Counting Rural Health Care Facilities: A Moving Target?

The Balanced Budget Act and Balanced Budget Refinement Act introduced many payment changes in the Medicare system, including prospective payment systems (PPS) for home health, skilled nursing facility, and outpatient services. Rural health care facilities are more reliant on Medicare revenue than their urban counterparts. Anecdotal evidence and preliminary reports have indicated that the supply and mix of health care services and facilities in rural areas has changed in response to these policy changes. We will examine the supply of hospitals, home health agencies, and other providers in rural areas in 1995 and 2000, using HCFA s Provider of Services files. Bivariate analysis comparing the urban and rural supply of providers will be conducted.

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