Some states' refusal to expand Medicaid and a recommendation by the Department of Health & Human Services to recertify critical access hospitals are causing concern about rural access to healthcare.
According to a health economist, if states refuse to expand Medicaid in accordance with healthcare reform, the rural poor will be hit the hardest, the Minneapolis Star-Tribune reports.
Tim McBride, an economist with the Rural Policy Research Institute's Center for Rural Health Policy Analysis, told attendees at a Milwaukee conference on rural healthcare that the majority of residents who would be covered under the expansion live in states that have opted out of expanding the program.
Most city residents who would become eligible live in states that have already accepted the expansion. Thus, McBride said, failure to expand Medicaid "is a rural issue."
"The truth is, this will be really important money for rural hospitals, rural health providers, rural communities," McBride said, adding that hospitals in states that opt out will be hit with reimbursement cuts without receiving any more money from the federal government.
In mid-August, HHS' Office of the Inspector General recommended that the Centers for Medicare & Medicaid Services decertify certain critical access hospitals (CAHs) that do not meet current location requirements.
According to the OIG's report, almost two thirds of CAHs, which serve rural communities, would not meet these requirements. The American Hospital Association criticized the HHS report for showing "an unfortunate lack of understanding of how healthcare is delivered in rural America," FierceHealthCare previously reported.
Moreover, the closure of CAHs would "have catastrophic effects for healthcare," Mike Burket, CEO of Platte Health Center, a South Dakota CAH, told the Black Hills Pioneer.