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Hospital chiefs hopeful, vigilant on U.S. critical-access debate

Hudson Hospital & Clinic CEO/President Marian Furlong1 / 2
Hudson Hospital & Clinic, shown above, and River Falls Hospital could be impacted by potential changes in “critical access” rulings. (Hudson Star-Observer photo by Chuck Nowlen)2 / 2

As the US budget maelstrom plays out in Congress, hospitals in Hudson and River Falls remain cautiously optimistic – with the emphasis on “cautiously” – that services related to their federal “critical access” designations will survive intact.

A key issue for Hudson Hospital CEO/President Marian Furlong and River Falls Area Hospital President David Miller is a current federal requirement that no two critical-access facilities may be closer than 10 miles apart.

That’s a tight threshold for the two hospitals, which both have critical-access designations.

Those designations, authorized in the 1990s to address a rash of rural hospital closings nationwide, allow special federal reimbursements for local Medicare and Medicaid patient care.

The Obama Administration has been trying for the last six years to raise the proximity limit in an effort to reduce federal Medicare and Medicaid costs. Limits of 15, 20 and 25 miles or more have been recommended, to be implemented in stages over time.

If the 10-mile limit is raised to those levels, the Hudson and River Falls hospitals would likely both lose their critical-access designations.

A Republican budget plan now guiding the budget debate in the US House of Representatives would retain the 10-mile standard.

Top-100 performance

Hudson Hospital, meanwhile, has been named one of the nation’s top 100 critical-access facilities two years in a row, and another such honor is expected this year.

River Falls Area Hospital was named to the top-100 list last year.

“So, when you look at us both in terms of patient satisfaction, outcomes and, basically, everything else where critical access is concerned, Hudson and River Falls are two of the highest-rated hospitals in the country for the services we provide,” Miller said in an interview last week.

Furlong added in a separate interview: “That’s what this whole debate should be focusing on – how well we provide our services to the communities we serve and the value we provide.”

She specifically referred to her organization’s “Triple Aim” standards: 1- improving the health of the population served; 2 – providing a good individual experience for patients; and 3 – creating value in the community for the care provided.

Furlong and Miller emphasized that each hospital has developed a worst-case action plan that will guarantee quality care for their patients, regardless of what happens with the next federal budget.

Strong state support

They also acknowledged that the Wisconsin Hospitals Association, state officials and other voices have built a powerful political presence where critical access and quality health services are concerned.

Asked whether that leaves her optimistic that the Obama Administration’s efforts will be beaten back, Furlong replied: “Let me put it this way: It’s snowing outside in April, but it looks like the sun will be out this weekend and it’ll be warmer next week, so I’ll be spending this weekend doing spring cleaning.

“I think Hudson and River Falls are very well-positioned (in the budget debate) and with any changes that might or might not occur in the communities. I can tell you one thing for sure: There’s a lot of noise out there right now, but every day, I will walk into my office and think of one question all day long – how can we provide the best care possible for the people we serve?”

Added Miller: “Should we be worried? Well, I’m a cautious worrier. I’m always worrying about all the things we do and whether our patients and their families will be better off, and their ability to adjust if something changes. One thing I’m not worried about, though, is whether our hospitals here will survive and continue to provide the best services possible.

“So, are our critical-access designations secure? I don’t think you can say that; they’re under more fire than ever. But I will say that if this question is decided based on a true economic standpoint, I think you have to agree that critical access is money well-spent in River Falls and Hudson.”

A spokesperson in the office of US Rep. Sean Duffy, meanwhile, noted that Duffy and others are especially vigilant in case the Obama Administration tries to change critical-access proximity limits via unilateral rules if their budget efforts fail. Such rules would likely come from the US Center for Medicare/Medicaid Services, the spokesperson said.

Calls to CMS officials were not returned as of the Star-Observer’s press time this week.