(February 2023) – The Kansas Hospital Association recently had the opportunity, along with several KHA members and partners, to attend the National Rural Health Association's Policy Institute in Washington, DC. Over the event's three days, speakers included U.S. Department of Veterans Affairs Secretary Denis McDonough, CMS Administrator Chiquita Brooks-LaSure, HRSA Administrator Carole Johnson and a host of congressional members. In addition, Michael Topchik, Chartis Center for Rural Health, presented their latest report, Rural Health Safety Net Under Renewed Pressure as Pandemic Fades. The report looks at rural hospital closures and the potential impact of the new Rural Emergency Hospital designation in slowing the rate of closures post-pandemic.
The discussion of the feasibility of the REH model was robust, as was the debate on the interpretation of the rules that would apply to REHs around the necessary provider designation and the 340B program. We also highlighted the need for Medicare telehealth flexibility, protection of the 340B program, and included nursing education programs in the definition of STEM for work authorization that provides foreign nurses an additional two years to complete their work visas while continuing to provide care.
The Kansas group shared data on the Medicare margins for the state and each congressional district to help our delegation understand why maintaining Medicare rates is so important. Statewide, Medicare margins are negative, falling between six percent and 4.8 percent over the last five years. In addition, the hospitals shared the challenges they face with reimbursement, while our partners discussed the value of telehealth and the need to support health care in rural areas. Our delegation was supportive and noted a need to make Medicare financially viable through innovation.
Further, members of the Kansas Congressional Delegation shared their desire to carry legislation in the 118th Congress to help address some of our concerns. Notably, Sen. Roger Marshall, MD, is looking to carry both the Medicare and You Handbook Improvement Act, which would improve truth in advertising for Medicare Advantage plans, and the Improving Seniors' Timely Access to Care Act, which would streamline Medicare Advantage plans' prior authorizations processes. Sen. Jerry Moran's staff indicated their desire to help address the nursing STEM issue, while many members expressed interest in our work to ensure the viability of the REH program. We appreciate their continued partnership and support of Kansas hospitals and the people we all serve.