America’s hospitals and health systems are places of healing, hope, comfort and caring. Today, they also face many challenges that jeopardize their ability to always be there ready to care.

These include the rising costs of caring for an aging population that is sicker; chronic workforce shortages; and dealing with a growing number of federal regulations and commercial insurer administrative requirements that often are barriers to care and coverage. At the same time, our field is planning for what happens when the COVID-19 emergency declarations end on May 11; is vulnerable to having Medicare and Medicaid provider payment reductions be held as a political hostage in discussions on the debt limit, deficit reduction and/or Medicare Hospital Insurance Trust Fund solvency; and is constantly defending against cyberattacks.

For the 2,200 rural hospitals and health systems in the U.S. and the 46 million people who depend on them for care in their communities, these challenges are exacerbated by others that are unique to rural providers. They include low patient volumes; a shortage of workers and supplies; and inadequate transportation and broadband networks, just to name a few.

Rural hospitals and health systems are the lifeblood of their communities and are committed to ensuring local access to high-quality, affordable health care.

The AHA has been working with Congress and the Administration to enact policies that provide additional support and resources to rural hospitals. And we achieved a number of victories last year.

Among other key priorities, we:

  • Secured two-year extensions for the Medicare low-volume adjustment and Medicare-dependent hospital programs, which both serve as critical lifelines for rural hospitals.
  • Continued for two years the pandemic waivers for telehealth.
  • Extended a higher reimbursement rate for rural ambulances.
  • Added more graduate medical education slots for hospitals in underserved areas, including rural.
  • Secured $2 billion in new infrastructure investments to improve broadband service in rural areas.

But we have much more work to do. Our 2023 Advocacy Agenda focuses on working with Congress and the Administration to ensure access to care for patients and provide financial relief to hospitals; strengthen the health care workforce; advance quality, equity and transformation; and enact regulatory and administrative relief.

Our Rural Advocacy Agenda, which we will release next week, also includes priorities such as supporting telehealth coverage, protecting the 340B drug pricing program and ensuring adequate reimbursement with flexible payment options for rural hospitals.

All of these issues will be front and center next week at AHA’s Rural Health Care Leadership Conference in San Antonio. With more than 1,200 health care leaders in attendance (a new record), we’ll have discussions led by top practitioners and thought leaders in our field about strategies for accelerating the shift to a more integrated and sustainable rural health care system.

Our nation’s hospitals and health systems have a long history of stepping up to meet great challenges. I’m confident our field will seize the moment to help shape the future for the patients and communities we serve as we continue to work to achieve our vision of a just society of healthy communities, where all individuals reach their highest potential for health.

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