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The Low-Volume Hospital Adjustment Before and During COVID-19 [1]
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Date: 2025-02
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The NC Rural Health Research Program has been tracking the Low Volume Hospital (LVH) adjustment’s impact on rural hospitals. As policy makers consider legislation to maintain or alter the LVH adjustment before its expiration on December 31, 2024, the impact on more vulnerable communities is a relevant consideration. Read our July 2024 brief, The Low-Volume Hospital Adjustment Before and During COVID-19 .
The LVH adjustment is for hospitals with fewer than 3,800 patient discharges in the previous year that are more than 15 miles from the nearest Inpatient Prospective Payment System acute care hospital. Qualifying hospitals receive a payment adjustment up to an additional 25% for every Medicare patient discharge.
Our 2016 brief analyzed characteristics of low volume and non-low-volume rural Prospective Payment System (PPS) hospitals from 2012 to 2014 under the Affordable Care Act’s qualifying criteria. We found that, without the adjustment, rural Low-Volume Hospitals (LVHs) would have had significantly lower profitability margins. This brief provides an update to those findings and uses the current LVH adjustment qualifying criteria to compare low-volume hospitals to all other rural PPS hospitals and explore the effect of taking away the adjustment on LVHs in the two years before COVID-19 (April 2018 to March 2020) and two years during COVID (April 2020 to March 2022). This analysis assesses the impact of the LVH provision on rural hospitals, it does not address the appropriateness of the qualifying criteria.
Key findings include:
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[1] Url:
https://www.shepscenter.unc.edu/product/the-low-volume-hospital-adjustment-before-and-during-covid-19/
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