Author Archives: Erin Mahn Zumbrun

Rep. Ryan selected as nominee for Speaker

Rep. Paul Ryan (R-WI) was selected as the nominee for Speaker of the House today by the House Republicans. Rep. Ryan defeated Rep. Daniel Webster (R-FL) during a closed-door election of the House Republican Conference.

Rep. Ryan is expected to be ratified by the full House Thursday. He will replace John Boehner  (R-OH) who will be stepping down later this week.

NRHA disappointed in tentative budget deal

Late Monday night, Congressional leaders and the White House reached a tentative budget deal that would raise the debt limit, avoid a shutdown in December, and would set spending levels through September 2017.

The National Rural Health Association is disappointed that the Bipartisan Budget Act of 2015 includes site-neutral payment cuts on hospital outpatient departments (HOPDs) and the extension of sequestration for Medicare payments. Rural hospitals play a critical role in providing 24/7 access to care and are the safety net providers for rural America.

The extension of the 2 percent cut in Medicare payments, which was first passed under the sequester, comes during a time when rural hospitals are already closing because of drastic cuts.

“Rural hospitals are closing at a record rate,” says Maggie Elehwany, NRHA’s vice president of government affairs. “We have seen 57 rural hospitals close since 2010, and another 283 rural hospitals are on the brink. Since the start of 2013, more rural hospitals have closed than in the previous 10 years combined, and rural communities across the nation are feeling the crisis in tragic ways. Our rural hospitals cannot shoulder any more cuts.”

The deal would provide $50 billion in fiscal year 2016 and $30 billion in fiscal year 2017 in sequester relief for both defense and non-defense spending, but hospitals would be left out in the cold.  Raising spending now in return for cuts further down the road has serious consequences for hospitals and providers that depend on Medicare reimbursements to keep their doors open to serve the older, poorer and sicker rural population.

NRHA will continue to advocate for strong funding for the rural health care safety net. Members of Congress must hear from you in support of critical rural health programs and to protect access points that will be impacted by this deal. Continue to follow NRHA’s blog for the latest news from Capitol Hill.

Join the fight to protect health care in your community. Contact your members of Congress today and let them know how important your facility is to your community. And plan now to meet with the Obama administration, your congressional members and national experts at NRHA’s 27th annual Rural Health Policy Institute Feb. 2-4 in D.C. Rural America is counting on you. Register today and save $100.

White House names Rural IMPACT demonstration sites

The White House today announced the 10 sites participating in the Rural IMPACT demonstration, an initiative to help address rural child poverty. More than six million rural Americans live in poverty, including about 1.5 million children.

The 10 rural and tribal communities participating in the demonstration are:

  • Berea (KY), Partners for Education at Berea College (Serving Knox County, KY)
  • Blanding (UT), The San Juan Foundation (Serving San Juan County, UT)
  • Blytheville (AR), Mississippi County, Arkansas Economic Opportunity Commission, Inc. (Serving Mississippi County, AR)
  • Hillsboro (OH), Highland County Community Action Organization, Inc. (Serving Highland County, OH)
  • Hugo (OK), Little Dixie Community Action Agency, Inc. (Serving Choctaw, McCurtain and Pushmataha Counties)
  • Jackson (MS), Friends of Children of Mississippi, Inc. (Serving Issaquena, Sharkey and Humphreys Counties, MS)
  • Machias (ME), Community Caring Collaborative (Serving Washington County, ME)
  • Marshalltown (IA), Mid‐Iowa Community Action, Inc. (Serving Marshalltown, IA)
  • Oakland (MD), Garrett County Community Action Committee and the Allegany Human Resources Commission (Serving Garrett and Allegany Counties, MD)
  • White Earth (MN), White Earth Reservation Tribal Council (Serving Mahnomen County and portions of Clearwater and Becker Counties)

Short-term CR introduced in Senate

The Senate introduced a continuing resolution this afternoon that would keep the federal government running through Dec. 11. The bill continues spending at the Fiscal Year 2015 levels minus .21 percent, the necessary cut to stay below the sequester cap.

