Understanding Rural Hospital Bypass mong Medicare FeeService FFS Beneficiaries in 2018 Backgroundural hospitals serve approximately 4 million rural Medicare beneficiariesand act as a central access ID: 938580
Download Pdf The PPT/PDF document "DATA HIGHLIGHT NO 19 SEPTEMBER2020" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
DATA HIGHLIGHT NO. 19 | SEPTEMBER2020 Understanding Rural Hospital Bypass mong Medicare Fee-Service (FFS) Beneficiaries in 20
18 Backgroundural hospitals serve approximately 4 million rural Medicare beneficiariesand act as a central access point for h
ealthcare services in the community1 However, rural hospitals inherently experience lower patient volumes than urban hospital
s due to population density and geography. Low patient volumes contribute to the financial vulnerabilityof rural hospitals.Wh
ile rural residents may receive inpatient care in their local community, some rural residents receive inpatient services at h
ospitals that are not their nearest rural hospital (rural hospital bypassWhen patients bypass their local rural hospital for
services that are available locally, it can further threaten the sustainability of their local rural hospital. Rural hospita
l bypass may occur for a number of reasons, including patient choice and the complexity of care a patient needs. Bypass for c
omplex procedures that are not offered at local rural hospitalssuch as coronary artery bypass graft surgery (CABG), can be ex
pected. Rural patients often mention limited services and lack of specialty care as reasons for bypassing their local rural h
ospital. Across inpatient and outpatient admissions, patients are more likely to access care nearby for emergency and urgent
care than for elective or scheduled care.4,6While patients may not use a local rural hospital due to limited services or lack
of specialty care, increasing the number of services and technologies offered by rural hospitals has only a small effect on
patient decision-making.PurposePrevious studies of rural hospital bypass behavior have included data for a limited number of
states. This data highlight focuses on a national perspective of rural hospital bypass with a refined definition of Key Find
ings In 2018, while almost 60 percent ofrural Medicare feeforservice (FFS)inpatient stays were at the Medicarebeneficiary
6;s nearest rural hospital,over 33 percent were at anotherhospital for services that could havebeen provided by the nearest r
uralpital. Beneficiaries bypassTribalhospitals and critical accesshospitals (CAHs), particularly CAHswith 15 beds or fewer, a
t the highestoverall rate Beneficiaries living in rural areasbypassed rural ProspectivePayment System (PPS) hospitalswith 26
to 100 bedsat the highestrate for treatment in urban hospitals Over half of all inpatient stays forintracranial hemorrhage or
cerebralinfarction (e.g. stroke) among ruralMedicare beneficiaries were not attheir nearestrural hospital. Ruralhospital byp
ass rates aresignificantly higher for ruralMedicare beneficiaries less thanage 75 years, males, Hispanicbeneficiaries, and no
ndual eligiblebeneficiaries. Data Source: Estimates were produced using Medicare Provider Analysis and Review files (MedPAR)