Rural Hospitals' Strategic Response to PPS for Outpatient, SNF, and HH Services

Funder:	Office of Rural Health Policy (ORHP)
Research center:	University of Minnesota Rural Health Research Center Phone: 612.624.6151
Lead researcher:	Jeffrey Stensland, PhD , 202.220.3726, jstensland@medpac.gov
Project completed:	August 2000
Topics:	Health services Home health Hospitals and clinics Long term care Medicare Prospective Payment System (PPS)

This project will evaluate how vulnerable rural hospitals are to changes in Medicare payments for outpatient services, skilled nursing services, and home health care services. In the second part of the project, we will conduct a survey of rural hospitals that are particularly vulnerable to the new prospective payment systems. We will ask hospital administrators how they plan to respond to the Balanced Budget Act of 1997 and evaluate how those responses will affect access to care in rural communities.

Publications

• Rural Hospitals' Ability to Finance Inpatient, Skilled Nursing, and Home Health Care
  Date: 10/2001
  Surveys 448 rural hospitals to see how they are restructuring in light of the Balanced Budget Act of 1997. Among its findings: the most popular strategy for small rural hospitals is to convert to Critical Access Hospital status-35 percent of those surveyed have done so; despite the closing of some facilities, the vast majority of rural patients still have access to one or more skilled nursing facilities and one or more home health agencies; and to help preserve access to care, policy makers should consider paying a portion of the bad debt and charity care expenses that Critical Access Hospitals incur when treating non-Medicare patients.