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The Rural Health Research Gateway found that from to47 rural hospitals ceased providing inpatient services. And currently, rural U. These hospitals typically serve older, poorer populations, making them more reliant on Medicare and Medicaid reimbursements — funds the federal government slashed under the Affordable Care Act.
Under the current system, large healthcare systems with the resources to drive widespread efficiency and technology adoption are at an advantage. Often, these financial audits reveal outdated systems still in use, which can be a death sentence for small, independent hospitals.
Looking closer, it was discovered the hospital was still operating under a per diem model, even though payers had moved to a diagnostic related group DRG model several years before.
So, the hospital was getting reimbursed the same amount of money for three-day stays as it was for day stays. Billing and purchasing should also be carefully audited.
For instance, group purchasing organizations GPOs are often an excellent cost-saving tactic. GPO agreements should be revisited frequently and at least once every year.
Know your options These at-risk hospitals often have serious debts to settle, as well as important decisions to make about how to handle them.
Here are four ways in which small, independent hospitals can address debt: This is bankruptcy handled through the court, and it does come with some risk.
These reorganizations can trigger default on bonds, making them due immediately. And, depending on contracts, bankruptcy can also result in the loss of revenue streams from CMS or other payors.
However, it may not be advantageous to do so depending on the terms of the Master Indenture agreement or those of the bonds themselves. Here hospitals restructure their debt and rework payment plans with debtors outside of court.
The new plans can help secure discounts and provide additional time for organizations to pay back debts without filing for bankruptcy.
Putting a hospital on the market is an attractive option to many struggling hospitals, but it can also be a tough sell. Larger systems often naturally absorb the patient flow from a closed hospital without purchasing the facility itself.
Knowing which option is appropriate for an individual hospital can depend on a number of factors, including the specific terms of the financing the facility has in place, and even geography. So, CMS can decide on a facility-by-facility basis whether it wants to continue to keep the facility in network.
For a small hospital to become financially sustainable, it must develop new revenue sources. One way to do this is for hospitals to team up with outpatient healthcare providers to tap into a new revenue stream, outside of inpatient care.
A hospital can simply make its facility available to the group and set up a revenue sharing program. As Medicare and Medicaid are now paying for behavioral health services, hospitals are developing additional behavioral health programs in order to generate new revenues and provide valuable services in their communities.
Whatever the program, new services supplement the core of the business and demonstrate relevancy in the community and the marketplace.
As is true with any business, small, rural hospitals cannot live — let alone thrive — on uncompensated services.The Laurel Grove Volunteer Fire Department was packed with Dan River Region leaders Monday afternoon as Gov.
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