MedPAC report riles rural health groups

The National Rural Health Association and the Medicare Dependent Rural Hospital Coalition, an informal collaboration of hospitals with Medicare-dependent hospital status, strongly dispute a new report from the Medicare Payment Advisory Commission, which suggests that certain Medicare rural hospital special payments may be too high or unnecessary. MedPAC found little difference in healthcare use between rural and urban beneficiaries, similar access and quality for the most part and questioned the need for extra payments.

“The National Rural Health Association strongly disagrees with this report,” said Alan Morgan, CEO, in a news release (PDF). “Rural patients and providers will ultimately pay the price as rural hospitals will be forced to eliminate services or close their doors if this report is enacted. The Medicare Payment Advisory Commission's conclusions are counter to national data. Primary-care workforce shortages remain a significant challenge in rural areas.”

MedPAC in its report suggests three guiding principles in structuring rural Medicare payments. Payments should be targeted toward low-volume isolated providers, and for example not pay two competing providers at higher rates. The magnitude of special rural payment adjustments should be empirically justified, the authors of the report wrote. Rural payment adjustments also should be designed to encourage cost-control on the part of providers, according to the report.