The other big point we're making is that these small rural hospitals are actually a huge value for the taxpayer. Congress is not losing money on these facilities. Rural hospitals provide 18% of care but only get 15% of Medicare reimbursements.
If you compare apples to apples, a common treatment in a rural setting, pneumonia or something like that, compared with the treatment in an urban or suburban setting it is 3.7% less expensive because you are reimbursing at primary care levels. Almost everything in rural areas is primary care. Urban and suburban is much more often specialty care at a higher reimbursement rate.
Our message to Congress is really look at the math before you do these things. If you close these rural hospitals you are obviously causing a hardship for seniors who would have to travel further for care but you are also shifting the cost to a more expensive area.
HLM: What are the biggest challenges for these rural amendments as they are debated next year?
Elehwany: It's all about how to pay for these things, both the SGR and all of these rural provisions. It sounds like we are going to fight that fight early next year. But if I had to summarize we couldn't be more thrilled about our champions.
The Senate Finance Committee really understands the challenges of delivering healthcare in rural America and the importance of these rural payments. We appreciate that and we are ready to stand with them as they wage the long fight to get a permanent fix bill.