On February 6, The Wisconsin Hospital Association joined the Rural Wisconsin Health Cooperative with a group of more than ten rural hospital leaders to urge Wisconsin’s Congressional leaders on Capitol Hill to support Wisconsin’s rural health care priorities.
Many of the hospital leaders spoke about how important it is for Congress to protect the 340B program for small, rural hospitals. Brian Stephens, CEO of Door County Medical Center, discussed how his hospital has used savings from the 340B program
to extend access to dental services for uninsured and Medicaid patients in their community. This has been extremely important, as few area dentists accept Medicaid patients. Heather Erickson of Amery hospital noted how they use savings from the 340B program to offset losses they take running an inpatient psychiatric program in their hospital. It can be very challenging for rural communities to have access to the full suite of behavioral health services, and the 340B program helps them sustain these vital services in Amery.
Hospital leaders also spoke about the challenges in recruiting new physicians and other health care professionals in their communities, especially with Congress putting an artificial cap on Medicare’s Graduate Medical Education in the late 1990s. To offset this, WHA and other hospital and health system leaders worked with state lawmakers to develop a state-funded grant program to increase residency slots for physicians, as well as training slots for advanced practice clinicians and allied health professionals.
Mike Sanders, CEO of SSM Health Monroe Clinic Hospital, noted how this state program has helped his hospital train and hire four new physicians, all of whom have remained at their rural hospital. WHA data shows that 86% of students who are from Wisconsin and go to medical school and a residency in Wisconsin, will stay and practice in Wisconsin, making this a vital tool in attracting physicians to rural areas. Yet despite the success of this state program, hospitals still bear a high cost to run residency programs. The group asked Congressional leaders for their support in filling the gap in Wisconsin’s projected health care workforce shortage, particularly due to the high number of Medicare patients who rely on this workforce, and the fact that Medicare typically only pays Wisconsin hospitals 75% of what it costs them to provide Medicare services.
The rural health care leaders also spoke about the challenges hospitals face when trying to innovate, due to antiquated federal regulations. In particular, Medicare’s telehealth restrictions have not been keeping up with the telehealth services hospitals can offer. Currently, Medicare will only reimburse for telehealth services if patients drive to a federally designated rural health care facility and receive services via two-way, real-time audio and visual communication. While Congress has extended some relief from these restrictions for certain services, such as telestroke and opioid treatment, the group advocated for removing these restrictions entirely to allow telehealth to reach its full potential.