WHA was back on Capitol Hill on Sept. 21 visiting members of Wisconsin's Congressional Delegation to urge them to extend key rural hospital designations and regulatory flexibilities.
Participating in the Capitol Hill visits were Vice President and Chief Financial Officer of Fort HealthCare Jim Nelson; Advocate Aurora Health Director of Federal Government Affairs Anthony Curry; Advocate Aurora Health Chief Government Affairs Officer Meghan Woltman; Gundersen Health Director of External Affairs Nathan Franklin; WHA Vice President of Federal and State Relations Jon Hoelter; SSM Health Vice President of Government Affairs and Public Policy Michael Richards; Rural Wisconsin Health Cooperative Executive Director Tim Size; and Marshfield Clinic Director Federal Government Relations Brad Wolters.
Following up on a trip to Capitol Hill earlier in the summer, the group of hospital leaders advocated for extending the Medicare-Dependent and Low-Volume Hospital Adjustment designation for "tweener" rural hospitals that currently expire Sept. 30, 2022. Without these designations, 17 Wisconsin hospitals could face cuts of more than $19 million annually. WHA had sent a coalition letter from the impacted hospitals and health systems earlier in the week explaining the importance of extending these vital programs, particularly given the challenging fiscal atmosphere hospitals are operating in currently as a result of high inflation, rising labor and prescription drug prices, and stagnant revenues from Medicare, Medicaid and commercial insurance.
In addition to these issues, the group advocated for Congress extending key hospital flexibilities that have existed as part of the public health emergency (PHE) declaration under COVID-19. The current PHE goes through mid-October and is expected to be renewed through mid-January of 2023, but its future after that is uncertain. If not extended, key flexibilities including telehealth, the Acute Care Hospital at Home program, and the waiver of the nursing home three-day rule would be in jeopardy. This could significantly impact hospitals’ ability to use innovative care models to reach patients as well as threatening the ability of patients to get timely access to post-acute care in nursing homes. These flexibilities have been a key tool in allowing hospitals to respond more nimbly to a severe sustained workforce shortage.
The group also advocated for extending a key incentive to participate in value-based payment programs. Among other things, the Value in Health Care Act of 2021 would extend a 5% bonus incentive payment for accountable care organizations (ACOs) participating in advanced value-based payment models that is slated to expire at the end of 2022. Given Wisconsin's low fee-for-service Medicare rates compared to other states, value-based payments are a way of rewarding high-quality high-value health care. Wisconsin currently has nine ACOs based in the state as well as nine ACOs based in other states that cover Wisconsin Medicare beneficiaries.
On Sept. 27, leaders in the U.S. House and Senate introduced a continuing resolution that would extend funding for the federal government through Dec. 16. Importantly, the legislation included funding for the Medicare-Dependent Hospital and Low Volume Hospital adjustment designations. Congress is expected to pass this legislation before the current September 30 deadline.
Congress is expected to adjourn for the month of October so members can focus on their re-election campaigns, meaning legislation to extend these key priorities into 2023 will not come until after the Nov. 8, 2022 elections. WHA will continue working with the American Hospital Association and other supportive groups to secure extensions for these important programs in the weeks and months ahead.
Contact WHA Vice President of Federal and State Relations Jon Hoelter with questions.