There's the CT or MRI machine that would have been upgraded years ago at a big-city hospital. A lobby with decor that's clearly not from this decade. A roof that needs to be replaced, but not necessarily this year.
"You pick and choose what things the hospital can do now, and what should wait," said
RMC, its sister hospital Stringfellow and
Under the current formula, according to data from RMC, Medicaid would pay
That's going to change -- at least a little -- on
"In a way, it's a huge victory for us," said
Hospital, heal thyself
Howard said she expects the rule change to bring an additional
Divided among all the state's hospitals, the money spreads pretty thin. RMC officials earlier this year said they expected to see an additional
Last week, RMC officials offered an upgraded estimate. With direct payments from Medicaid and indirect payments from other Medicare recipients, the company might see
It's money the hospital can definitely use, administrators say. To see the difference, North said, just go to
The lobby and waiting areas at RMC "look like what a hospital used to look like," North said, because remodeling has been a low-priority expense when money was tight.
The wage index has been a front-burner issue for small town hospitals for years, so why the change now?
"Rural hospitals play a special role," Becker said. "Is the emergency room in my town or am I going to ride in an ambulance for 30 or 40 minutes? That's something voters can see."
Rural health care was a hot-button issue in last year's local midterm elections. Some candidates decried the closure of RMC Jacksonville early in the year. Others offered plans to replace the hospital's services, or promised to study the cost of air ambulance service in northern
Becker said the political geography of the rural hospital crisis may have helped nudge the Trump administration toward a change. States at the bottom end of the wage index tend to be in the red column and states at the higher end are often blue.
But it's not clear that the change will help the most struggling small-town hospitals. RMC CEO
The pay gap trap
There's a chance the new wage index could itself lead to a money problem for
North said that could help the RMC retain staff, who might be tempted to move to
But the new wage index expires in four years, which could leave the hospital committed to higher salaries, even as the extra
Hospital advocates say the windfall from the wage index change pales in comparison to the biggest item on their wish list. If
"Medicaid expansion would blow away what we're getting from the wage index," Bass said.
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