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Will the 'Save Rural Hospitals Act' save rural hospitals?

by Lisa Chamoff, Contributing Reporter | December 06, 2015
From the December 2015 issue of HealthCare Business News magazine

The bill, which is currently with the House Subcommittee on Health, would also reverse cuts to federal reimbursement of bad debt for critical access hospitals and rural hospitals, which has a big impact on these facilities. “There have been studies done on the impact bad debt alone is having on rural hospitals,” Elehwany says. “We know those cuts have had a horrific impact on rural providers.”

The National Rural Health Association worked with Congressional offices to help get the bill introduced. The main solutions, Elehwany says, are stopping the various cuts in Medicare and figuring out a new model for rural hospitals. “We haven’t developed a model since 1997 with critical access hospitals,” Elehwany says.

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A Senate bill introduced in June by Sen. Chuck Grassley, R-Iowa, would designate critical access hospitals, or a hospital with a maximum of 50 beds in a rural community, as a rural emergency hospital, meaning the facility would have to provide 24-hour emergency medical and observation care. “It’s really targeted at those small struggling rural hospitals that have a small inpatient volume,” says Priya Bathija, senior associate director of policy for the American Hospital Association. “It will be interesting to see how it moves forward. We think that these ED proposals are a step in the right direction, but it’s not a “one size fits all” solution for rural hospitals.”

The American Hospital Association recently created a task force on ensuring access to health care in vulnerable communities that is exploring other models. Anderson, of Southeastern Health, is one of the task force members. While the AHA task force is in the early stages of its work, Anderson says her organization has been taking proactive steps to avoid becoming a vulnerable rural hospital. Southeastern Health has expanded its clinics to more rural communities, so travel is less of an issue for patients, opened same-day clinics for people who can’t make a set appointment and also offers telemedicine services, though that comes with increased costs that many rural facilities may struggle with.

Southeastern Health has also partnered with Campbell University, a private university in Buies Creek, N.C., to create an osteopathic medicine program with the goal of addressing physician shortages, which is an issue in rural areas. They now have 40 students training through the program, as well as 25 residents who have graduated from other programs helping to start a residency program in family and emergency medicine. “Our goal is to try to infuse physicians in the area through that training program,” Anderson says. “We believe if they are trained in a rural community they will stay in a rural community.”

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