NRHA is thankful for rural victories

As Thanksgiving is around the corner, the National Rural Health Association is thankful for the many rural victories we have had to celebrate National Rural Health Day. National Rural Health Day has grown and is being recognized on Capitol Hill like never before.  Several significant speeches were given on both the House and Senate Floor.  Additionally, with the passage of the Senate Resolution and the direct supervision bill, this National Rural Health Day is our most successful to date.

Here are a few highlights of last Thursday:

S. Res. 588 (formerly S. Res. 26.) passes in the Senate.  On the evening of National Rural Health Day, Senators Moran (R-KS) and Klobuchar (D-MN) pushed to pass a resolution detailing the importance of rural hospitals and rural providers to patients and the rural economy.  Additionally, it outlines how important it is to provide fair reimbursement to those rural providers.  NRHA is thankful for Senators Moran and Klobuchar, as well as the other 17 original cosponsors.

Congress extends direct supervision enforcement moratorium. HR 4067, introduced by Congresswoman Jenkins (R-KS) passed both the House and Senate and now awaits the President’s signature.  It is anticipated that the President will sign.  The bill will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for critical access hospitals and rural prospective payment system hospitals with 100 or fewer beds.

NRHA and AHA send joint letter to Congress commemorating Rural Health Day. NRHA and the American Hospital Association teamed together to send a letter to the House Rural Health Coalition and the Senate Rural Health Caucus outlining the importance of Rural Health Day.  This event, we believe, exemplifies a new commitment on behalf of each association to work together toward to betterment of all rural hospitals.

NRHA is thankful for our rural champions and our NRHA members who support rural health care. But our work is not over yet. During December and the next year, NRHA will continue its efforts to protect the rural health safety net. NRHA asks you to continue the fight the 26th Annual Rural Health Policy Institute Feb. 3-5 in Washington, D.C. Click here to register today.

Senate passes rural health care resolution

Last night on National Rural Health Day, Senate Resolution 588 passed the Senate. The resolution, introduced by Senators Jerry Moran (R-KS) and Amy Klobuchar (D-MN), recognizes that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

Rural Americans face unique challenges in accessing health care. Per capita, they are sicker, older and frailer than their urban counterparts. The rural elderly are more likely to have chronic conditions such as arthritis, hypertension, diabetes and heart disease. They are also likely to be required to travel a greater distance when seeking care than urban counterparts.

The resolution states that “the closure of a hospital in a rural community often results in severe economic decline in the community and the departure of physicians, nurses, pharmacists, and other health providers from the community, and forces patients to travel long distances for care or to delay receiving care, leading to decreased health outcomes, higher costs, and added burden to patients.”

The National Rural Health Association applauds Sens. Moran and Klobuchar for recognizing the needs, challenges, and opportunities for rural health care facilities are also vastly different from those faced by their urban counterparts. Higher percentages of Medicare beneficiaries, recruitment challenges, workforce issues, and unique budgetary challenges are all examples of areas where rural facilities differ from their suburban and urban counterparts.

NRHA also thanks the 17 original cosponsors:

Senators Baldwin (D-WI); Boozman (R-AR); Cochran (R-MS); Crapo (R-ID); Donnelly (D-IN); Durbin (D-IL); Enzi (R-WY); Franken (D-MN); Grassley (R-IA); Heitkamp (D-ND); Heller (R-NV); Hirono (D-HI); Hoeven (R-ND);  Johnson (D-SD); Tester (D-MT); Thune (R-SD); and Wicker (R-MS).

NRHA and AHA send joint letter to Congress for National Rural Health Day

The National Rural Health Association and the American Hospital Association sent letters to the Senate Rural Health Caucus and the House Rural Healthcare Coalition in honor of National Rural Health Day yesterday.  The letters point to several legislative positives as well as continuing priorities for rural hospitals, including Medicare extenders and regulatory relief.  NRHA and AHA thank the chairs of both the Caucus and Coalition for their leadership and their ongoing commitment to rural America.

Sen. Grassley and Rep. Smith celebrate National Rural Health Day

The National Rural Health Association applauds Senator Chuck Grassley (R-Iowa) and Representative Adrian Smith (R-NE) for being stalwart champions for rural America.

