OIG Recommendation 'Would Kill Rural Health'

John Commins, for HealthLeaders Media , August 16, 2013

"The practical effect is that it would kill rural health," Morgan says. "I know that is a strong statement, but OIG viewed this with blinders on, not looking at how healthcare is delivered in rural America. We aren't talking about just closing 800 rural hospitals potentially. We are also talking about closing the EMS services in many of those communities and removing access to mental healthcare in many communities. Most of these hospitals have provider-based rural health clinics and a lot of these hospitals have nursing home beds in effect."

"OIG is viewing this strictly [as] a narrow payment issue and not recognizing what this will do to the rural healthcare safety net," he says. "It's about access and this report is only about finances and not access. It is a spending and finance issue and we seem to have forgotten the rationale for the creation of this program, which was an access issue."

Jordan said OIG is merely recommending that "CMS periodically check if each critical access hospital still provides services that rural beneficiaries can't easily get somewhere else, and therefore deserves the increased financial support from Medicare and beneficiaries. We also recommend that necessary providers be required to meet the distance requirement."

If CMS follows the OIG recommendations, Jordan believes it would not necessarily result in nearly two-thirds of critical access hospitals losing their designation.

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