Hospital administrators skeptical about Rural Emergency Hospital program

For the first time in 25 years, the government is planning a bill regarding rural hospitals, offering funding if they eliminate unused inpatient beds to focus on emergency department and outpatient services, but many hospitals are waiting for further details on funding before deciding if they will participate, Kaiser Health News reported via the Texas Tribune July 13. 

Rural hospitals often see too few patients to keep the lights on but are still necessary to the communities they serve. The upcoming Rural Emergency Hospital Program hopes to curb this by offering a chance to rural hospitals to close their infrequently used departments and instead focus on critical areas of care for the patients in each rural community. 

U.S. Sen. Chuck Grassley, R-Iowa, who co-sponsored legislation that led to the program, told Kaiser Health News that CMS requirements to keep inpatient departments open were impractical due to lack of patients.

The legislation aims to keep more rural hospitals from closing, boosting payments for Medicare patients in rural facilities as well as a "flat facility payment," but how much these payments will be remains to be seen.

Zero hospitals in Kansas are on board with the plan, according to Jennifer Findley, vice president of education and special projects for the Kansas Hospital Association in a statement to Kaiser Health News. Instead they are "waiting and very anxious" for CMS to announce further information on funding. 

In comment letters to CMS, some hospital systems asked how funding for behavioral health and telehealth services would be incorporated into the program. Chicago-based CommonSpirit Health shared that although birth and delivery is infrequent for rural hospitals, one of its critical access hospitals used telehealth to save the life of a baby or mother twice in the past year. 

While CMS confirmed it will roll out the program in January 2023, it has declined to give further information on the program. 

Existing critical access hospitals are currently defined as sites with 25 or fewer inpatient beds and a four-day or less patient length of stay, meaning struggling hospitals may still get caught in the fringe.

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