The Rural Health Clinic Services Act (P.L. 95-210) was passed by Congress in 1977 with the goal of increasing access and availability of primary care services for Medicare and Medicaid beneficiaries in rural America. To ensure financial stability of this new provider, Congress allowed qualified RHCs to receive cost-based reimbursement from Medicare and Medicaid for physician services and physician directed services.
Today, the continued viability of Rural Health Clinics (RHC) is threatened by provisions in the Balanced Budget Act of 1997 (BBA) that allows states to phase out Medicaid cost-based reimbursement. A study was undertaken in Fall of 1997, prior to the passage of BBA, to assess the impact of RHCs on access and availability of primary care.
A survey was sent to all of the certified Rural Health Clinics in Texas. The Dillman Total Design Method procedures were employed in conducting the study. Of the 447 RHCs, 342 responded to the survey for a response rate of 81%
The introduction of Rural Health Clinics in Texas has improved access and availability of primary care to rural Texans. The concern over BBA is legitimate given that Medicaid is a substantial part of the operating budget for forty-six percent of the responding clinics. Further, there is a growing body of anecdotal evidence that many hospitals across the State are closing their clinics in anticipation of the loss of cost-based reimbursement.
Learning Objectives: By the end of this session participants will be able to: (1) List the requirements a clinic must meet to become a certified rural health clinic, (2) Define cost based reimbursement, (3) Discuss the implications of BBA'97 on Rural Health Clinics
Keywords: Access to Care, Balanced Budget Act
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.