A recent study published in Health Affairs determines minimum-distance requirements for rural, critical access hospitals would be disruptive to communities that depend on those hospitals, while only creating modest Medicare savings. More than 1,300 rural hospitals have been converted to critical access hospitals since 1997 when the Medicare Rural Hospital Flexibility program went into effect. The program entitles critical access hospitals to Medicare cost-based reimbursement instead of the hospital prospective payment system (PPS). Recent changes propose that critical access hospitals be located a minimum distance from the nearest hospital. The study showed critical access hospitals within 15 miles of another hospital are typically larger, higher quality and financially stronger than critical access hospitals farther than 15 miles from other hospitals. Reverting to PPS, according to the study, would have considerable negative effects on critical access hospitals near other hospitals. Study abstract