Medicare payment options for rural hospitals: the name game.

Within the framework of Medicare laws and regulations governing payments for acute-care services are various options affecting payments to individual hospitals, many of which are directed at rural hospitals. Several changes in the classifications for sole community hospitals, Medicare-dependent hospitals, and rural referral centers have been implemented through the Balanced Budget Act (BBA) of 1997 and subsequent legislation. The critical access hospital classification implemented through the BBA makes available on a national level the former rural primary care hospital classification. Each of these four classifications provides for different payment enhancements.