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Choosing to convert to critical access hospital status.

Dalton K, Slifkin R, Poley S, Fruhbeis M - Health Care Financ Rev (2003)

Bottom Line: The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers.Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations.The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

View Article: PubMed Central - PubMed

Affiliation: University of North Carolina at Chapel Hill, USA. kathleen_dalton@unc.edu

ABSTRACT
The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers. Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties. Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations. The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

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Distribution of Inpatient PPS Profitability in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998
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f3-hcfr-25-1-115: Distribution of Inpatient PPS Profitability in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998

Mentions: PPS payments averaged only 95 percent of costs for hospitals opting to convert to CAH status compared to 111 percent of costs in other low-volume hospitals. Conversion to CAH status is primarily a reimbursement-driven decision, and we should expect to find systematic differences between converting and non-converting low-volume hospitals in Medicare profitability measures, regardless of how similar or dissimilar the two groups may be along other dimensions. However, the distribution of the PPS ratios for CAH converters and other low-volume hospitals shows a surprising amount of overlap (Figure 3). The difference in the averages between the two groups is consistent with the reimbursement incentives that are intrinsic to CAH participation, but both the proportion of CAH converters that were earning PPS surplus, and the proportion of non-converters that were operating at a loss, are greater than might have been expected.


Choosing to convert to critical access hospital status.

Dalton K, Slifkin R, Poley S, Fruhbeis M - Health Care Financ Rev (2003)

Distribution of Inpatient PPS Profitability in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194839&req=5

f3-hcfr-25-1-115: Distribution of Inpatient PPS Profitability in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998
Mentions: PPS payments averaged only 95 percent of costs for hospitals opting to convert to CAH status compared to 111 percent of costs in other low-volume hospitals. Conversion to CAH status is primarily a reimbursement-driven decision, and we should expect to find systematic differences between converting and non-converting low-volume hospitals in Medicare profitability measures, regardless of how similar or dissimilar the two groups may be along other dimensions. However, the distribution of the PPS ratios for CAH converters and other low-volume hospitals shows a surprising amount of overlap (Figure 3). The difference in the averages between the two groups is consistent with the reimbursement incentives that are intrinsic to CAH participation, but both the proportion of CAH converters that were earning PPS surplus, and the proportion of non-converters that were operating at a loss, are greater than might have been expected.

Bottom Line: The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers.Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations.The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

View Article: PubMed Central - PubMed

Affiliation: University of North Carolina at Chapel Hill, USA. kathleen_dalton@unc.edu

ABSTRACT
The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers. Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties. Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations. The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

Show MeSH