AHA Urges Government Officials to Pass the Rural Hospital Support Act

The bill has been reintroduced to the Senate.

By Mackenna Moralez, Associate Editor

The American Hospital Association is urging Congress to pass the Rural Hospital Support Act in a letter addressed to Senator Bob Casey and Senator Chuck Grassley. 

“Rural hospitals are essential access points for care, economic anchors for communities and the backbone of our nation’s rural public health infrastructure,” the letter states. “These hospitals have maintained their commitment to ensuring local access to high-quality, affordable care during the COVID-19 pandemic and beyond, in spite of unprecedented financial and workforce challenges over the last three years.” 

The bill was first introduced in 2021 with the goal of modifying and extending payment adjustments for “rural hospitals under Medicare’s inpatient prospective payment system.” If passed, the bill would provide financial stability for Medicare-dependent healthcare facilities.  

“Rural Hospital Support Act would make the enhanced low-volume Medicare adjustment permanent,” the letter continues. “Medicare seeks to pay efficient providers their costs of furnishing services. However, certain factors beyond providers’ control can affect the costs of furnishing services. Patient volume is one such factor and is particularly relevant in small and isolated communities where providers frequently cannot achieve the economies of scale possible for their larger counterparts.” 

There are over 500 rural hospitals at immediate risk of closure due to financial losses and lack of financial reserves to sustain operations, according to a report by the Center for Healthcare Quality and Price Reform. Almost every state has at least one rural hospital at immediate risk of closure, and in 21 states, 25 percent or more of the rural hospitals are at risk.   

Nearly all the rural hospitals that are at risk of closing are in isolated rural communities. If closed, community residents would no longer be able to receive emergency or inpatient care without having to travel long distances. 

“The sole community hospital (SCH) program plays an important role in maintaining access to care in rural communities,” the letter states. “SCHs must show they are the sole source of inpatient hospital services reasonably available in a certain geographic area to be eligible for the program. They receive increased payments based on their cost per discharge in a base year. By allowing SCHs to choose an additional base year from which payments can be calculated, your legislation provides the increased support needed now by many rural hospitals.” 

The bill has been read twice and referred to the Committee on Finance. It has since been reintroduced to the Senate.  

Mackenna Moralez is the associate editor for the facilities market.  

April 6, 2023

Topic Area: Maintenance and Operations

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