The fight for rural healthcare funding in Washington

DULUTH, Minn. -- It's harder to find allies for rural healthcare in a polarized Congress in Washington, a rural health policy official told attendees of the Minnesota Rural Health Conference here this morning.

"We have lost a lot of the moderates," said Maggie Elehwany, policy vice president of the Kansas-based National Rural Health Association. "We’ve always found our greatest champions to be moderates in both parties.”

That’s because those on the far left tend to be more urban and those on the far right might be primarily concerned with reducing budgets. She did say that Minnesota’s rural hospitals and clinics are better represented than those in many states, by Sens. Al Franken and Amy Klobuchar. “You don’t have to do a lot of selling,” she said.

Rural providers are facing what Elehwany called a “perfect storm” of difficult circumstances, including proposed reductions to reimbursements and the targeting of what are called critical access hospitals, federally subsidized providers in remote areas.

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“The federal government has a tremendous amount of debt,” she said. “Both Democrats and Republicans want to control federal spending. They are going to target everything. The president continues to propose cuts to critical access hospitals. That’s why it’s so important that we let folks know the value of what you do.”

“The challenges for rural healthcare have never been greater,” she said.

She suggested that rural providers talk loudly and often about their accomplishments, noting that the primary care model used in rural areas is an efficient one. “We provide 18 percent of the in-patient, out-patient and long-term care for Medicare patients, yet receive only 15 percent of Medicare expenditures.” That’s a good value, she said.

If legislators want to hear about job creation, she suggested rural providers point out that bringing a doctor to a small community can generate as many as 20 jobs. “Take this kind of example and translate that to what you do. Every (small rural hospital) and rural clinic should have a fact sheet. Everyone has to justify their existence if they are to receive federal funding.”