I hear it all the time “Rural hospitals like GVMH are O.K. but if you’re sick, I mean really sick, you had better go to Kansas City”. Rural hospitals fight this – you’re not big so you must not be all that good – perception every day. It seems that this perception is true of rural hospitals across the country, not just GVMH.
GVMH has been very committed to technology and our diagnostic capability is as good as any size hospital and better than most. We are ahead of the curve with our EHR adoption, we are one of the few hospitals in the country to have a 128 slice CT, we have a new MRI and our nuclear diagnostic capability is usually only found in much larger hospitals. We are never going to do open heart surgery or lung transplants so we will never be able to meet every need but what we do, we can do very well.
There is a proposal before congress to reduce Medicare payments to rural hospitals more sharply than urban hospitals. This reduction proposal is driven by perception more so than reality and the data backs it up.
A recent report shows that Medicare spending per beneficiary is 3.7% less costly in rural settings than urban settings. The report also shows that per-capita Medicare inpatient hospital spending for rural beneficiaries to be 2% less than for urban beneficiaries and per-capita physician service payments to be 18% less for rural beneficiaries. I would also venture to guess that a primary care physician in a rural setting knows his or her patients on a much more personal level than a primary care physician in an urban setting…more on this in a minute.
What’s more important in the report is that the lower spending did not equate to lower quality. The report’s author found that neither rural nor urban providers could be a clear winner when looking at CMS Hospital Compare Process of Care measures. There was also no performance difference in outcomes measures related to 30 day readmission rates for heart attack, heart failure and pneumonia.
The article doesn’t even mention the greatest value rural hospitals provide to their patients. Rural hospitals provide a greater degree of “touch” than urban hospitals. At GVMH we care for our friends and neighbors every day and there’s something to be said for caring for a person that you might see at church, the grocery store or movie theater later in the same week.
You can’t put a price tag on the value of “touch”.