Will the Outpatient Prospective Payment System Increase the Number of Distressed Rural Hospitals in Iowa, Texas, Washington, and West Virginia?

This report discusses the shift from a traditional cost-based approach to Outpatient Prospective Payment Services (OPPS) in rural hospitals in Iowa, Texas, Washington, and West Virginia. It discusses the potential negative impact OPPS will have on rural hospitals evaluated in these States. The report includes options to assist small, Government-owned, and Medicare-dependent facilities that may incur financial constraints from OPPS and describes possible benefits of implementing permanent exemptions. It also includes tables and figures.