The Centers for Medicare & Medicaid Services has released a list of counties and parishes that will lose their rural designation that allows acute care facilities within their boundaries to receive extra payments as critical access hospitals.
The CMS list includes 72 counties and parishes in more than 30 states or Puerto Rico. These include Walla Walla County in Washington, where the city of Walla Walla has grown by more than 20 percent over the past quarter century, and Kingman County in Kansas, which although it has seen its population shrink over the past decade, is within commuting distance of rapidly growing Wichita, the state's largest city. Others include Rappahannock County, which although it is in a fairly rural portion of Virginia, has become a commuting suburb of the District of Columbia., for some residents.
Altogether, the changes impact 45 providers situated within those counties. CMS provided their addresses, but not their names. Among them are Soldiers and Sailors Hospital in Penn Yan, New York; Montgomery Hospital in Montgomery, West Virginia; and Kula Hospital in Kula, Hawaii, among many others.
Rural hospitals are already considered by some policy experts to be in financial duress. Many suffer from low census counts, while those in states that have declined to expand Medicaid eligibility under the Affordable Care Act are losing out on millions of dollars in additional funding each year. The Office of Inspector General of the U.S. Department of Health and Human Services has also announced it wants to make changes to the critical access designation, which has drawn fire from the hospital sector.
The hospitals' management can reapply for their critical access designation through a couple of avenues, according to AHA News Now. They can demonstrate to the CMS that they are operating in an area with a Rural-Urban Commuting Code of four or higher. Such codes were developed by the U.S. Census Bureau to designate specific tracts based on population density, urbanization and volumes of daily commuters. Or, they can obtain a designation from state lawmakers or regulators that their hospital should be considered a rural facility.