In November 2022, CMS finalized a new Medicare provider designation for rural hospitals in its final Outpatient Prospective Payment System ruling. As outlined in the details, the ruralemergency hospital designation will be implemented in January 2023, allowing rural and critical access hospitals to receive a 5% payment increase for their services, provided they meet the conditions of participation. They will also get a monthly facility payment.

The conditions for hospitals include maintaining an average length of stay of no more than 24 hours and having emergency care available 24 hours a day, seven days a week. Hospitals that receive the new designation cannot provide acute inpatient care but are expected to provide emergency and observation care and potentially some outpatient services.

This is a significant opportunity for many rural hospitals, especially those that find themselves
operating with very thin margins every month. The impetus for REH is to keep the facility from
closing, which can result in severely limited access to care in their communities. Rural leaders
have been encouraging CMS for years to rally around rural communities, and while this doesn’t
answer all prayers, it certainly is a blessing to many.

OPYS is supporting a CAH that is actively pursuing the REH status. The team has consumed all
the material CMS has put forth and the state guidelines. While not all questions have been
answered, we are determined to come alongside our partners to ensure they have all the
assistance they need.

We recognize that not all physician management companies truly have their partners’ best
interests at heart, but we strive daily and with all our partners to give them what they need. It
is our hope to assist countless rural hospitals if their administration is striving to become an
REH. We know there are many hurdles to overcome, and countless questions to be answered,
but OPYS has deep resources, and we aren’t afraid to ask questions, especially if it helps our
partners.

If your facility is looking to become an REH in 2023 and you are looking for the right partners to
help you navigate along the way, please contact OPYS at 1-800-526-6797 or email OPYS at
info@OPYS.com. We know you have choices in physician management, and we are honored to
work with your team to provide the best care for your community while helping your facility to
be financially sound.