I just finished reading a disturbing article in the December 27 issue of the Wall Street Journal titled, “New Risks at Rural Hospitals.” The article describes a relatively new program put in place by the Centers for Medicare and Medicaid Services (CMS) designed to provide financial assistance to small rural hospitals. Good idea right? Maybe a horrible idea?
In short, CMS has designated certain small rural hospitals as “critical-access hospitals” and decided to reimburse those hospitals for surgeries, etc. in a way that is more favorable than had been done previously. The result – those small hospitals have increased the number of more complicate surgeries performed in their facility in order to be financially rewarded by CMS.
The problem, highlighted by the article, is that these small hospitals don’t have doctors and nurses with the necessary experience to perform all of these additional surgeries and patients are suffering (and dying) as a result. For example, the 30 day mortality rate for inpatient joint replacements was almost twice as high for critical-access hospitals as it was for general hospitals. The article also revealed that the fastest-growing surgical procedures at critical-access hospitals are elective orthopedic surgeries which could have been performed at larger hospitals with more experience.
If you or a loved one have a choice, I recommend avoiding critical-access hospitals for elective surgeries. There are seven critical-access hospitals in Virginia and they include:
1. Bath County Community Hospital in Hot Springs, VA
2. Carilion Giles Memorial Hospital in Pearisburg, VA
3. Dickenson Community Hospital in Clintwood, VA
5. Page Memorial Hospital in Luray, VA
6. Shenandoah Memorial Hospital in Winchester, VA
7. Carilion Stonewall Jackson Hospital in Lexington, VA