Critical Access Hospitals: Views on How Medicare Payment and Other Factors Affect Behavioral Health Services

Small “critical access” hospitals are often the only source of health care in rural communities. While they provide emergency mental health care, only some provide other in- and outpatient psychiatric care.

Medicare generally pays these hospitals at cost, but most inpatient psychiatric services aren’t eligible for cost-based payment. Hospital officials had mixed views on whether this swayed decisions to offer inpatient psychiatric care.

Medicare payments aren’t the only factor limiting mental health care for these hospitals’ patients. Hospital officials cited shortages of mental health care workers and available inpatient psychiatric beds.

What GAO Found

Critical access hospitals (CAH) are small rural hospitals, which are often the principal or sole source of...