THE VALUED VOICE

WHA Joins RWHC for Rural Health Virtual Advocacy in DC

On Feb. 11, the Wisconsin Hospital Association (WHA) joined the Rural Wisconsin Health Cooperative (RWHC) and health care leaders from across Wisconsin to advocate for rural health care priorities. While COVID has put a damper on physical travel to Washington, D.C., these virtual meetings provide a convenient option for busy hospital and health system leaders to speak directly with their federal members of Congress.
 
Among a number of important topics covered were the 340B prescription drug discount program, the COVID vaccine rollout, and changes made to reimbursement of rural health clinics in the year-end COVID package signed into law by former President Trump on Dec. 30, 2020.
 
In speaking with Congressman Mark Pocan, Black River Memorial Hospital President and CEO Mary Beth White-Jacobs explained how her hospital is able to provide chemotherapy infusion right in Jackson County, something they would not be able to do without savings from 340B. Stoughton Health President and CEO Dan DeGroot also described how savings from 340B helps his hospital fund one of the only geriatric psychiatric inpatient hospitals in the state, which serves patients with severe dementia from 16 different counties surrounding the Madison area.
 
Unfortunately, some drug makers have stopped paying 340B discounts at contract pharmacies, leaving hospitals to bear the increased cost. Congressman Mark Pocan said he continues to support the 340B program and intends to sign onto a letter in the U.S. House of Representatives to incoming Health and Human Services (HHS) Secretary Xavier Becerra. The letter urges HHS to enforce the requirement that drug makers provide discounts regardless of whether drugs are dispensed at in-house or contract pharmacies and to reimburse hospitals for discounts that were unlawfully denied.
 
Participants also discussed changes to the rural health clinic (RHC) reimbursement model made in the 2020 year-end COVID package. Like rural critical access hospitals, rural health clinics received enhanced reimbursement from Medicare based on their costs. This is designed to keep access to care in rural communities, where there are often not enough people on commercial insurance to offset low Medicaid and Medicare reimbursements.
 
Because some RHCs have their reimbursement capped, the year-end COVID package attempted to narrow the gap between capped and uncapped RHCs. While there was no intention of lowering any existing RHC’s reimbursement, a drafting error would require any RHC that began operations after Dec. 31, 2019, to receive a lower, capped reimbursement. Rural health supporters are advocating for delaying that unintentional date to a later date, so that existing RHCs and those in the process of being certified would not have to receive a lower reimbursement than budgeted for.
 
Door County Medical Center (DCMC) President and CEO Brian Stephens discussed how important RHC reimbursement has been for keeping access to care in Door County and its surrounding rural locations. He noted the telehealth reimbursement model for RHCs needs to take costs into consideration in order to keep operations viable so we can maintain access to care in rural areas. Congressman Gallagher said he remembered discussing this issue when former HHS Deputy Secretary Eric Hargan visited DCMC last summer and supports finding a long-term solution that keeps rural care and telehealth offerings in rural communities.
 
Rural health care leaders also discussed how the COVID vaccine rollout is going in their communities, something Congressman Glenn Grothman was very interested to hear. Prairie Ridge Health (Columbus) Vice President of Patient Care Services Jamie Hendrix and ThedaCare Vice President of Berlin and Wild Rose Medical Centers Tammy Bending noted the vaccine rollout has been improving, with more people aged 65 and older getting vaccinated every day, but supply constraints continue to make it difficult to keep appointments when hospitals receive fewer doses than they anticipate. Overall, COVID activity has been decreasing, and hospitals are optimistic that trend will continue to improve as more people are vaccinated.