The 'traditional myth' complicating the rural emergency hospital designation

The new rural emergency hospital designation went into effect Jan. 1, but some critics argue the program is based on a longstanding misconception about rural healthcare, The Washington Post reported Jan. 17. 

Harold Miller, president and CEO of the Center for Healthcare Quality and Payment Reform, referenced what he called the "traditional myth" that the reason why rural hospitals lose money is because they are providing inpatient services to a small number of patients. 

"Therefore, if you could somehow relieve them of that responsibility, then everything would be fine," he told the Post. "The problem is that's not necessarily true."

CMS released the final rule for the new designation in November. The rule aims to curb rural hospital closures by offering them a chance to shutter infrequently used inpatient beds and focus on providing outpatient and emergency department services.

Mr. Miller told the Post that if hospitals eliminate their inpatient units, they usually can't recover all of the costs associated with it but still miss out on that revenue. He said, for example, that a nurse at a small rural hospital will often also tend to the emergency department, so if inpatient care is eliminated, the hospital still needs that nurse.  

Carrie Cochran-McClain, DrPH, chief policy officer and head lobbyist for the National Rural Health Association, defended the new designation, saying it's for "very specific communities" that don't or can't sustain inpatient capacity to allow them to maintain an access point for emergency services, according to the report. 

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