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NRHA continues to fight for MDH, LVH


The National Rural Health Association (NRHA) continues to fight to restore the Medicare Dependent Hospital (MDH) designation and the Low-Volume Hospital (LVH) adjustment. Dramatic reductions put Medicare beneficiaries’ access to critical primary, emergency and hospital care in severe jeopardy. “These designations are critical to the rural health care delivery system,” said Alan Morgan, CEO of NRHA. “Without them, delivering care to rural Americans is at risk. Hospitals will have no choice but to reduce services and staff.” The MDH designation helps rural hospitals that struggle to maintain financial stability under Medicare’s fee schedule because of their small size and the large share of Medicare beneficiaries who make up their patient base. Because of their vital nature in serving the rural Medicare beneficiary population, Congress enacted various payment modifications to help these facilities stay open and guarantee hospital access to rural Medicare beneficiaries. This designation reimburses hospitals based on their historical costs of providing care rather than on a prospective schedule based on costs incurred by other facilities. Similarly, the LVH adjustment is designed to help isolated facilities that treat a very low number of beneficiaries. First proposed by the Medicare Payment Advisory Commission in 2001, the adjustment operates on a sliding scale and helps qualifying facilities offset the high fixed costs of providing care to seniors that are not offset by the urban-centric prospective payment system. To learn more about MDH and LVH, click here.

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