Requiring critical access hospitals that are less than 15 miles from another hospital to revert to the hospital prospective payment system would generate modest savings for Medicare but likely be disruptive to the communities that depend on these hospitals for their health care, according to a study in the April issue of Health Affairs. “A substantial reduction in financial support could lead to a renewal of the high rural hospital closure rates of the 1990s, with concomitant deleterious effects on the health of those communities,” the authors said. The study also found that patients were more likely to receive certain recommended care at CAHs located less than 15 miles from another hospital. The CAH program provides cost-based reimbursement to low-volume hospitals whose Medicare costs exceed prospective payment system rates. Several changes to CAH eligibility have been proposed, most focused on mandating that hospitals be located a certain minimum distance from the nearest hospital. Initially, CAHs were required to be more than 35 miles from the nearest hospital, or more than 15 miles in areas with mountainous terrain or only secondary roads. From 1997 through December 2005, states could waive the distance requirements for hospitals designated by the governor as “necessary providers” of health care services. Since 2006, new CAHs must meet the distance requirements, but existing necessary provider CAHs have been allowed to remain in the program.

Related News Articles

Headline
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure…
Headline
The Centers for Medicare & Medicaid Services announced Sept. 26 that average premiums for Medicare Advantage and Part D would decline slightly in 2026.…
Headline
States have until Sept. 30 to submit an optional letter of intent to the Centers for Medicare & Medicaid Services indicating they plan to apply to the…
Headline
Susan Doherty, AHA’s vice president of field engagement, and Rebecca Chickey, AHA’s senior director of behavioral health services, write on the unique ways…
Headline
The AHA expressed support Sept. 22 to House and Senate sponsors of the Medicare Advantage Prompt Pay Act (H.R. 5454/S. 2879), legislation that would apply a…
Headline
The Centers for Medicare & Medicaid Services Sept. 18 released a final rule on policy and technical changes to Medicare Advantage, the Medicare…