title: Vulnerability of rural hospitals to Medicare outpatient payment reform.
abstract: Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals. Areas examined include: (1) How dependent are rural hospitals on outpatient revenue? (2) Are they more likely than urban hospitals to be vulnerable to payment reform? (3) What types of rural hospitals will be most vulnerable to reform? Using Medicare cost report data, the authors found that small size and government ownership are more common among rural than urban hospitals and are the most important determinants of vulnerability to payment reform.
authors.affiliation: Project HOPE Center for Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, USA. pmohr@projhope.org
authors.forename: P E
authors.initials: PE
authors.lastname: Mohr
authors.forename: S J
authors.initials: SJ
authors.lastname: Franco
authors.forename: B B
authors.initials: BB
authors.lastname: Blanchfield
authors.forename: C M
authors.initials: CM
authors.lastname: Cheng
authors.forename: W N
authors.initials: WN
authors.lastname: Evans
mesh_terms: D000368:Aged; D003625:Data Collection; D005377:Financial Management, Hospital / Q000639:trends*; D006302:Health Services Research; D006743:Hospital Bed Capacity, under 100; D017721:Hospital Costs / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data / Q000639:trends; D006278:Medicare / Q000331:legislation & jurisprudence*; D015999:Multivariate Analysis; D010044:Outpatient Clinics, Hospital / Q000191:economics* / Q000458:organization & administration; D010067:Ownership; D011445:Prospective Payment System / Q000331:legislation & jurisprudence*; D014481:United States