access hospital program was intended to financially stabilize small, rural
institutions by providing them with higher Medicare reimbursement rates. The
hospitals in the program are supposed to have 25 or fewer beds and be at least
35 miles away from another facility (15 miles across mountainous terrain) in
communities that would otherwise have limited access to health care services.
The effort was a response to a spate of 360 rural hospital closures in the
1980s and 1990s.