Editorial: Keep payments to rural hospitals

A confluence of factors affecting health care could have a serious effect on rural residents and hospitals in Wisconsin.

A health economist has reported rural residents will benefit from the federal Medicaid expansion under the Patient Protection and Affordable Care Act, except in states that didn’t take the coverage. Like Wisconsin.

In order to fund the Medicaid expansion, though, reimbursement rates to hospitals will be cut.

This will affect rural hospitals in Wisconsin, which won’t get Medicaid expansion dollars and, in turn, patients. These facilities could also lose Medicare payments under a proposal that would pare the Critical Access Hospital program.

The proposal would remove the Critical Access Hospital status from rural hospitals that do not meet certain distance requirements, according to a proposal from the Department of Health & Human Services’ Office of the Inspector General.

The majority of the 58 Critical Access Hospitals in the state, including Community Memorial Hospital in Oconto Falls and Oconto Hospital & Medical Center in Oconto, could feel the cuts.

Our rural hospitals will not be the only ones that suffer if these Medicare payments are eliminated. The patients those hospitals serve, the people those facilities employ, and the businesses those health care providers buy from will also be affected.

If hospitals close, patients will have to travel farther for health care. If you lived in the Oconto Falls area, for example, would you rather go to your nearby hospital or drive more than 30 miles to Green Bay? Will you feel comfortable knowing that if you need immediate emergency care in the middle of the night and your rural hospital is now closed?

Older patients might feel it necessary to move to bigger cities where they have to navigate more traffic in order to see their health care providers instead of being able to stay in their homes longer.

The reason the Critical Access Hospital program was started was to stem the closure of the small, rural facilities that couldn’t survive financially because of their size and the patients they served. These hospitals serve patients who “report a fair to poor health status, suffer from chronic diseases, lack health insurance” and are “heavier, older and poorer than residents of urban areas,” according to the The DHHS’ National Advisory Committee on Rural Health and Human Services reported in December.

So one part of the DHSS shows the importance of these hospitals while another part calls for cutting their funding.

Plus, the Medicare beneficiary cost is 3.7 percent less in rural than urban areas, the report said.

The Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative have written to our lawmakers in Washington and Madison, urging them to fight against this program. So far, Sen. Tammy Baldwin, D-Madison, has responded by adding her name to a letter to the Senate Finance Committee letter calling for “proper Medicare reimbursement” levels.

We join with these officials in asking Congress to defeat this proposal. We agree that cuts can be made in Medicare to save money, but not ones that affect the quality of care for people who do not live in urban areas.