Advocates have long protested that federal regulations unfairly penalize rural and safety-net providers for factors beyond their control, but new research suggests rural providers are ahead on care coordination and infection prevention.
Researchers from the Department of Health and Human Services analyzed outcomes from urban and rural providers for value-based purchasing initiatives in fiscal 2015, including the federal Hospital-Acquired Condition Reduction and Hospital Readmissions Reduction Programs, according to (.pdf) an HHS report.
On hospital-acquired infection reduction, only 14 percent of rural facilities were penalized during the study period, compared to 26 percent of urban providers. HHS officials attribute this in part to superior care coordination work on the part of rural providers, enabled by small referral and post-acute care provider networks that “can encourage collaboration across care types and settings."
Echoing the concerns of groups such as the American Hospital Association, the report notes the disadvantages unrelated to care quality many rural providers face, including access to care among their patient populations and a higher proportion of disabled or impoverished patients.
However, the report found urban providers remain far ahead of their rural counterparts on readmission reduction, albeit with a smaller gap than that of hospital-acquired infection reduction; 76 percent of urban facilities were penalized for readmission rates last year, compared to 79 percent of rural facilities.
In the most recent round of penalties, over half of hospitals across the board will have their payments recut due to insufficient readmission reduction, FierceHealthcare previously reported, with 49 providers receiving the maximum payment cut of 3 percent.