The federal health care reform passed with much controversy during the summer included, among its provisions, some extra assistance for a handful of small hospitals caught in a Medicare no man's land.
Three of those hospitals are in Alaska, including Bartlett Regional Hospital and Sitka's Mount Edgecumbe Hospital and Soldotna's Central Peninsula Hospital.
All three are caught in the unusual situation of providing crucial and sometimes expensive services, but serving a population that's so small they don't benefit from the economies of scale that big cities have.
At the same time, they are too big to qualify as "critical access" hospitals, a designation that helps tiny rural hospitals that provide emergency rooms to keep their doors open.
Bartlett and the other hospitals serve populations isolated by distance or geography that makes it difficult for patients to get to those big-city hospitals.
For the last five years, Bartlett has received extra per-patient Medicare reimbursement as part of a federal demonstration project intended to fill in a gap in the nation's health care system.
Now, as part of the new federal health care reform law, that program has been both extended for an additional five years and expanded to include additional hospitals.
"Alaskans who depend on Medicare face the country's most unique circumstances and greatest difficulties when it comes to receiving care and services," Sen. Mark Begich, D-Alaska, stated in a press release. He authored an amendment to the health care bill to continue the program.
Mount Edgecumbe Hospital's Frank Sutton said the program fills a need that is most acute in Alaska.
"In extremely rural, remote areas, Medicare funding doesn't quite cover the higher costs, but you have to provide the services because you are the only game in town," he said.
Mt. Edgecumbe provides services to tribal members which were once provided by the Indian Health Service. Based on an island, most of its patients arrive by plane or boat.
It is run by the Juneau-based Southeast Alaska Regional Health Consortium, or SEARHC.
Sutton estimated the extension of the program would mean about $2.2 million for the hospital.
"This demonstration project has made a significant difference for us," he said.
Soldotna hospital officials told the Peninsula Clarion a renewal of the program meant about $2.6 million for them.
At Bartlett, it will provide about 0.6 percent of the budget, said spokesman Jim Strader. With a budget of $78 million last year, that comes out to about $500,000 a year.
The additional reimbursement is less crucial in Juneau, but comes as Bartlett is in the midst of important construction projects designed to improve service to the community, he said.
"It's a little bit of a pad," he said.
"We've been in the construction and we've been able to go forward with that. We haven't felt we've needed to hold back on any of them," he said.
The program's renewal lasts for five years.
The rural help goes to about 20 hospitals nationwide now, but Sutton said they appreciated the help of the Alaska congressional delegation
"Retention of this program is pretty important, and our Congressional staff were very interested in making sure that happened," he said.
Contact Pat Forgey at 523-2250 or firstname.lastname@example.org.