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Critical Access Hospitals: Protecting an Essential Community Resource. Critical Access Hospital Overview. Legislative History. Federal law: 1997 State law: 2001 Goal: Assure essential health care services in rural areas Must meet certain criteria, including:
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Critical Access Hospitals: Protecting an Essential Community Resource
Legislative History • Federal law: 1997 • State law: 2001 • Goal: Assure essential health care services in rural areas • Must meet certain criteria, including: • No more than 25 inpatient beds • 24 hour emergency services • Defined distance from other hospitals (10-25+ miles) • Short stays (4 days or less)
Washington Characteristics 38 Critical Access Hospitals 40% of hospitals in state Serve over 60% of state area The only health resource for miles Often center of care network with primary care, long term care, emergency medicine
Medicaid is a Significant Payer Note: Wide range of Medicaid, from 2% – 43% “Other”’ includes uninsured, underinsured, and people who do not pay for care
State CAH Spending as a Percent of State Medicaid Budget Very Little of Total Medicaid Budget Spent on CAH
Total CAH Medicaid Payments Proposed Cut is Almost 50% of Payments Dollars in millions
Individual Hospital Margins Before the Cut Each bar represents an individual hospital
Individual Hospital Margins After the Cut Each bar represents an individual hospital
Impact on Patients • Loss of local services • Increased travel time to care • Inability to travel for care increases risk of prolonged illness, disability, even death
Loss of Services Some CAHs will close—in a few cases, fast Others will eliminate important services Adversely impact access to care In some communities, lives will be lost
Effect on System • Compromises entire health care system • Increases costs by… • Delaying/avoiding care • Requiring long distance transports • Contributing to fragmentation of services • Not simply a “rural” problem
Economic Impact Largest/one of the largest employers in town; Significant payroll; excellent family wage jobs Vital for attracting and keeping businesses in the rural community Layoffs and service closures will happen if the cut is enacted Significant ripple effect
What We Need Legislators to stand strongly against this cut Oppose any budget that includes it