NPR on CAHs: an overlooked perspective

The Dec. 8 NPR piece produced by Kaiser Health News (KHN) didn't report that Medicare costs are lower for rural patients than their urban counterparts. Medicare spends 4.5% less per beneficiary for rural residents compared to those living in urban areas, according to a recent Stroudwater report which used 2008 Dartmouth Atlas data. The value that rural providers (including Hood Memorial Hospital in Amite, La.) bring to the Medicare program is evident, even including alternative payment methodologies applied to small, rural facilities. Closing Critical Access Hospitals (CAHs) and sending their patients to large, urban hospitals will in fact not save money, but cost more. Rural communities struggle with disproportionate share of poverty, obesity and chronic conditions when compared to an urban environment. Independent studies have affirmed the quality of rural health care providers. For example, rural hospitals have lower risk-adjusted rates of potential safety-related events (Jollife, 2003), rural hospitals have significantly lower adverse event rates than urban counterparts (Whitener and McGranahan, 2003) and rural hospitals have significantly lower rates of post-operative hip fracture, hemorrhage and hematoma (Cromartie, 2002). The article accurately portrays the difficulty that small, rural hospital administrators have in running a hospital located in a rural environment. NRHA congratulates Hoppie Jones, Hood Memorial CEO, for doing an outstanding job in the midst of daunting circumstances.