Rural hospital advocates found new hope for Medicare payment increases in the second rural healthcare bill introduced in Congress this month. The bill, proposed by Sens. Sam Brownback (R-Kan.) and Ben Nelson (D-Neb.), would raise the bed limit to qualify as a critical-access hospital to 50 beds from 25 and establish cost-based payment for rural community hospitals with 50 or fewer acute-care beds that don't qualify for the critical-access program. The bill would transition many community hospitals from prospective payment to cost-based payment, which is what the critical-access program provides. Brownback said the cost of the bill would equal one-half of 1% of total Medicare spending, but he would not provide a specific figure. Earlier this month, Sen. Kent Conrad (D-N.D.) and others introduced a bill that would permanently equalize the Medicare base payment rate for rural and urban hospitals. Nelson said the rural healthcare bills on the table represent part of a "mosaic" of changes needed to assist rural hospitals. All the proposals could become part of more sweeping Medicare reform, he said. -- by Jeff Tieman
Cost-based pay proposed for many rural hospitals
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