NRHA's Rural Health Voices blog offers informed commentary on the latest news in rural health care from NRHA staff and editorials from selected contributors.

Accountable Care Organizations final rule released today

The Department of Health and Human Services (HHS) issued the final rule for Accountable Care Organizations (ACOs) today. The new program is designed for physicians, hospitals and other providers to coordinate the care of Medicare patients with the goal of improving quality while reducing cost. Successful ACOs would share in any savings they produce for Medicare on top of their usual fee-for-service reimbursements. To view the regulation, please visit

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CMS announces regulatory reforms for hospitals, providers

On October 18, the Centers for Medicare and Medicaid Services (CMS) announced two sets of regulatory reforms designed to improve transparency, help providers operate more efficiently by reducing their regulatory burden and save hospitals and healthcare providers more than $5 billion over five years. These reforms will affect Critical Access Hospitals (CAHs) and a broad range of health care providers and suppliers.Under the proposed rule, the Medicare Conditions of Participations, CAHs could...

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Rulemaking Committee Recommends New HPSA/MUA Designation Methodology

Do we know where the Health Profession Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs) are located in the United States? Perhaps. But for now, we will need to wait until the Government tells us where they are going to be located in the future. On October 13th, the Negotiated Rulemaking Committee for the Designations of HSPAs and MUAs (created by section 5602 of the Affordable Care Act) approved a report to the Secretary of HHS with methodology for identifying shortage areas...

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USA Broadband Maps

Maps have a way of telling the story of a 1,000 words. The National Broadband Map is a tool to search, analyze and map broadband availability across the United States. Check out your rural community to see what is available in your area. This resource also helps to clearly understand the rural/urban divide when it comes to broadband.

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NRHA Applauds the Introduction of HR 3212, the CAH Designation Waiver Authority Act of 2011

Late last week, Congressmen Thornberry (R-TX), Ross (D-AR) and Donnelly (D-IN) introduced HR 3212, the CAH Designation Waiver Authority Act of 2011.  This legislation would allow a limited number of small, rural PPS hospitals to convert to CAH status after review by their state governments and the Department of Health and Human Services.  This bill would limit the granting of CAH statuts to hospitals that are already in existence and cap the total number of hospitals that would be granted...

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Senator Tim Johnson stands up for Critical Access Hospitals

Senator Tim Johnson (D-SD) wrote the Joint Select Committee on Deficit Reduction yesterday outlining his grave concerns about proposed changes to the Critical Access Hospital program.  In his letter, Senator Johnson points out the economic support and access to care that these vital safety net facilities provide.  Critical Access Hospitals are usually one of the two largest employers in rural communities and provide millions of dollars in wages, salaries, and benefits every year. NRHA...

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Craig Thomas Rural Hospital and Provider Equity Act Introduced in United States Senate

On Tuesday, October 11th, Senators Kent Conrad (D-ND), Pat Roberts (R-KS), Tom Harkin (D-IA), and John Barrasso (R-WY) introduced Senate Bill 1680, the Craig Thomas Rural Hospital and Provider Equity Act of 2011.  This bipartisan legislation includes provisions that would modify outpatient therapy supervision requirements, extends various rural Medicare payment provisions, allows for telehealth services across state lines, and provides long-term funding authorizations for state offices of...

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This Is Not a Drill: Speak Up for Rural Hospitals

Guest Editorial by Tim Size, Executive Director, Rural Wisconsin Health Cooperative, Sauk City and Past NRHA President This is not a monthly test of your outdoor warning siren. I have worked in rural health for over thirty years. We have never faced a situation as threatening as the federal cuts that may hit rural hospitals.   Senator Tom Coburn (an Oklahoma Republican) speaks for many when he said he understands the need to be careful when scaling back government spending. As he told Fox...

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NRHA Government Affairs Continues Advocacy Efforts

NRHA sent the following communication to Capitol Hill offices this morning. Please contact NRHA Government Affairs at (202) 639-0550 with any questions. "Various proposals to the Joint Select Committee on Deficit Reduction include billions in reimbursement cuts to rural hospitals. These proposals erroneously claim that they eliminate “higher than necessary reimbursement” to rural facilities. However, small rural hospitals, known as Critical Access Hospitals (CAHs), account for only 5.3% of...

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Rural facilities targeted in deficit reduction plans

The Budget Control Act of 2011 (BCA) calls for $1.2-$1.5 trillion reduction in federal expenditures over the next ten years.  A “Super-Committee” has been formed and tasked with developing the policies that will produce these reductions.  Rural hospitals have been targeted in various proposals to the Super-Committee and to Congress as a whole. The specific payment reductions advocated by each proposal vary and a number of groups have put forward various ideas.  Proposals include: The...

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