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Hospitals that decide to convert to a new type of rural provider won’t have to report quality metrics next year, but they also won’t qualify for a popular drug discount program — a likely dealbreaker for some.

That’s according to Medicare’s final rule laying out the parameters for so-called Rural Emergency Hospitals, a designation that takes effect Jan. 1, 2023 for facilities that opt in. These facilities will run emergency rooms, but not inpatient care. They’ll get higher Medicare reimbursement and additional facility payments of about $3.3 billion annually.

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