Ifound the list of “Most profitable criticalaccess hospitals” (Dec. 19/26, 2011, p. 32) issue very misleading. My main concern is how the purchase and affiliation of criticalaccess hospitals by larger health systems is affecting the cost of healthcare and the existence of CAHS wishing to remain independent. From my research on the hospitals listed, 19 of the 25 are owned by larger hospital systems. This has caused a major shift in how the CMS is now looking at CAHS. When the CAH program began, the additional cost to the CMS for paying 101% of costs to CAHS was a little over 1% of the total Medicare payments. This has now increased to more than 5% of Medicare’s budget. The larger systems roll overhead costs into the CAH, creating higher costs and thus higher Medicare reimbursement.
I realize that the purchase of a CAH by a larger system often actually saves the hospital. However, I believe that when this happens, the purchased hospital should no longer be a CAH. It is in fact a part of the system, and the very nature of the hospital being critical to the rural community actually no longer exists as it has now become a feeder hospital to the larger system. Sooner or later, the CMS and Washington are going to hit the target that is now on all critical access hospitals’ backs, and that will cause tremendous harm to the remaining independent CAHS.
Rudy Snedigar Barton County Memorial Hospital