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8 Sept 2013 - Another Challenge for Rural Hospitals

One of my long-time concerns for rural America is the availability of professional medical care within a reasonable distance of farms and ranches. Rural hospitals have faced increasing challenges over the past decade...slow payments by Medicare, attracting doctors and specialists who prefer to go to big city hospitals, and the cost of buildings and equipment.

And now, another challenge as shared with me by my personal doctor at the Mayo Clinic in Scottsdale, AZ. He has taken good care of my health for the past 12 years, but a few days ago, he e-mailed me with an issue he feels needs more attention in rural communities and asked me to share it with my readers, listeners and viewers. So here is his e-mail.

“The Office of the Inspector General is planning to remove Medicare’s Critical Access Hospital (CAH) designation for hospitals that do not meet certain distance requirements. The CAH program represents less than 5-percent of Medicare’s total hospital budget, but provides more than 60-million rural Medicare beneficiaries in the United States with access to health care close to home. Rural hospitals are often one of the largest local employers, and CAH cuts likely would put some at risk for financial instability.”

He concluded...”Sounds like something farm communities should be up in arms about. Surprisingly, at least to me, there has been little or no coverage of this issue in the national press.”

Government rules can be complicated, and limited space does not allow me to share all of the criteria for a Medicare participating hospital to be designated a CAH, but here are a couple I can understand.
- Be located in a State that has established a State Rural Health Plan
- Furnish 24-hour emergency care services 7 days a week, using either on-site or on-call staff.
- Be located more than a 35-mile drive from the nearest hospital or CAH.

If my doctor who is on staff at an urban hospital is concerned about this challenge to rural hospitals, then I’m concerned, and you should be, too. There are many websites available to help you understand the issue and I would suggest your first stop should be the Medicare Learning Network. Twenty U.S. Senators have sent a letter calling on the Senate Finance Committee to defend Critical Access Hospitals and I suggest you do the same to support your rural hospital.

My thoughts on Samuelson Sez.