- Bipartisan legislation to improve patient access to rural emergency hospitals has been introduced to Congress, according to multiple sources.
The Rural Emergency Acute Care Hospital (REACH) Act would create a new rural emergency hospital classification under Medicare. The new classification would allow critical access hospitals and prospective payment system hospitals with 50 or fewer beds to convert to a rural emergency hospital that still offers emergency and observation services.
Currently, many rural hospitals are categorized as Critical Access Hospitals under Medicare. Those facilities must maintain a certain number of inpatient beds to receive the proper Medicare reimbursements.
However, those inpatient beds are difficult to maintain in rural areas. If passed, the bill would allow these hospitals to phase out those inpatient beds in exchange for maintaining some other protocol, such as being able to easily and quickly transfer patients to a larger, inpatient hospital.
The bill’s sponsors – Chuck Grassley, Amy Klobuchar, and Cory Gardner – claim that the legislation calls for no new regulations for hospitals, but rather offers another option.
The bill also calls for rural emergency hospitals to receive up to 110 percent reimbursement rates for reasonable costs and offers reimbursements for patient transportation services to acute care hospitals.
The three legislators say the bill would prevent some of these hospitals from closing because they would become more financially sustainable. Hospital and emergency department closures have been plaguing rural areas in recent years, making it even more difficult for patients to access the emergency treatment that they need.
“A car accident or a heart attack is dangerous under the best of circumstances, but it’s a lot more dangerous for someone who’s far away from an emergency room,” Grassley said in a statement on his website. “When a rural hospital closes, its emergency room closes with it. This proposal will fill a pressing need, help keep hospital doors open, and offer hospital services where and when people need them most.”
Keeping these rural EDs open will help patients get timely access to treatment, which is critical in times of emergency, Gardner noted.
“Coloradans living in rural communities should not be denied access to healthcare simply because they do not live in a large metropolitan area,” Gardner stated. “This commonsense, bipartisan legislation provides rural hospitals an option to continue providing emergency services to rural America even if they do not meet Medicare’s criteria for inpatient beds. During an emergency, time is of the essence, and it is critical that we maintain access to life-saving treatment regardless of your zip code.”
Allowing more emergency hospitals to remain open will also have larger community effects, Klobuchar explained.
“Our rural hospitals are essential institutions in communities across Minnesota. They don’t just provide vital health services, they employ thousands of doctors, nurses, pharmacists and other health care workers,” Klobuchar pointed out. “Millions of people depend on keeping these hospitals open. Our bipartisan legislation will help ensure that rural Minnesotans and Americans across the country have access to medical care when and where they need it most.”
The legislation, which has thus far been reviewed by the Senate Committee on Finance, has been praised by the American Hospital Association (AHA).
In a letter to Grassley, Klobuchar, and Gardner, AHA Executive Vice President Tom Nickels, explained that more work must also be done to expand emergency treatment access to all vulnerable patients.
“The [rural emergency hospital] has the potential to improve access to care for all vulnerable communities, not just those in rural areas,” Nickels said. “We believe, with the appropriate limitations, it also should be available to all communities.”
Congress must also ensure patient access to other healthcare services outside of emergency care.
“For example, we must evaluate and develop innovative approaches that would support access to primary care, psychiatric and substance use treatment, post-acute and diagnostic services,” Nickels explained.
Nickels concluded the letter by recommending the Senators consult AHA’s Task Force on Ensuring Access in Vulnerable Communities. The organization has issued several resources geared toward ensuring better patient healthcare access across the care continuum and in a multitude of different communities.