How Do Medicaid Programs Pay CAHs For Outpatient Services?
Outpatient Medicaid business is often of greater financial importance than inpatient revenues for small rural hospitals. Officials in 13 of the 42 states studied reported that they have a special outpatient payment policy for CAHs. Although this represents fewer states than have adopted alternative Medicaid reimbursement policies for inpatient services, 45% of all certified CAHs are located in these 13 states. Nine of these 13 states reimburse CAHs for 100% of the costs associated with treating Medicaid beneficiaries. The other four states provide an enhanced rate to CAHs, but do not guarantee 100% cost settlement. In two other states, Kentucky and North Dakota, it was not necessary to create a special policy for CAHs, as all hospitals are paid costs for outpatient care. Only one state contact (from California) reported that small rural hospitals have a different fee schedule than other hospital groups. Has Risk-Based Medicaid Managed Care Had An Impact On CAH Payments? In states with
