Proposed Healthcare Changes and RHC’s

Donna White

Donna White

By Donna White, Principal Consultant and Owner of Legacy Consulting Services and Legacy Billing Solutions in Montgomery, Alabama.

After two rounds of Democratic debates, a huge spotlight has been placed on Healthcare. While people on both sides of the aisle agree an overhaul to the system is a necessity, the agreement ends there. We have heard several proposals, and one in particular could lead to devastating consequences to America’s Rural Healthcare System.

Anyone in the Revenue Cycle Industry knows that most provider’s top five payors include Medicare. However, it is also known that Medicare rates alone would not sustain any practice, but in particular, those in rural communities.

Rural Health Clinics, or RHCs, focus on providing outpatient services targeted around primary medical care to patients in rural and medically underserved areas in the U.S. By default, most RHC’s see a lot of Medicare patients simply due to location and population. That Medicare, and Medicaid, population is supplemented by commercial insurers that often pay much more than the Medicare allowable.

This brings in the single payer notion proposed by some candidates. Rural Health Clinics, and Critical Access Hospitals, would most likely have to close their doors if they were solely paid the current Medicare rates. Which would devastate rural communities that would lose access to health care completely.

So, what are some options? Some propose a mix of government payors and private insurers, allowing more accessibility to healthcare, but allowing those with plans they are happy with to keep them. This would certainly help keep healthcare in rural communities a float. The other option is to look at the payment structure for a single government payor and see how increasing those rates could help keep rural health centers open but maintain the lower healthcare costs they seek. However, we have not seen a plan come from either party that will alleviate the growing healthcare costs for patients nationwide.

There is no easy answer. That’s why healthcare remains a top priority issue amongst both parties. However, Rural Health Clinics and Critical Access Hospitals need to do more to make their voice heard on how this would affect them. Because if they close their doors, we’ve completely negated the idea of accessible health care for all.

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