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Evaluation of the grant program for rural health care transition.

The following summary is of a report from the Secretary of Health and Human Services released to Congress on December 12, 1994.

Legislative Mandate

Section 4005(e) of the Omnibus Budget Reconciliation Act of 1987 states, in part:

(1) The Administrator of the Health Care

Financing Administration, in consultation

with the Assistant Secretary for

Health (or a designee), shall establish

a program of grants to assist small

rural hospitals and their communities

in the planning and implementation of

projects to modify the type and extent

of services such hospitals provide... (8) The Administrator shall report to

Congress at least once every 6 months

on the program of grants established

under this subsection.


The Report was prepared by the evaluation contractor, Mathematica Policy Research, Inc., and describes:

* The progress of the 1990,1991, and 1992 grantee hospitals in implementing their projects.

* The impact of the grants on the hospitals and their communities.

* Physician recruiting by the grantees, based on a targeted questionnaire for the 1991 grantee hospitals.

* The effects of management change among the 1991 and 1992 grantees.

The following summarizes findings from the report:

* A physician recruitment survey designed for the 1991 grantees reveals that approximately three-quarters were attempting to recruit physicians. Most communities were recruiting in response to recent losses (68 percent) or expected losses (50 percent). Only 38 percent were recruiting on the basis of a formal assessment of need.

* The grantees appeared to be offering physician candidates competitive reimbursement packages. The median income guarantee, perquisites, and expected number of visits per week were all similar to national levels for general and family practitioners and pediatricians. For surgeons, the grantees offered lower income guarantees, but also expected the physician to make fewer visits per week. Data limitations prevent any conclusions as to whether on-call schedules hindered grantees from recruiting physicians.

* To evaluate the effect of management changes on 1991 and 1992 grantees' progress and financial status, the research team interviewed 36 grantees that had experienced a change in affiliation, management contract, or administrator since receiving their grants. Only about one-quarter of the grantees interviewed reported falling behind schedule as a result of the management changes.

* Although most of the hospitals that either joined, left a multihospital system, or dropped a management contract did so because of financial problems, results are inconclusive as to whether finances improved for the hospitals after management changes.

* Among 1990 and 1991 grantees, the majority of projects were on schedule. The most frequent grant-supported activities were recruiting, equipment purchases, staff training and development, and community education, wellness, and prevention programs.

For Further Information Contact:

Siddhartha Mazumdar Office of Research and Demonstrations Health Care Financing Administration 7500 Security Boulevard, C-3-15-06 Baltimore, Maryland 21244-1850 (410) 786-6673
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Publication:Health Care Financing Review
Date:Jun 22, 1995
Previous Article:Health care indicators.
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