Rural Health Reimbursement Pain Points – Part 3

This is the final part in our three-part series on rural health reimbursement pain points

• Click here to read Part 1
• Click here to read Part 2

As we conclude our series on operational and revenue related issued that rural health providers face, we want to look at additional factors that can be impacting on the organization’s revenue flow.

Strategic Decision Making with Regard to Growth and Market Share

Hospitals continue to face tough decisions with regard to growth and market share, especially with continued cost pressures and low margins. Some solutions may include considering outsourcing certain services or expanding the services offered. The decision process can be hard however for rural health providers. Many times, these providers are hesitant to proceed because they are not sure where to expand their services and still remain competitive. Contracting for this work can be hard due to volume constraints. Many do not have the financial strength to allow them to “swing and miss.” Overall, it is important that rural providers remember that they cannot be all things to all people in their rural community. They need to evaluate where they can make the most impact and develop relationships with providers outside their community who can manage the other areas. 

Small Providers Receive Less Attention Compared to Large Providers

In an expansive health system, it can be difficult to be the “small fish in the big pond.” Rural health providers often do not receive the same attention as their larger, urban counterparts. It is important for rural health providers to remember that they are different. They have a different funding mechanism, and they need to understand that they have a different reimbursement model and thus, different revenue opportunities. It is important that the health system leadership and board understands this and that they are educated on the value you offer to the system.

Differing Definitions of Rural

Each governing body behind a rural practice may have a different definition of what rural is. In fact, there is not one universal definition of rural. As a result, it can be difficult to make sense of the differences and to understand what your organization may be eligible for. It is important that you evaluate your designation and what this means in your geographic area. Identify the reimbursement methodology and reporting requirements for your designation, working to ensure optimization of these opportunities.

Though rural health providers face some unique challenges, it is important to remember that the role rural providers play in healthcare is second to none. For questions or more information on the common pain points or rural health in general, please contact our Rural Healthcare Reimbursement Manager, Caren Puvalowski.