Rural health care state of the union

By: Alex T. Olson | 4/30/19

---

NRHA’s Annual Rural Health Conference is back. Over a thousand rural health care leaders will convene May 7-10 in Atlanta to address some of the critical issues and emergencies facing rural hospitals, clinics, educators, and providers across the country. So what has changed since last year’s conference?

The struggle to keep rural hospitals open is an ongoing battle. In fact, NRHA’s Maggie Elehwany openly states that rural health is in a state of crisis. Considering close to 46 percent of rural hospitals are functioning at a loss and more than 100 rural hospitals have closed since 2010, many in the industry are working feverishly to keep the lights on.

In NRHA’s recent report on government affairs for the fiscal year of 2018, the association had a number of rural health care wins to highlight, evincing that their advocacy efforts are working. Some of the bright spots of the past year included various legislative and regulatory victories in the fight for sustainable rural health care.

A recap of rural health care policy and legislative success in 2018

• Expanded and robust funding for important rural health programs through the appropriations process
• A rural health section of the Farm Bill with important improvements for rural health care, such as a liaison between USDA and HHS and improvements for rural providers utilizing USDA rural development loans, including a new technical assistance program
• Passing of the Opioid Crisis Response Act with inclusion of every NRHA ask
• Reauthorization of Medicare extenders important to rural health care for multiple years
• Stopping a change to CMS’ interpretation of “like hospitals” to protect some hospitals’ CAH status
• Securing an exemption for sole community hospitals from a 28 percent reimbursement cut for 340B drugs
• Approval of the FCC’s $100 million Connected Care Pilot Program in support of telehealth for rural America

These wins and more were underscored by NRHA’s growing presence on social media and increased visibility on Capitol Hill. Public messaging and meetings with members of Congress helped NRHA’s Government Affairs Team set the tone for what will come in 2019. However, even though progress has been made through improved government relations, they’re just getting started.

Advocating for rural health care in 2019

The challenges for rural health care in America run the gamut from socioeconomic disadvantages to the sheer size of the rural American landscape. As part of their 2019 plan and leading up to their Annual Rural Health Conference, NRHA will be placing a special focus on these key issues.

1. Continued health care regulatory priorities
Providing the rural population with a strong, unified voice when it comes to health care regulations, including:

• Continued development of Medicaid waiver polices.
• Solutions for CAHs’ 96-Hour Rule and Merit-based Incentive Payment Systems.
• Preservation of the 340B Program for rural populations.
• Updates to supervision requirements for outpatient therapy services.
• Improve USDA grants to ease application process and usefulness for rural providers.

 
2. Rural health care workforce shortages  
Attracting and retaining skilled health care workers is one of the most difficult rural health care challenges providers are facing.
 
NRHA reports that developing a program to foster growth in the rural health care workforce will be a key initiative for 2019, especially in the areas of obstetrics and maternity care. A 2017 study revealed that an astonishing 58 percent of rural counties do not have access to hospital-based OB care and more than 200 rural maternity wards have closed from 2004 to 2014.
 
3. Affordable access to rural health care and telehealth
Too often health care legislation marginalizes the rural sector of the industry. In 2019 NRHA will continue to support programs designed to improve access to rural care and make it more affordable for the rural population.
Efforts will include pushing for regulatory changes that support health care in rural areas and reforms to the Affordable Care Act that have unintentionally hurt the rural population.

NRHA ‘s future forecast

NRHA CEO Alan Morgan recently said we are at the dawn of a renaissance in rural health care. NRHA plans on turning this vision into a reality by addressing the following:

• A steady focus on the unique challenges surrounding rural providers and their patient base.
• Building more awareness around regulations that place undue burdens on rural health care.
• Working with and advocating through Congress for new solutions to prevent rural hospital and clinic closures.

Sustainable health care for rural America won’t come without hard work on all sides. The heaviest workload continues to fall at ground zero and will take the resilient efforts of rural hospitals and the communities they serve. However, with continued support from organizations like NRHA and through partnerships with invested health care vendors, a bright future for rural health care is more than possible.

Get involved and see firsthand what NRHA is doing to advocate for rural health. Join us in attending the nation’s largest rural health conference, NRHA’s Annual Rural Health Conference May 7-10 in Atlanta.

For more information including an agenda, visit the NRHA’s events page.