Hot Topics in Rural Health
Rural hospitals and health systems are committed to ensuring local access to high-quality, affordable health care. However, these hospitals continue to experience ongoing challenges that jeopardize their ability to provide local access to care and essential services. These include continued workforce shortages, emerging challenges posed by commercial and Medicare Advantage plans, soaring costs of providing care, severe underpayment by Medicare and Medicaid, and an overwhelming regulatory burden. The AHA continues to work with Congress and the Administration to enact policies to support rural hospitals. We also are working to support a public policy environment that will protect access to care, advance innovation and invest new resources in rural communities.
NRHA advocates for policy positions developed by the association’s membership on behalf of rural health stakeholders. Rural health stakeholders can keep track of recently introduced legislation and view a full list of NRHA-endorsed legislation, via their Rural Health Legislative Tracker.
NRHA policy papers present an in-depth assessment of an issue, with background information, status, impacts, proposed policy interventions, and recommendations for action relative to the position. Policy papers are used to discuss a longer-term vision for a rural health issue and NRHA’s role in advocacy. Policy papers are developed as a resource to draw from, serve as references, and use as background information on issues critical to rural health.
Reach out to the NRHA Government Affairs team with any questions. While on the website, take a minute to also check out NRHA Advocacy Campaigns that can be customize for rural organizations.
National attention on the financial vulnerability of Critical Access Hospitals (CAHs) and rural hospitals and their risk of closure is not a new phenomenon. Rural hospitals have long struggled with chronic workforce shortages, high operating and staffing costs, inadequate reimbursement, operational and regulatory issues, and the diverse demographics of rural communities. CAHs and rural hospitals are also challenged to adapt to an evolving health care environment with a declining need for inpatient beds, increasing competition by non-hospital and non-traditional providers, changing care paradigms, and a growing adoption of value-based payment models. There is an extensive history of efforts to support small rural hospitals in response to prior waves of closures, dating from 1973 to the present. This paper summarizes state and federal programs, demonstrations, and models to support CAHs and other rural hospitals. Grouped by program characteristics, the summaries provide lessons learned to inform current policy discussions, describe the trends driving the various waves of rural hospital closures, and explore trends likely to impact CAHs and other rural hospitals in the foreseeable future. Flex Monitoring Team >
Eligible Hospitals (EH) and Critical Access Hospitals (CAH), Outpatient Quality Reporting (OQR), and Eligible Clinician (EC) quality reporting programs. CMS updates the specifications annually to align with current clinical guidelines and code systems so they remain relevant and actionable within the clinical care setting. Measures will not be eligible for 2025 reporting unless and until they are proposed and finalized through notice-and-comment rulemaking for each applicable program.
Rural Healthy People 2030 is a companion to the federal Healthy People 2030 program designed to set health promotion and disease prevention goals for the United States over the next decade. Relying on data from a national survey of rural stakeholders, Rural Healthy People 2030 works to identify the most important Healthy People priorities for rural America, as identified by rural stakeholders, for the current decade.