So why are these small, rural hospitals providing these services? It turns out that Medicare is structured in such a way that the hospitals have a strong financial incentive. Those higher payments they receive for patient care extend to elective, inpatient surgery, not just to emergency care. And as a result of these higher reimbursement rates, some general hospitals have merged with critical-access hospitals and shifted many of their inpatient surgical procedures to their less experienced, but more lucrative, partners.
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