The bill contains language defunding Planned Parenthood for one year and redirecting mandatory funds to community health centers.

The Senate will vote on Thursday. According to reports, the Democrats are expected to filibuster and the bill is expected to fail.

There are only five working days left before the end of the fiscal year. Continue monitoring this blog for the latest news from Capitol Hill.

Save Rural Hospital Act needs your help: Urge your representative to sign on as a co-sponsor today

The National Rural Health Association encourages you, and all rural health leaders across the country, to contact their member of Congress and urge them to cosponsor HR 3225, the Save Rural Hospitals Act.

Members of Congress are home in their districts for the next two weeks, so now is the time to reach out to them.

HR 3225 will stop the flood of rural hospital closures by ending Medicare cuts to rural hospital and eliminating burdensome regulatory requirements. The bipartisan bill also offers a path forward for rural hospitals that may still continue to struggle by allowing them to transform into an innovative new payment model that fits the unique delivery needs of a rural community.

This is urgent. Fifty-six rural hospitals have closed, and 283 additional hospitals on the brink of closure.

NRHA asks you to visit the district office, attend town hall meetings and invite your member of Congress to tour your rural facilities. Explain to them how important your hospital is to the patients you serve and the rural economy. Don’t wait. HR 3225 will eliminate millions in Medicare dollars that have been cut from your hospital. America’s rural safety net hospitals needs this bill passed now.

Visit for more information on the HR 3225, the Save Rural Hospitals Act, and how you can help get this important bill passed.

Today marks 50th Anniversary of Medicare and Medicaid

As today marks the 50th Anniversary of President Lyndon B. Johnson signing Medicare and Medicaid into law, the National Rural Health Association recognizes the importance Medicare has on access to care in rural America.

Medicare serves a disproportionate number of rural Americans. Twenty-three percent of Medicare beneficiaries live in rural America, while only 20 percent of the population resides in rural America. Rural beneficiaries are more likely to be dually eligible for both Medicare and Medicaid than their urban counterparts.

Medicare – a major component of rural health care – pays rural providers less than their urban counterparts. Medicare spends 2.5 percent less on rural beneficiaries than it does on urban beneficiaries. Rural health care providers operate on very thin margins and many rural communities have severe medical workforce shortages. Yet, rural physicians, who put as much time, skill and intensity into their work as their urban counterparts, are reimbursed at lower rates.

Continued cuts in hospital reimbursements have taken their toll, forcing far too many rural hospital closures and leaving many of our nation’s most vulnerable populations without timely access to care. Fifty-five rural hospitals have closed since 2010; 283 more are on the brink of closure. Since the start of 2013, more rural hospitals have closed than in the previous 10 years—combined. If Congress allows these 283 rural hospitals on the brink to close, then 700,000 patients would lose direct access to care.

And this loss of access will result in increased Medicare expenditures. Rural hospitals provide cost-effective primary care. It is 2.5 percent less expensive to provide identical Medicare services in a rural setting than in an urban or suburban setting. This focus on primary care, as opposed to specialty care, saves Medicare $1.5 billion per year. Quality performance measurements in rural areas are on par if not superior to urban facilities. That is why NRHA fully supports the Save Rural Hospitals Act introduced earlier this week by Reps. Sam Graves (R-Mo.) and Dave Loebsack (D-Iowa). This important bill will not only stabilize rural hospitals but also presents a new rural model to keep access to health care in rural communities.

As we celebrate this milestone for Medicare, NRHA asks members of Congress to remember how Medicare provides access to care for the older, sicker and more vulnerable populations, and to consider the impact of access to care Medicare provides. Medicare serves an essential role in ensuring access to necessary health care that meets the unique needs of rural communities.

As we look toward the next 50 years of Medicare, more must be done to ensure rural Americans have access to the health care resources necessary to allow them to lead healthy lives.

Learn more about Medicare’s impact on rural America and the Save Rural Hospitals Act at 1 p.m. CDT today (Thursday) during a free NRHA grassroots advocacy call.