national rural health association

Katie Hiler / KBIA

If you’ve ever lived in - or even visited - a small town, you know they can be pretty quaint. And Milan, Mo, population 1,881, is no exception.

Milan’s local hospital, Sullivan Country Memorial, has been around since 1953. Joe McCarty, a local resident and now patient in Sullivan’s long-term care unit, has lived in Milan almost his entire life – he’s turning 100 this year. Joe made his living as a cartoonist and up until just a few months ago he worked for the local newspaper.

Rural Assistance Center

    

Rural hospitals play a vital role in delivering quick emergent care to people in some of the more isolated areas of the country. These institutions provide 24/7 emergency services to rural communities where the next closest hospital could be 35 miles away or more. But because they often serve so few people, it’s hard for them to be financially successful. So the federal government set up the critical access hospital program, whereby hospitals meeting certain criteria would receive Medicare refunds at 101 percent of reasonable costs.  

Since the program began in 1997, 1,331 hospitals have been given critical access hospital status, 35 of which are in Missouri. But policy makers are beginning to question whether that’s too many for the government to handle financially.

hospital room
Fotos GOVBA / flicker

  Compared to their urban counterparts, rural hospitals serve a population that tends to be older, sicker, uninsured and have less income. Rural hospitals provide a lot of uncompensated care and run on more narrow profit margins.

To stay open, these hospitals depend on special federal designations that give them a higher rate of reimbursements from Medicare and Medicaid. For example, when a hospital designated as a critical access hospital, Medicare reimbursements can make up to a third of its entire revenue

Angela N. / Flickr

The U.S. Supreme Court will likely rule on the fate of the federal health care reform law this Thursday. That ruling could affect provisions of the law aimed at improving health in rural America.