1. Critical Access Hospital Coalition Workshop Financial Impact Study August 22, 2003 Richard Donkle, CPA Rural Wisconsin Health Cooperative

2. CAH’s in Wisconsin YEAR Number of Facilities 19993 20006 20019 20028 20032

3. CAH’s in Wisconsin Inpatient Medicare Reimbursement 199719981999200020012002 Acute % Payment/Costs 92.18%88.88%85.37%89.48%95.14%100.00% Swing Bed % Payment/Costs 31.83%32.23%32.83%42.05%64.59%100.00% Swing Bed Per Diem $247.71$272.55$293.83$316.64$542.70$876.41

4. CAH’s in Wisconsin Outpatient Medicare Reimbursement 199719981999200020012002 Outpatient % Costs/Charges 58.14%55.25%53.06%52.52%53.57%57.19% Outpatient % Payment/Charges 51.62%47.91%46.88%47.49%51.22%57.19%

5. CAH’s in Wisconsin

17. Year199719981999200020012002 Medicare Utilization (Days) 69.87%73.32%73.25%72.75%74.60%76.39%

18. CAH’s in Wisconsin 199719981999200020012002 Average Total Acute LOS 3.443.433.223.223.162.91 Average Medicare Acute LOS 3.753.493.653.533.453.34 Swing-bed days as % of Total Days 31.27%34.59%36.61%36.52%38.62%40.19%

19. CAH’s in Wisconsin ServicesPre-CAHPost-CAH Skilled Nursing Facilities 88 Swing Bed 1616 Home Health Agency 32 Hospice01 Rural Health Clinics 02 Ambulance66

20. Critical Access Hospital Coalition Workshop Financial Impact Study August 22, 2003 Richard Donkle, CPA Rural Wisconsin Health Cooperative