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Value of Rural Hospitals Linked to ED Utilization

John Commins, for HealthLeaders Media, June 20, 2012

Any comparisons of urban and rural healthcare costs come freighted with caveats.

For starters, rural hospitals usually cannot provide the array of specialized and expensive care seen in larger urban hospitals, making per-patient cost comparisons difficult. There can also be stark differences in patient populations. And rural hospitals do not enjoy the economy of scale and leverage with vendors and insurance companies that are seen in larger urban hospitals.  Critical access hospitals get higher reimbursements from the federal government for care delivery, further muddying comparisons.

Still, there is a nagging perception out there that the 1,700 or so management teams at rural hospitals across the nation don't provide the same level of care delivery value as urban hospitals. 

A study by Portland, ME-based consultants iVantage Health Analytics challenges that perception.

"We just keep seeing the data repeat the fact that on the measures the industry is looking at--safety, process, outcomes, satisfaction, the big value measures--we don't see gigantic differentiation between urbans and rurals," says iVantage Executive Vice President John R. Morrow.

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1 comments on "Value of Rural Hospitals Linked to ED Utilization"


Roger Downey (6/20/2012 at 4:54 PM)
Yes, patients in rural areas treat their local hospital EDs as a primary care destination. The reason those small EDs don't see serious health problems is because residents know they don't have access to specialty care at them. The Copper Queen Community Hospital, a small acute care, critical access facility in Bisbee, Arizona, had that reputation: people knew it could treat the minor ailments, but for serious problems they had to make the 85-mile trip to Tucson. That began to change in late 2009 when the Copper Queen embarked on a telecardiology program. Before that time, patients who presented with cardiac symptoms were flown to Tucson via emergency helicopter where they would undergo evaluation for two or three days. Cost: $10,000 for the helicopter flight and $10,000 for the hospital stay. Once the telecardiology program was in place, patients presenting at the ED were assessed by a Tucson cardiologist via videoconference. Six months after the program began in December 2009, the hospital had dealt with 36 cardiac patients who would all have been flown to Tucson. Because they had telemedicine visits with the Tucson cardiologists, only nine of the 36 were flown there, saving the healthcare system more than $500,000 in transport costs. Most of the other nine were kept for observation in their hometown hospital and released with a heart monitor and/or medication. The telemedicine assessements also saved their relatives the inconvenience of traveling to and from Tucson, meals, lodging costs, etc.