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Member Research & Reports

Member Research & Reports

Minnesota Finds Minimum Distance Requirements for Critical Access Hospitals May Harm the Rural Health Care System

A new study from the University of Minnesota School of Public Health finds more than 250 hospitals nationally could lose critical access status because of a minimum distance requirement, which requires the hospital to be located at least 15 road miles from the next nearest hospital.

These critical access hospitals had higher patient volume, were more financially stable, were more likely to publicly report quality data, and had better quality performance than critical access hospitals located farther from other hospitals.

[Photo: Ms. Michelle Casey]

The study also found loss of critical access hospital status and cost-based reimbursement from Medicare would have considerable negative impacts on these hospitals and the rural communities that depend on them for health care.

The study findings were published in the April issue of Health Affairs.

“Currently there are more than 1,300 critical access hospitals located in 45 states, and these hospitals serve a high proportion of Medicare patients,” said Ms. Michelle Casey, lead author of the study and deputy director and senior research fellow in the School of Public Health Rural Health Research Center. “A substantial reduction in financial support from Medicare could lead to additional rural hospital closures and increased travel time for emergency, inpatient, and outpatient care for rural residents.”

Ms. Casey and her colleagues compared hospitals that could lose their critical access status due to a minimum distance requirement with the remaining critical access hospitals in terms of organizational characteristics, quality, and financial performance, and examined the financial impact of losing cost-based reimbursement.

“Our research shows that cost-based reimbursement from Medicare can help ensure that high-quality rural hospitals are able to continue providing care to their communities,” said Ms. Casey.