Report: Rural Hospitals Struggle Under Obamacare Burdens

Wednesday, 28 May 2014 09:21 PM

By John A. Oswald

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America's rural hospitals are struggling to keep their doors open, unable to absorb Obamacare-induced cuts in Medicare or fund costly mandatory systems upgrades, Fox News reports.

Since the beginning of 2013, 18 rural hospitals have gone out of business. That's more than shut their doors in the entire 10 prior years.

There's no light at the end of the tunnel, worried rural hospital administrators told Fox News.

A reduction in Medicare reimbursements and a quality-care incentive program is causing more stress, particularly when margins are razor-thin and belts already tightened, they said. About 60 percent of their funding comes from Medicare.

More hospitals lost funding than gained it from the quality-care incentive program in its first two years.

"Medicare has raised payment rates to 1,231 hospitals based on two dozen quality measurements, including surveys of patient satisfaction and — for the first time — death rates. Another 1,451 hospitals are being paid less for each Medicare patient they treat," Kaiser Health News reported.

Some states were hit harder than others:

"Medicare is reducing reimbursement rates for at least two-thirds of hospitals in 17 states, including California, Connecticut, Nevada, New Mexico, New York, North Dakota, Washington and Wyoming, as well as the District of Columbia."

Midwest Medical Center CEO Tracy Bauer told Fox that the Galena, Illinois, hospital is stressed by a regulatory system that won't sit still.

"Regulations are always changing, and you look at additional cuts, you look at the federal budget, you look at the state budget and you don't know when that next cut is going to be," said Bauer. "It's the difference between you being able to provide access in a rural area to not being able to."

The biggest change this year is the federal demand that all medical records go electronic.

"Going from paper to electronic medical records is a big process," said Midwest's Dr. Michael Wells. "It takes a lot of personnel and staff and support for information technology just alone, so it's a huge task for a smaller hospital when we don't have the number of employees to support that."

Some of the promised benefits of the Affordable Care Act also may not be realized, Fox reports.

President Barack Obama said while selling his signature healthcare reform law that because more Americans would be insured, costly trips to emergency rooms would fall.

But a Harvard study in January predicted the polar opposite would happen and the millions who opted for Medicaid would visit emergency rooms in greater numbers.

Even those Americans who opted for one of the private providers in the health exchanges may still go to the ER. Reports Fox:

"Brock Slabach from the National Rural Healthcare Association said often poorer people choose the least expensive option among the plans provided under Obamacare, but still can't afford to pay the deductibles required before doctor visits are covered. As a result, those patients don't go to the doctor regularly, but instead run to the emergency rooms when a medical issue becomes a crisis. It is the same costly problem that existed before Obamacare went into effect."

The closing of rural hospitals also devastates small-town economies, Fox says, and forces patients to drive dozens of miles out of their way to see a doctor or get emergency treatment.

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