Abstract
This study explored the impact of Medicare sequestration on the ability of Critical Access Hospitals (CAHs) to provide hospital-based healthcare services in a primarily rural Midwestern state. Rural populations are often identified as older, poorer and sicker than their urban counterparts. Due to the increased age of rural populations and their use of Medicare, CAH facilities are highly dependent on Medicare as their primary insurance payer source. The aim was to identify the impact of the ongoing cuts in Medicare reimbursement due to sequestration on the rural healthcare environment and in doing so, provided evidence to help support policy decisions that will address the healthcare needs of rural Americans. This research used a two-phased, explanatory sequential mixed methods approach incorporating both qualitative and quantitative data. Thirty-four CAH Chief Executive Officers (CEOs)/Administrators participated in this study that included a survey to collect quantitative data and interviews of a smaller subset of survey participants for the qualitative data collection phase. The quantitative and qualitative findings were integrated through a joint display table. Based on the findings, an educational campaign designed to inform Congressional policy makers on the negative impact the ongoing Medicare sequestration has had on access to care in rural America was proposed. With the increasing age of rural Americans, there will continue to be a growing demand for hospital-based healthcare services. The implications of this study are informed elected officials creating policy decisions to support access to hospital-based healthcare services in rural America.
Keywords: Medicare sequestration, Critical Access Hospital Program, leadership, rural, public policy