Skip to main content

Rural Hospitals Prep for 'March' on Washington

 |  By John Commins  
   July 25, 2012

Representatives for rural hospitals from states across the nation will head to Washington, D.C. next week to lobby for renewed funding for low-volume adjustment and Medicare-dependent hospitals.

The provisions are set to expire at the end of the federal fiscal year on October 1 and the National Rural Health Association says that could jeopardize the solvency of hundreds of hospitals that are often a critical source of healthcare in their rural communities.

About 212 hospitals across the nation have MDH status, which requires that they be in a rural area, have no more than 100 beds, and show that Medicare patients represent at least 60% of their inpatient days or discharges. A study done for NRHA found that in 2009 MDHs operated at a negative 4% margin on average.

Without hospital-specific and transitional outpatient payments the study estimated that those MDH margins would have fallen to negative 12.6%.

NRHA's March for Rural Hospitals is on July 30-31. More than 50 rural hospitals and organizations are attending, and NRHA is extending an open invitation to anyone who cares about the issue. "We are all hands on deck at this point. Anybody can show up. It is a free conference. We aren't asking anyone to pay anything," says David Lee, NRHA's manager of government affairs and policy.

NRHA is asking rural health providers to support the bipartisan Senate Bill 2620 (HR 5943), which will renew for one year funding for both Medicare-dependent hospitals and low-volume hospitals.

"We are trying to raise the noise level on both of these provisions," Lee says. "They affect relatively few hospitals, so the people who are affected need to be as loud as possible because some of the other provisions can drown them out. And we hope these rural provisions aren't forgotten when everything else is looked at."

Even in this gridlocked and dysfunctional Congress, rural healthcare providers should remain optimistic about the chances for SB 2620. For starters, it's not terribly expensive. The Congressional Budget Office has scored a one-year extension as costing less than $100 million over 10 years, which Lee called "a very small number relative to the federal budget."

Also, the bill is one of the few items in Congress that has bipartisan support in both chambers. The Senate sponsors are heavyweight Sens. Charles Schumer, (D-NY) and Chuck Grassley, (R-IA). The House companion legislation has 29 cosponsors from both parties.

It doesn't matter if a state bleeds Red or drools yellow dog Blue, every senator and many representatives have rural constituencies and these elected officials understand the important roles that hospitals—and their employees—play in their communities.

"Some of these hospitals account for as much as 20% of the economic production in their communities," Lee says. "They are the largest employer or the second largest after their school district in their rural county. They are very important not just to deliver care but driving the economy and attracting outside business to come there by making sure there are adequate healthcare services."

On Monday, rural hospital advocates will meet with Congressional staffers to discuss the status of the bill and other legislation that affects rural health. On Tuesday those advocates will fan out and meet with their respective Congressional delegations.

Practically speaking, SB 2620 would kick the MDH/LVH can down the road for another year. It's not clear if there is any momentum towards a longer-term fix. Perhaps extending MDH and LVH provisions will become an annual event in Congress, similar to the Sustainable Growth Rate sideshow that has become the bane of physicians' lobbies.

At this point in this toxic political environment, if money continues to flow, a short-term fix may be the best hope for rural hospitals. There are worse fates.

Pages

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

Tagged Under:


Get the latest on healthcare leadership in your inbox.