing critical-access hospitals to expand beyond the 25-bed limit would help them fight crises like the H1N1 outbreak. These hospitals would be able to expand or contract the number of beds as long as the annual average was 20, in a plan proposed by Sen. Ron Wyden, D-Ore.

Some experts say the original definition of a critical-access hospital is no longer accurate. Robert Berenson, a former Medicare official, told the reporters, "Over time, it's become clear that the concept has changed, so it looks like almost any rural hospital is being considered as a critical access hospital, with no longer the expectation the patient will be transferred." (Read more)

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