Rep. Smith delivered a statement on the floor of the U.S. House of Representatives recognizing National Rural Health Day. The video of the remarks is here.

Sen. Grassley took the U.S. Senate floor today to deliver a statement on the importance of rural health care and to recognize rural health care providers:

“Approximately 62 million Americans live in rural areas, and they depend on an ever shrinking number of healthcare providers.  Rural providers play an important role in improving the health of their communities and supporting local economies.  I want to thank our rural providers—individuals, hospitals and clinics for all that they do.

Rural providers support a population that makes invaluable contributions to this country through food production, manufacturing and other vital industries.  Yet, more people in rural areas are living below the poverty line than their urban counterparts.  Rural hospitals are struggling to continue providing care due to declining payments, many exacerbated by the Affordable Care Act. The past few years have been marked by increasing rural hospital closures, with 27 hospitals shutting their doors in the last two years.  The trend is concerning and deserves attention as many more facilities and communities are at risk right now.

Once a hospital is gone, the devastating impact on the community cannot be undone.  The economic impact is unmistakable. The typical critical access hospital creates over 140 jobs in primary employment and $6.8 million in local wages while serving a population of over 14,000.”

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Celebrate National Rural Health Day through advocacy!

Media outlets across the country, from USA Today to the US News and World Report, are noting the rural hospital closure crisis.  Today, on National Rural Health Day, NRHA encourages all rural health advocates to raise their voices together to ask Congress to support rural health care providers and the patients they serve.

Since 2010, 43 rural hospitals have closed. As many as 283 more hospitals are on the verge of closure.  Call or email Congress NOW and tell them to stop the cuts to rural hospitals.

  • Rural hospitals provide quality, affordable care to 62 million rural Americans.  Small, rural hospitals, known as Critical Access Hospitals (CAHs), represent over 26% of all community hospitals, yet Medicare expenditures to CAHs are less than 5% of the Medicare hospital budget.
  • CAHs provide cost-effective primary care.  In fact, the government spends 2.5% per year on rural Medicare beneficiaries than on urban beneficiaries.  This focus on primary care, as opposed to specialty care, saves Medicare $2.2 billion a year.
  • Rural health care providers account for 20% of local economic output and are critical to attracting new business, workers, and visitors.
  • Congress must take affirmative steps to stop rural hospital cuts and stop the closures!

Remember to sign up for NRHA’s Policy Institute to continue your fight for rural health!

Senators urge President Obama to protect Critical Access Hospitals

Senator Tammy Baldwin (D-WI) and 26 other senators wrote a bipartisan letter to President Obama urging him to exclude the Critical Access Hospital (CAH) reimbursement cuts and the 10-mile exclusion proposal from his Fiscal Year 2016 Budget request.

Obama’s Fiscal Year 2015 budget proposed reducing Medicare reimbursements for CAHs and removing the CAH designation for hospitals located within 10 miles of another hospital.

“Rural Hospitals have experienced significant Medicare reimbursement cuts that have strained critical resources. CAH facilities already face unique challenges, such as remote geographic location, workforce shortages, and limited resources, as they continue to provide 24 hour access to care for isolated rural communities,” the letter says. “Since the beginning of 2013, 24 rural hospitals have closed; this is double the pace of the previous 20 months. Proposals to reduce payments to CAHs will only serve to exacerbate the current problem and cause further care shortages in these isolated areas.”

The National Rural Health Association applauds Senator Baldwin and the other cosigners. NRHA urges members of Congress to stand up and protect the rural health care safety net.

USA Today: “Rural hospitals in critical condition”

43 Rural Hospitals Closed: 283 more closures are likely

Since the beginning of 2010, 43 rural hospitals—with a total of more than 1,500 beds—have closed, according to data from the North Carolina Rural Research Program. The pace of closures has quickened: from 3 in 2010 to 13 in 2013, and 12 already this year. Georgia alone has lost five rural hospitals since 2012, and at least six more are teetering on the brink of collapse. Each of the state’s closed hospitals served about 10,000 people—a lot for remaining area hospitals to absorb.

