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SGR Repeal Bill Holds Extra Promise for Rural Hospitals

John Commins, for HealthLeaders Media, December 18, 2013

So, the bottom line is, the House and Senate have a continuing resolution as a temporary patch until the end of March that continues level funding for three months. We will fight the bigger fight for a permanent fix for both the doc problems and the rural provisions later on early next year. We are grateful because it is the season to be grateful, however, we know that we have a long fight ahead of us.

HLM: Are you concerned that the House did not include this language in its budget bill?

Elehwany: It is very troubling. There are a number of rural hospitals whose members of Congress's sit on the key committees—Ways and Means and Energy and Commerce—and we are urging these hospitals to let them know how absolutely critical these payments are. They are making the difference in many hospitals of whether they can maintain certain services and staff and in many cases whether or not they can keep their doors open.

The problem is that rural just doesn't have, obviously, the volume of urban centers so there are only a little over 200 of these Medicare-dependent hospitals across the country. It is a very critical payment. They are payments for hospitals that have a higher percentage of Medicare patients and seniors. It has to be at least 60% but for some of these hospitals it's 70% to 80%.

If they lost these payments, they would have to make up a 19% margin from the few private insurers they have and that is just not possible. Plus, the senior population in rural America is unusually challenging. There is a higher percentage per capita of poor seniors with higher percentages of chronic disease.

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