Sole Community Hospitals (SCHs) and Critical Access Hospitals (CAHs) are rural hospitals, but they have some key differences in their eligibility criteria, reimbursement rates, and regulations. Here are some of the main differences between SCHs and CAHs:
Eligibility criteria:
SCHs are located in rural areas and are the only hospital within a specified geographic area. They typically have fewer than 50 beds and serve as the primary source of inpatient care for residents in the surrounding community. CAHs, on the other hand, must be located in a rural area more than 35 miles from another hospital or inaccessible by secondary roads. They typically have fewer than 25 beds and must meet certain other criteria to be eligible for reimbursement under the Medicare program.
Reimbursement rates:
SCHs are eligible for Medicare reimbursement at a higher rate than other rural hospitals. This increased reimbursement can help SCHs cover the costs of providing essential healthcare services to their communities. CAHs are also eligible for higher Medicare reimbursement rates, but the reimbursement rate for CAHs differs from that of SCHs.
Regulations:
SCHs are not required to be designated as such by any federal agency. However, they must meet certain eligibility criteria to participate in the 340B program. CAHs, on the other hand, are designated by the Centers for Medicare & Medicaid Services (CMS) and must meet certain criteria to be eligible for reimbursement under the Medicare program. They are also subject to other regulations and requirements related to patient care, quality improvement, and other areas.
Size:
SCHs typically have fewer than 50 beds, while CAHs typically have fewer than 25 beds. Regardless both types of hospitals may provide various services, including emergency, primary, and specialty care.
Location:
SCHs are typically the only hospital within a specific geographic area and serve as the primary source of inpatient care for residents in the surrounding community. CAHs must be located in a rural area more than 35 miles from another hospital or inaccessible by secondary roads.
While both Sole Community Hospitals and Critical Access Hospitals are critical in providing healthcare services to rural communities, they have some key differences in their eligibility criteria, reimbursement rates, and regulations. It is important for healthcare providers to carefully consider each option's benefits and drawbacks before deciding which designation to pursue.