February 27

Rural hospitals could feel Medicare funding pinch

A change in a federal designation could affect how much some hospitals receive in reimbursements.

By Kelsey Ryan
McClatchy Newspapers

(Continued from page 1)

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Bridgton Hospital is one of Maine’s critical access hospitals.

2007 Press Herald File Photo

One of the biggest concerns to Widener would be losing an emergency department.

“We have industry here in Harper that use heavy machines, and farmers are around heavy machines,” Widener said.

“If you have an accident of some sort, that’s over an hour if you have to take an ambulance to Wichita. In a trauma situation, or if you’re having a heart attack or stroke, those minutes are golden.”

Medicare is the dominant payor for most critical access hospitals.

“Right now, theoretically, they get 101 percent reimbursement,” Bell said. “But with sequestration, that goes below 100 percent because it requires a 2 percent reduction in Medicare payments.”

“The program was designed to provide protections for those hospitals deemed critical to health care access. They did have some reimbursement protections built in, but those have frankly been diluted a little bit. But the biggest issue is if that designation were removed, it would literally kill a number of rural hospitals in our state. I just don’t think there’s any question about that.”

For most small hospitals, cash flow is a big issue.

“It really restricts what you can do sometimes,” Harper’s Widener said. “If you want to implement a new program or service, the reimbursement isn’t always there — but your outlay is.”

Harper’s hospital receives some local tax revenue. Without it, the hospital likely wouldn’t survive, Widener said.

The federal report stated that in 2011, critical access hospitals cared for about 2.3 million Medicare recipients, and Medicare paid about $8.5 billion for that care.

“Part of the problem you have is trying to plan for the future,” Widener said.

“It’s hard to plan when you don’t know what’s going to happen next. … Are we going to get paid or not? If we do this now and get paid for it later, are they going to come back and retroactively take it back?”

Hospitals are the largest or one of the largest employers in many rural areas.

“In some of these towns, it’s the life or death of the town,” Widener said.

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