The Nebraska Center for Rural Health Research

Medicare Payment to Rural Hospitals:
Including Impact of the BBA

November 18, 1999

Author: Keith J. Mueller, Ph.D.

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Table of Contents:

Medicare Payment to Rural Hospitals: Including Impact of the BBA

Impacts of Special Note On:

Characteristics of Rural Hospitals

Rural Hospital Financing

Aggregate PPS Inpatient Margins for Selected Hospital Groups

Rural Hospital Profitability by Bed Size, 1987 - 1996

Rural Hospital Profitability by Bed Size, 1987 - 1996

Rural Hospitals Provide Multiple Services

Reliance on Various Sources of Revenue (Walsh Center Report)

Result: Cumulative Impact of Multiple Changes in Payment

Result: Cumulative Impact of Multiple Changes in Payment (2)

Recognition of the Issue of Low Volume

Recognition of the Issue of Low Volume (2)

Recent Recognition of the Volume Issue

Recent Recognition of the Volume Issue (2)

Recent Recognition of the Volume Issue (3)

Recent Recognition of the Volume Issue (4)

Special Case: The Wage Index

Special Case: Home Health and Rural Hospitals

Special Case: Home Health and Rural Hospitals (2)

Special Case: Home Health and Rural Hospitals (3)

Impacts of the Balanced Budget Act of 1999

Impact of the BBA: Illustrations

Impact of the BBA: Illustrations (2)

Impact of the BBA: Illustrations (3)

Impact of the BBA: Illustrations (4)

Summary of Key Points

Policy and Other Responses

Policy and Other Responses (2)

References

References (2)

Acknowledgment of Funding Sources Relevant to this Presentation