Rural care centers, often referred to as critical-access facilities, are most often the single source of health care in their communities. Local residents depend on these care providers from everything from consultations to emergency services, as the next closest provider may be as far as 45 miles away. They also serve some of the most isolated and rural communities, where economic opportunities are scarce, and poverty rates are high.
Unfortunately, these facilities may charge Medicare subscribers between two and six times more for outpatient services than other hospitals, according to a report released by the inspector general at the Department of Health and Human Services.
These facilities, because of the low patient population, receive more Medicare benefits than other facilities so they can remain financially solvent. However, Medicare patients are to pay 20 percent of the amount a critical access hospital charges. This can lead to significantly higher charges for critical access patients.
Patients in critical-access hospitals paid almost $33 on average for an electrocardiogram, compared with $5.35 for patients at other hospitals, according to the report. Patients who received IV therapy to rehydrate in rural hospitals had to pay an $18 coinsurance, compared with $5 elsewhere. For residents that are already struggling financially, these charges can quickly add up to exceed their preparations.
With little relief in sight from legislators, critical care access facilities in the state need to ensure that they are reimbursed properly for treatments provided to continue offering quality care. The decision to outsource receivables management can result in a drastic reduction in the dollars written off to bad debt, as well as provide a more manageable claims load for in-house staff.