Indicators Per 1,000 Population

Source: American Hospital Association

Rural Access Grants Available to Arkansans

An applicant workshop/key stakeholders meeting for a multi-million dollar grant to provide rural access to care was held March 25 in Little Rock. Frank Wise, administrator of Fulton County Hospital in Salem, appeared on a panel sharing his perspective on access to care in rural Arkansas. Through the Southern Rural Access Program, the Robert Wood Johnson Foundation has made available $13.8 million over three years for the first phase of an effort to improve access to basic healthcare in Arkansas and seven other rural medically underserved states. Grants will support efforts in the eight states to develop and implement long-term strategic plans to increase the supply of primary care providers in underserved areas; design delivery and reimbursement systems to provide basic health services to residents in underserved areas; and build capacity at the state community level to address the healthcare conditions that disproportionately affect the residents of rural, underserved areas. Grants are expected to be awarded in late fall or early spring, 1999.

Comparative Utilization, Community Hospitals, by State, 1996
Indicators Per 1,000 Population

Source : American Hospital Association

In 1996, Arkansas still ranked comparatively high in the number of hospital beds, admissions and patient days per 1,000 population. The state was in or near the highest quartile in each of those categories compared to the other 49 states and the District of Columbia, and was significantly above the U.S. average for those indicators. That may reflect the still relatively low penetration of managed care in Arkansas.

Consolidated Billing Policy Revised

The Health Care Financing Administra-tion has revised a controversial consolidated billing policy that was earlier proposed to comply with certain provisions of the Balanced Budget Act. The Act requires consolidated billing for Medicare-certified skilled nursing facilities (SNF) as a part of the new SNF Prospective Payment System (PPS) scheduled for implementation July 1. To meet this requirement, HCFA originally proposed that no other provider or supplier could bill separately for any Medicare Part B services provided to a Part A SNF inpatient. The policy meant that hospitals where Medicare SNF patients receive outpatient services would have to bill the SNFs for the services directly, rather than bill Medicare.

The American Hospital Association successfully argued with HCFA that hospitals across the country would be forced to track an estimated 59 million outpatient Medicare claims annually to determine which were for patients from Medicare-certified SNFs and which were not. The requirement would also have placed hospitals at risk of even more fraud charges, since mistakes would be inevitable. As a result, HCFA revised the proposed policy to exclude hospital outpatient services (except those provided as part of the SNF's plan of care, such as laboratory and therapy services) from the consolidated billing requirement. Notice of the revised policy was sent from HCFA to its Medicare Fiscal Intermediaries and Carriers in Transmittal No. AB-9818.

Arkansas Hospitals: Location, Classification, Beds, Special Units & Control