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Ederhof M, Chen LM. Critical Access Hospitals and Cost Shifting. JAMA Intern Med. 2014;174(1):143–144. doi:10.1001/jamainternmed.2013.11901
With more than 1300 acute care hospitals, the Critical Access Hospital (CAH) program is the largest Medicare program aimed at maintaining access to health care for rural Americans.1 However, there is debate about how best to support the financial viability of CAHs while limiting rising health care costs. Under Medicaid, almost 2 dozen states have adopted or are considering cost-based reimbursement for CAHs, while other states use alternative payment mechanisms.2 President Barack Obama’s 2014 budget proposal calls for a reduction in CAHs’ Medicare reimbursement from 101% to 100% of costs. Several states have criticized the proposed cuts,3 given the small margins of CAHs.4 In the context of ongoing discussion about CAH reimbursement, it is important to better understand how health care providers currently utilize funds from the CAH Programs.
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