What Rural Health Providers Want from Washington

Rural health providers have a long to-do list for Congress.

Driving the news: When the chairman of the powerful House Ways and Means Committee last month put out a call for ideas on shoring up rural America’s fraying health care system, rural providers came prepared.

  • The National Rural Health Association sent a letter last week outlining actions Congress can take, ranging from enhanced support for staff retention at the poorest facilities to carveouts from some controversial policies strongly opposed by the broader hospital industry.

Why it matters: Eighty percent of rural areas in the country are medically underserved areas, while rural Americans tend to be older, sicker and poorer than their urban counterparts. Almost 200 rural hospitals have closed in the past two decades, and hundreds more are on the brink of financial collapse.

The rural providers called on Congress to:

  • Exempt rural hospitals from price transparency rules, calling them “costly and burdensome” for the facilities.
  • Increase payment rates and force Medicare Advantage plans, who account for a growing share of their patients, to speed up payments that providers say are taking too long to arrive.
  • Authorize Medicare to extend a policy that boosts reimbursement to hospitals that pay lower wages to their employees, which aims to lessen pay disparities between rural hospitals and higher-wage facilities usually in urban areas.
  • Maintain rural hospitals’ access to the 340B federal discount drug-purchasing program as Congress weighs changes to it, and make it easier for different rural provider types to participate in the program.
  • Permanently extend telehealth flexibilities put in place during the pandemic.
  • Help rural providers move away from fee-for-service payment and into value-based payment programs. The providers say they have been largely overlooked in alternative care models coming out of Medicare’s innovation lab.

Of note: NRHA said rural hospitals should be exempt from future site-neutral hospital payment policies that Congress is considering.