A Walk From The Country
Monday, September 21, 2020
Join the rally yell for rural hospitals.
Walk amongst us to Washington, DC to relieve rural hospitals inwards America.
Rural hospitals are facing the greatest challenge to their existence inwards the history of our country. In the adjacent year, 283 rural hospitals human face upwards the incertitude of possible closure. It is fourth dimension to act. We are quest rural hospitals from all over the solid set down to ship a representative to our June 1st, 2015 walk from Belhaven, North Carolina to Washington DC to petition Congress to top measures to ensure rural hospitals sustainability.
I was curious, every bit rural hospitals already acquire special handling from the Congress. For example, this article inwards Modern Healthcare notes:
A police describe that allows rural hospitals to nib Medicare for rehabilitation services for seniors at higher rates than nursing homes in addition to other facilities has led to billions of dollars inwards extra authorities spending, federal investigators say.
Most patients could have got been moved to a skilled-nursing facility inside 35 miles of the infirmary at virtually one-fourth the cost, HHS' inspector full general said inwards a study beingness released Monday. Hospitals juggling tough residual sheets have got come upwards to persuasion such "swing-bed" patients every bit lucrative, fueling a steady rising inwards the number of people getting such attention in addition to costing Medicare an additional $4.1 billion over vi years, the study said.
The authors wrote that the windfall helps to "support a hospital's fixed costs in addition to offset losses from other lines of business."
Legislation passed past times Congress inwards 1997 created the designation of "critical access hospitals" to assist pocket-size facilities inwards remote areas survive. Rather than paying laid rates for services every bit throughout the ease of the Medicare system, the federal authorities reimburses the hospitals for 101 percentage of their costs. They likewise frequently have province funding in addition to grants.
So I went to the walk website to come across what to a greater extent than I powerfulness learn. It said:
Rural hospitals are facing the greatest challenge to their existence inwards the history of our country. In the adjacent year, 283 rural hospitals human face upwards the incertitude of possible closure. It is fourth dimension to act.
Now it is fourth dimension for America to stand upwards up in addition to demand that Washington DC operate on our rural infirmary crisis. Our rural hospitals are simply every bit of import every bit whatsoever urban medical centers. We feed America in addition to deserve to continue our electrical flow flat of healthcare. When hospitals close, emergency rooms unopen in addition to that agency needless deaths -- our children, identify unit of measurement members in addition to neighbors. We have got to stand upwards up for ourselves in addition to THE WALK volition acquire Washington’s in addition to the nation's attention.
Not helpful, in addition to hence I looked elsewhere. It may live that Medicare's zeal to trim down readmissions in addition to apply penalties to the "laggards" has an impact:
The Affordable Care Act was designed to ameliorate access to wellness attention for all Americans in addition to volition give them simply about other run a jeopardy at getting wellness insurance during opened upwards enrollment starting this Saturday. But critics say the ACA is likewise accelerating the demise of rural outposts that cater to many of society's most vulnerable. These hospitals process simply about of the sickest in addition to poorest patients — those to the lowest degree aware of how to rest healthy. Hospital officials debate that the law's penalties for having to re-admit patients presently later on they're released are impossible to avoid in addition to practice a crushing burden.
But is likewise seems to live a state--not federal issue--arising especially inwards those states that have got non chosen to purpose the damage of the Affordable Care Act to acquire federal assist to position to a greater extent than people on Medicaid:
Department of Health in addition to Human Services Secretary Sylvia Burwell, inwards component subdivision since June, grew upwards inwards rural West Virginia in addition to says she is "particularly acutely focused on" the challenges facing rural hospitals. More Medicaid expansion would acquire a long way toward addressing them, she said inwards a word briefing inwards October.
But the article offers mixed signals on that issue:
Low Medicare in addition to Medicaid reimbursements wound these hospitals to a greater extent than than others because it's how most of their patients are insured, if they are at all. Here inwards Stewart County, it's a work that expanding Medicaid to all of the poorest patients -– which the ACA intended but 23 states including Georgia have got non done, according to the federal authorities — would help, but wouldn't solve.
I'm non certainly why the article refers to depression Medicare reimbursements, given the special handling of rural hospitals. The Medicaid rates, again, are a province determination.
This summary seems to acquire to the pump of things:
Half of the rural hospitals that shuttered since early on 2010 closed completely. Many of the ease directly operate every bit rehabilitation in addition to nursing facilities, or outpatient clinics. A few operate every bit emergency departments or 24-hour urgent attention centers, offering simply about — but far from all — the services the old hospitals did. But Lewis in addition to others say that piece these 24-hour facilities could stabilize stroke or pump assault victims earlier they caput on to larger hospitals, they are fifty-fifty less financially viable, given the poor, uninsured populations they serve in addition to the fact that emergency rooms are the most expensive parts of hospitals.
Here's my take, but I'm happy to live corrected. Rural hospitals have got received special protection from the United States of America authorities for years, every bit each Congressional district has them in addition to every bit they are frequently the major employers inwards pocket-size towns. The marker to which they've operated every bit to a greater extent than total service institutions was alone sustainable because of federal support, in addition to many have got probable incurred investment in addition to staffing costs to offering services at a flat that could non live justified, inwards damage of clinical volumes. Now, the pendulum has swung a bit, in addition to a number of these hospitals are finding that the electrical flow revenue mix is unfavorable. With nowhere else to turn, the politically active local officials in addition to advocates are going dorsum to the good for to a greater extent than federal assistance.
And in addition to hence it is hither that nosotros plough to Congress which, because of self-imposed limitations on the federal budget, volition notice itself making choices betwixt these local hospitals and--among other things--funding for graduate medical teaching inwards the urban academic medical centers. We are virtually to come across nothing amount politics inwards action. Rural versus urban. Community hospitals versus AMCs. Meanwhile CMS quietly supports incredibly wasteful investment inwards other areas, inwards reply to behind-the-scenes lobbying from equipment manufacturers in addition to investment bankers. I don't retrieve this volition live pretty.