Many small, rural hospitals are having a hard time fitting into new accountability standards of the Affordable Care Act. Critical-access hospitals aren’t yet part of Medicare’s pay-for-performance plan, and Congress never provided money for testing how to tie bonuses and penalties to hospital performance.
Greater distance and less access to technology can make it harder for rural residents to enroll in health-insurance programs. But the biggest barriers may be state decisions about whether to expand Medicaid and operate their own health insurance exchanges. Minnesota and Virginia offer a study in contrasts in rural enrollment methods.
After a "fiscal-near-death experience," a statewide organization for California’s rural health-care groups starts anew. The re-established State Rural Health Association faces the challenging task of serving California’s far-flung and diverse rural communities.
Although rural residents are more likely to live in states that rejected Medicaid expansion under Obamacare, West Virginia (the third most rural sate in the nation) bucked the trend. A health-care advocate describes how the Mountain State went about exceeding projections for Medicaid – and describes what remains to be done.
Many rural patients “bypass” rural hospitals and get admitted at urban facilities, a federal study shows. Rural from rural America who stay at rural hospitals tend to be older and on Medicare. They are also less likely to get medical procedures like surgeries.
The federal government needs to overhaul the rules that govern small, rural hospitals. Otherwise, we’ll see a drastic number of closures and a loss of critical medical services for small communities. Who is going to step up?