Limited-Service Hospital Pioneers: Challenges and Successes of the EssentialAccess Community Hospital/Rural Primary Care Hospital (EACH-RPCH) Program and Medical Assistance Facility (MAF) Demonstration

摘要

Small communities in rural America are struggling to maintain health careresources in the face of increasing competition and a dwindling population and economic base. In response to the threatened survival of small rural hospitals, the Health Care Financing Administration has supported two initiatives to introduce innovative limited-service hospitals: the Essential Access Community Hospital/Rural Primary Care Hospital (EACH-RPCH) program, implemented in seven States, and the Medical Assistance Facility (MAF) demonstration in Montana. Both establish anew Medicare provider that is exempt from specific key requirements of participation, and both offer enhanced reimbursement. Other States have looked to these two programs as possible models for their rural communities. This report documents the evaluation of the EACH-RPCH program from its start in October 1991 through September 1994. The report assesses the implementation process, initial operating experience, and potential impact of the program on access and cost as related to limited service hospitals.