Slide Presentation from the AHRQ 2007 Annual Conference

Medicare Programs for Rural Hospitals and Number of Hospitals Participating in 2002

The text reads: "...despite a range of special programs designed to help rural hospitals,"

The slide presents a chart with Medicare programs for rural hospitals and the number of hospitals participating in 2002. The chart shows a time line with descriptions of hospital programs from 1980 to 1997.

• 1980: Hospital Swing Beds. Rural hospitals providing skilled nursing care with swing beds are paid the average Medicare rates per patient day in freestanding SNFs in their census region plus reasonable costs for ancillary services.
• 1983: Sole Community Hospital. Geographically isolated hospitals are paid the greater of the current PPS system or a base year cost per discharge updated to the current year and may receive higher DSH payments (n = 750*).
• 1983: Rural Referral Center. Large rural specialty facilities may receive higher DSH payments and eased geographic reclassification requirements (n = 254*)
• 1987: Small Rural Medicare-dependent Hospital. Hospitals with 100 beds and Medicare loads over 60% receive greater of PPS rate or updated base year costs (n = 333).
• 1989: Essential Access Community Hospital (EACH) Program. Demonstration program creating a new category of limited service rural hospital under Medicare, the Rural Primary Care Hospital used as a building block for Critical Access Hospital (n = 4).
• 1989: Geographic Reclassification. Allows hospitals that compete for workers with urban or other rural areas to receive the higher reimbursement rates provided in the other area (n = 472).
• 1997: Critical Access Hospital (CAH). Geographically isolated hospitals with no more than 15 acute care beds that provide 24 hour emergency care receive cost based reimbursement for inpatient, outpatient, and swing bed services (n = 560).

* Includes 72 hospitals that are both Sole Community and Rural Referral Centers.

Source: American Hospital Association