The Journal of the American Medical Association (JAMA) reported today “among Medicare beneficiaries undergoing common surgical procedures, patients admitted to Critical Access Hospitals (CAH) compared with non–CAHs had no significant difference in 30-day mortality rates, decreased risk-adjusted serious complication rates, and lower-adjusted Medicare expenditures, but were less medically complex.” The study reviewed four common surgical procedures performed in CAHs: appendectomy, cholecystectomy, colectomy, and hernia repair.
The study also took a look at cost. It was discovered that Medicare expenditures adjusted for patient factors and procedure type were lower at CAHs than non–CAHs, $14,450 vs $15,845 respectively. A difference of −$1,395.
CAHs are a major source of care for many rural patients. Articles in the past have featured conclusions that confuse more than illuminate the subject of quality in these facilities. It is refreshing to see research that focuses on procedures that CAHs perform, and perform well.
The very definition of value is the intersection between quality and cost. In this case, CAHs are high value providers of care to not only payers, but to the 62 million patients that depend upon them for their health care.