Bill Overview
Title: ARCH Act of 2022
Description: This bill extends certain payment adjustments for Medicare-dependent hospitals and low-volume hospitals until the end of FY2027 (the adjustments currently expire at the end of FY2022).
Sponsors: Rep. Miller, Carol D. [R-WV-3]
Target Audience
Population: People who rely on Medicare-dependent and low-volume hospitals
Estimated Size: 60000000
- The ARCH Act of 2022 targets hospitals that cater to Medicare beneficiaries.
- Rural communities often have fewer healthcare options and depend heavily on local hospitals.
- Medicare-dependent hospitals and low-volume hospitals are likely to be smaller hospitals, commonly found in rural areas.
- The bill impacts populations that rely on Medicare, including a significant number of the elderly and people with disabilities living in rural areas.
- According to the AHA, there are about 4,750 acute care hospitals in the U.S.; a portion of these are Medicare-dependent and/or low-volume hospitals.
- Rural hospitals serve approximately 57 million Americans according to rural health association data.
- Globally, similar healthcare dependence exists in rural communities, but the ARCH Act specifically targets U.S. legislation and populations.
Reasoning
- The ARCH Act is designed to support rural hospitals that might otherwise struggle financially, ensuring these hospitals can continue to provide essential services to their communities. The policy targets Medicare-dependent and low-volume hospitals, commonly found in rural areas.
- A portion of the U.S. rural population relies on these hospitals for emergency services, routine health care, and specialized treatments. Thus, the policy primarily affects older adults and those with disabilities who depend on Medicare services provided by these hospitals.
- Given that this policy does not directly provide services like additional doctors or healthcare technology, its impact is more about sustaining current levels of healthcare access rather than introducing new levels.
- The impact of this policy is expected to be more pronounced in smaller, more isolated communities where alternative healthcare options may be non-existent or difficult to access.
- The implemented budget limits the expansion of the policy to ensure that it focuses on crucial hospitals that need financial help, thereby preventing closures of critical healthcare access points in rural areas.
Simulated Interviews
Retired school teacher (Appalachian Mountains, Virginia)
Age: 75 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- I'm worried what would happen without local hospital access.
- This policy gives me peace of mind knowing my healthcare needs can be met close to home.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Farmer (Western Kansas)
Age: 62 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 12/20
Statement of Opinion:
- The hospital has been there since before I was born, and keeping it open is essential.
- I support any policy that helps the hospital stay open and provide services.
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 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 2 |
Rural health clinic administrator (Northern Michigan)
Age: 40 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Our community desperately needs this support to keep hospitals operational.
- The policy means fewer people need to be transferred long distances for care, which can save lives.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Retired farmer (Rural Mississippi Delta)
Age: 85 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 13/20
Statement of Opinion:
- It gives me hope I can continue to live in my home rather than moving to a city for healthcare.
- I'm grateful for any help we can get to avoid hospital closures.
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 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 5 | 2 |
Emergency Medical Technician (EMT) (Central Nebraska)
Age: 29 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- This bill is critical for ensuring we can keep responding to emergencies effectively.
- Rural hospitals are our lifeline; this policy gives stability to our work.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Family Physician (Small town in Iowa)
Age: 55 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- Keeping these payments is crucial to maintain patient care standards.
- This policy ensures that our community hospital can serve its patients effectively.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 4 |
| Year 10 | 9 | 3 |
| Year 20 | 8 | 3 |
Homemaker (Rural Oregon)
Age: 34 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 12.0 years
Commonness: 9/20
Statement of Opinion:
- It is vital for my parent's survival and well-being that the hospital remains open.
- This policy supports our community's health and safety.
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 | 7 | 4 |
| Year 20 | 6 | 3 |
Veteran Affairs counselor (Rural Texas)
Age: 47 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- This helps veterans get the care they need locally.
- A long drive to the nearest facility isn't feasible for everyone.
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 | 7 | 3 |
| Year 10 | 6 | 3 |
| Year 20 | 6 | 2 |
Retired nurse (Florida Panhandle)
Age: 68 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 14/20
Statement of Opinion:
- It's good to see some support for the hospitals providing care to the elderly here.
- We need these hospitals to be financially stable to keep serving us effectively.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Postmaster (Rural Southwest Pennsylvania)
Age: 53 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 9/20
Statement of Opinion:
- A lack of local hospital access would really hurt our community.
- By supporting these hospitals, this policy ensures we are not left behind.
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 | 7 | 4 |
| Year 20 | 6 | 3 |
Cost Estimates
Year 1: $150000000 (Low: $145000000, High: $155000000)
Year 2: $153000000 (Low: $148000000, High: $158000000)
Year 3: $156000000 (Low: $151000000, High: $161000000)
Year 5: $162000000 (Low: $157000000, High: $167000000)
Year 10: $162000000 (Low: $157000000, High: $167000000)
Year 100: $162000000 (Low: $157000000, High: $167000000)
Key Considerations
- The policy ensures continued operation of critical rural hospitals.
- Without these adjustments, a significant number of rural hospitals might face shutdowns or severe cutbacks in services, critically impacting healthcare availability.
- Rural healthcare provision is already strained; this policy acts as a stabilizing fiscal measure.
- Consideration to include dynamic responses to future rural population changes and healthcare advancements should be acknowledged.