Crit­i­cally mis­lead­ing

Modern Healthcare - - OPINIONS LETTERS -

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

La­mar, Mo.

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