The Medicare Payment Advisory Commission heard staff suggestions that would reduce overall payments to critical-access hospitals and the number of hospitals qualifying for the status, but commissioners said they would continue to debate both matters.
In the first two days of meetings, MedPAC staff recommended that Medicare continue to pay critical-access hospitals on a cost-based basis for ancillary services but adopt fixed prospective payment rates for routine services provided to post-acute patients. Staff also recommended revoking critical-access status from hospitals that are within 15 miles or 45 minutes of another hospital and facilities that have at least 75% of their admissions from patients who would be able to reach another hospital within 45 minutes. About 150 current critical-access hospitals fall into that category.
Commissioners expressed several concerns, including the lack of data on the quality of care at such facilities, and said the case had not been made that there were too many critical-access hospitals too close to other facilities. MedPAC must make an interim report to Congress on critical-access hospitals in June. -- by Tony Fong