Bill would aid rural health care

McInnis introduces plan to bring relief to some agencies

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— Legislature introduced by Rep. Scott McInnis, R-Colo., could bring some much-needed Medicare relief to the local Visiting Nurse Association and other rural health-care agencies in Colorado.

On Tuesday, McInnis proposed a bill that would give hospice providers a 15 percent increase and home health-care agencies a 20 percent increase in Medicare reimbursement rates.

And those increases are greatly needed for the local agencies with 60 percent to 70 percent of the VNA's patients on Medicare, said Jan Fritz, the VNA's director of home care and hospice.

"If they increase Medicare reimbursements to 15 percent above what the current daily rate is, it will help us survive," Fritz said.

One of the greatest disadvantages facing rural health-care agencies such as the VNA is distance.

With the Craig and Steamboat VNA offices visiting patients from Toponas to Dinosaur, the travel expenses and time can be costly.

"When you are in a large geographic area making two or three visits per day, that drives up the cost," Fritz said. "In urban areas, nurses can get five or six visits a day within a 10-mile radius. It's not a huge, huge area to cover."

In addition to travel expenses and needing more nurses to cover fewer patients, rural agencies' Medicare reimbursement rates are much lower than those in urban areas.

Because reimbursements derive from population per square mile, rural hospices and home health-care agencies are given a double blow.

"Our revenues are at a much lower rate and we have more traveling than urban areas, who are at a much higher rate. (The reimbursement) formula is not conducive to rural health care," Fritz said.

After lobbying McInnis to improve health care in rural areas, the local VNA's executive director, Susan Birch, said Tuesday's proposed legislation is needed for rural home health-care agencies to work.

"It is huge. Unless our government funds some changes, we could very well be out of business, unless we fix it," Birch said. "(McInnis' legislation) is a partial fix for the problem."

McInnis' proposed bill also has potential impacts on Yampa Valley Medical Center.

As a hospital defined as a sole community hospital in the introduced bill, the medical center would be held harmless for two years regarding reimbursement payments under Medicare.

Chief Executive Officer Karl Gills said he did not think the medical center would be as greatly impacted as other rural hospitals because Steamboat is a younger community with fewer patients on Medicare.

"Without seeing the whole (legislation), it is likely that we have some benefits (from the proposed legislation), but it is not to the degree of other rural communities whose percentage of Medicare patients are much higher," Gills said.

The medical center has 19 percent of its patients on Medicare compared to the statewide average of 30 percent.

Birch was not the only one to discuss rural health issues in Colorado with McInnis, who will be coming to Steamboat Springs for a town meeting Saturday.

"When traveling through Colorado, an area of growing concern amongst constituents is having quality and access to health care," McInnis said. "Because of this feedback, I sat down and worked to create a reasonable proposal that will address these important safety net issues in rural Colorado."

Two other states, Kansas and Montana, have proposed similar health-care legislation for rural communities.

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