March madness is upon us. I’m not referring to the NCAA Basketball tournament, the bizarre weather that transitions from winter to spring or the Ides of March that Shakespeare warned us about. But, we’re counting down to the end of March and the expiration of the Sustainable Growth Rate (SGR) moratorium, low-volume hospital (LVH) add-ons and the Medicare Dependent Hospital (MDH) program. Get ready for the ride because March promises to be a maddening one for rural providers.
NRHA is working hard to ensure that Congress passes a permanent repeal of the SGR and the permanent extension of both the LVH and MDH programs…all without any “pay-fors” that harm rural providers. A schedule of possible pay-fors (repeated from the Obama Budget) have been circulated among Congressional leaders that are very disturbing, which includes eliminating CAH’s within 10 miles from another facility, reduce CAH reimbursements to 100% of costs and reduce Medicare coverage of bad debts. NRHA has been assured by Congressional leaders that none of the possible pay-fors have been agreed to.
That being said, March madness is here. As we countdown the days until March 31, pressure on Congress to get something passed will mount. Your participation in our advocacy campaign is vital. Make sure your members of Congress know that you’re against pay-fors that harm rural providers. Now is not the time to retreat on key programs that have stabilized the rural health safety-net over the years.
The stakes have never been higher. We’re already seeing the evidence of small, rural hospitals closing here and here. It’s not an exaggerated claim. It will take all of us to send the message that investing in rural health is a sure bet, noting that the Medicare spend per beneficiary in rural is 3.7% less than urban. This metric includes ALL of the so-called rural additions to payments for doctors and hospitals (CAH, MDH, LVH, FQHC, RHC and the GPCI floor)!
Finally, while you complete your brackets for the NCAA tournament, be reminded that Shakespeare said, “Beware of the Ides of March.” Indeed, don’t let rural get stabbed in the back. Call your legislators and let them know that you need them to protect rural health!