Reimbursement of Rural Referral Centers under the Medicare Prospective Payment System

摘要

The report examined rural teaching hospitals and rural referral centers (RRCs) to determine how their costs differ from urban hospitals and other rural hospitals. Among the major conclusions are: RRCs' 1984 costs are 13 percent higher than those of other rural hospitals when case mix, teaching, and wage differences are taken into account; The higher RRC costs appear to be largely 'explained' by their proportion of referral cases and their larger number of beds; Holding case mix, teaching, and wages constant, RRCs' costs are about 10 percent lower than average urban hospitals; The RRC/urban cost differences appear to be largely explained by proportions of outlier patients; 'Large' rural teaching hospitals are not more costly per case than 'small' rural teaching hospitals when case mix and wages are taken into account.