“The Affordable Care Act was designed to improve access to health care for all Americans and will give them another chance at getting health insurance during open enrollment starting this Saturday. But critics say the ACA is also accelerating the demise of rural outposts that cater to many of society’s most vulnerable. These hospitals treat some of the sickest and poorest patients—those least aware of how to stay healthy.” For the complete article, see USA Today.

USA Today profiles the now closed Stewart-Webster Hospital in Georgia. “We saved lives,” says Ammons, who was a nurse at the Stewart-Webster. “We saved a lot of lives.”

As many as 283 more hospitals are on the verge of closure.  Call or email Congress NOW and tell them to stop the cuts to rural hospitals.

  • Rural hospitals provide quality, affordable care to 62 million rural Americans.  Small, rural hospitals, known as Critical Access Hospitals (CAHs), represent over 26% of all community hospitals, yet Medicare expenditures to CAHs are less than 5% of the Medicare hospital budget.
  • CAHs provide cost-effective primary care.  In fact, the government spends 2.5% per year on rural Medicare beneficiaries than on urban beneficiaries.  This focus on primary care, as opposed to specialty care, saves Medicare $2.2 billion a year.
  • Rural health care providers account for 20% of local economic output and are critical to attracting new business, workers, and visitors.
  • Congress must take affirmative steps to stop rural hospital cuts and stop the closures!

Remember to sign up for NRHA’s Rural Health Policy Institute to continue your fight for rural health!

NRHA honors rural veterans

This Veterans Day, we remember and honor those rural veterans who have served our nation. Rural Americans have always been committed to serving their country – more than a quarter of the country’s veterans live in rural communities and a disproportionate number of those serving in the military hail from rural communities.

A diverse group of rural veterans represent rural America. The percent of women veterans residing in rural areas has more than doubled between 1992 and 2011, rising from 3 percent to 7 percent and rural minority veterans have increased from 6 percent to 10 percent.

Veterans are often pillars and leaders in their rural communities. They have committed their lives to protecting and serving the country. The National Rural Health Association applauds their service.

NRHA has consistently been a staunch advocate for expanding access to care for rural veterans, including improving availability of providers, care delivery mechanisms and provider understanding of the special needs of rural veterans. NRHA urges members of Congress to stand up for rural veterans and protect their access to care in their rural communities.

Election Takeaways for our Rural Agenda

Well, yesterday was another fascinating exercise in democracy. And while there is much to analyze, the significant takeaway is this: Rural America continues to turn a brighter shade of red as the rural/urban electorate seemingly grows further and further apart. The expanding rural/urban divide could even be seen in not-so-rural states like Maryland who shockingly elected only their second Republican Governor in nearly 50 years. This is entirely because the voter turn-out was low in Baltimore but high in eastern and southern Maryland, the rural portions of the state.

Yesterday’s election has two other significant underlying stories…

(for the rest of the blog visit NRHA Connect.)

Is rural America prepared for Ebola?

By Raymond Christensen, MD
NRHA 2014 president

The National Rural Health Association has long advocated that we are either all prepared to deal with emerging public health crisis, or as a nation, we are simply not prepared at all. Such is the case for the emergence of the Ebola virus. Decades of rural public health underinvestment raise serious concern as to the ability of a rural community to handle an Ebola-positive patient.

Each rural community needs to assess and determine inherent risks and capacities that can be brought to bear in responding to any public health threat. Ebola is no exception.

From a rural perspective, the ability to identify and diagnose, and then the contact tracing role of local public health officials are the great unknown at this point.

Health professionals, volunteers/first responders and the public must be educated to better identify, respond to, and prevent the health consequences that Ebola presents and to promote the visibility and availability of health professionals in the communities they serve.

For far too long, rural public health has been underfunded. As a result, the infrastructure is thin.  Training and the ability to properly diagnose before the infection gains a foothold in a rural community will be key.

As a nation, we must be prepared for the identification of a future Ebola case to present in a small rural community. As such, local, state and federal authorities need to have a plan in place for this potential outcome. The solution will likely involve a local, state and federal response, and how all these parts of our health system interact will be key to a successful outcome.

NRHA will continue to advocate for rural public health, patients and providers.