Bill Overview
Title: Save America’s Rural Hospitals Act
Description: This bill establishes and otherwise modifies payment requirements for rural health care providers under Medicare and Medicaid, including by (1) exempting Medicare payments to rural hospitals from sequestration, (2) making permanent certain payment increases for services in rural areas (e.g., Medicaid primary care services), and (3) permanently removing the 96-hour physician certification requirement for inpatient critical access hospital services under Medicare.
Sponsors: Rep. Graves, Sam [R-MO-6]
Target Audience
Population: People relying on rural hospitals globally
Estimated Size: 28000000
- The bill focuses on modifying payment requirements under Medicare and Medicaid programs, directly impacting patients who use these services.
- Medicare and Medicaid are major healthcare programs in the United States, catering primarily to the elderly, low-income individuals, and certain disabilities; rural populations often rely heavily on these services due to limited healthcare options.
- Rural hospitals, which face unique financial challenges and are critical sources of care in their communities, will be financially impacted by these modifications, thus affecting the availability and quality of care for individuals in rural areas.
- By making payment increases permanent for certain rural services, the bill is likely to improve financial stability for rural healthcare providers, potentially expanding access and improving care quality for rural patients.
- The exemption of Medicare payments from sequestration and removal of the 96-hour certification requirement aim to ease operational burdens on rural hospitals, having a direct positive impact on their patients.
- Access to healthcare in rural U.S. areas is typically challenging; thus, the bill is likely to have a substantial impact on the wellbeing of rural populations relying on these hospitals for care.
Reasoning
- The policy primarily targets healthcare provisions in rural areas, specifically modifying Medicare and Medicaid payment structures to benefit rural hospitals.
- Given the budget restrictions and the focus on a population reliant on rural healthcare, a significant portion of the population in rural areas using Medicare or Medicaid will likely be affected.
- Rural hospitals face unique challenges like financial instability and limited resources; therefore, this policy directly addressing these issues could lead to increased hospital resilience, and in turn, improve patient care and satisfaction.
- A portion of the population in rural areas might not see direct changes, especially if they do not primarily use Medicare/Medicaid services or if they reside in regions with more robust healthcare infrastructure.
- Most impact will be on the elderly, lower income, and individuals with specific health needs residing in rural areas.
Simulated Interviews
Retired school teacher (Rural Ohio)
Age: 68 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- I'm pleased this bill is focusing on our rural hospitals.
- The 96-hour rule was really holding back proper care; glad it's being removed.
- I hope this helps keep our hospital open.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 8 | 2 |
| Year 20 | 8 | 1 |
Farmer (Rural Kansas)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- Healthcare costs are huge for my family; anything that helps is positive.
- I'm skeptical about how much difference it will actually make.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 7 | 2 |
| Year 20 | 6 | 2 |
Nurse (Rural Mississippi)
Age: 32 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- More funding means better working conditions and improved patient care.
- If our hospital closes, many here would have nowhere to go.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 3 |
| Year 20 | 8 | 3 |
IT Specialist (Urban Texas)
Age: 56 | Gender: other
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 7/20
Statement of Opinion:
- Doesn't really affect me; I'm more concerned about urban issues.
- Sounds good for those who need it in rural areas though.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Retired (Rural Alabama)
Age: 73 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 11/20
Statement of Opinion:
- This will help me get better care without having to travel far.
- The last few years have felt like a decline in healthcare quality here.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 7 | 3 |
Stay-at-home mom (Rural Montana)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 13/20
Statement of Opinion:
- Removing burdensome regulations should help keep our local hospital going.
- Less stress on the hospital means better care for my kids.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 3 |
| Year 10 | 8 | 2 |
| Year 20 | 9 | 1 |
Part-time janitor (Rural Georgia)
Age: 64 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- The cutbacks have been tough; hope this bill eases things.
- Healthcare is different for us out here.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 7 | 2 |
| Year 20 | 6 | 1 |
Small Business Owner (Rural West Virginia)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 13/20
Statement of Opinion:
- Our hospital is a lifeline for this community.
- Policy sounds like it could make a big difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 3 |
| Year 10 | 8 | 2 |
| Year 20 | 9 | 1 |
Teacher (Suburban Illinois)
Age: 47 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- Doesn't affect me directly, but rural healthcare is important.
- It's a good initiative for those in need.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Librarian (Rural New York)
Age: 60 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- I'm hopeful these changes will ease burdens for both me and the hospital.
- The healthcare struggle has been real here.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 7 | 2 |
| Year 20 | 7 | 2 |
Cost Estimates
Year 1: $3000000000 (Low: $2500000000, High: $3500000000)
Year 2: $3050000000 (Low: $2550000000, High: $3550000000)
Year 3: $3100000000 (Low: $2600000000, High: $3600000000)
Year 5: $3200000000 (Low: $2700000000, High: $3700000000)
Year 10: $3500000000 (Low: $3000000000, High: $4000000000)
Year 100: $3500000000 (Low: $3000000000, High: $4000000000)
Key Considerations
- This bill would require additional federal spending without direct offsets, thus increasing the deficit unless other funding mechanisms or savings are found.
- The policy aims to address specific challenges faced by rural healthcare providers but could lead to long-term dependency on increased reimbursement rates.
- The implementation of the policy could vary based on state-level Medicaid program designs.