McInnis bill could improve rural health care
McInnis, a Grand Junction Republican, has introduced House Resolution 4112, , which aims to improve and increase access to Colorado’s rural hospitals by enhancing current Medicare reimbursement levels for sole community and critical access hospitals, home health care agencies and home hospice providers.
The medical center is one of 26 sole community hospitals in Colorado, ranging from Mercy Medical Center in Durango to Yampa Valley Medical Center in Steamboat Springs and Spanish Peaks Regional Health Center in Walsenburg. The hospital also provides hospice services.
“Any improvement in reimbursement in Medicare will make a big impact on us,” says Shaun Scanlon, VVMC’s senior vice president and chief financial officer .
Although a large portion of VVMC business comes from commercial insurance and managed care – Medicare and Medicaid accounts for 13 percent of the business at the hospital in Vail, compared to 30 to 40 percent in city hospitals – the hospital still loses about $300,000 a year with Medicare services, Scanlon says.
“If we can get to a place where we can break even and not lose money on government programs, that means we won’t have to make it up from non-governmental payers,” he says.
Sole community hospitals are facing uncertain reimbursement levels under new Medicare payment programs. The proposed legislation would prevent these hospitals from potential cuts and allow better data to be collected to determine reimbursement rates.
“When I travel through Colorado, an area of growing concern amongst
constituents is having quality and access to health care,” McInnis said.
“Because of this feedback, I sat down and worked to create a reasonable
proposal that will address these important safety net issues in rural
In spite of losing money with Medicare, Vail Valley Medical Center is in a fortunate position because of the demographics in the valley, Scanlon said.
“I came from a big hospital in Massachusetts where 40 percent of our patients were Medicare. In the valley, because of a large younger population we’re not so impacted by Medicare reimbursements,” he said.
“However, any improvements will help us do our job better.”
Home health and hospice care
As part of the proposed legislation, hospice providers serving frontier
areas, including Leadville and Glenwood Springs, will receive a 15 percent increase above the current per day rate to compensate for the increased expenses. Home health care agencies, meanwhile, will receive a 20 percent increase for services furnished in frontier areas.
Under hospice care for rural areas, Medicare reimbursement rates are set at the lowest levels.
Home health care and home hospice programs in rural areas are often subject to costs not typically associated with urban health and hospice care. For example, many providers are required to travel long distances, significantly increasing travel costs and reducing the amount of total visits a home health care provider can achieve in a given work day. In addition, hospice providers typically employ a small number of employees, resulting in higher benefit costs to the provider.
In addition, McInnis’ proposed legislation would include a study to ensure
hospice care under Medicare is being implemented as Congress intended, and adds some common sense to cases where hospice patients die but were ruled ineligible for hospice care.
The bill is currently being considered at the House Ways and Means Committee in Washington D.C..
“Rural Coloradans deserve access to quality health care,” said McInnis, a
the committee. “This legislation ensures that the access and care will be there when it’s needed.”
Veronica Whitney can be reached at (970) 949-0555 ext. 454 or at firstname.lastname@example.org.
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