This week’s observance of Labor Day reminds us of the many contributions workers have made to America’s strength, prosperity and well-being. The millions of caregivers and team members at our hospitals and health systems are counted among the ranks of those who have worked hard to make our nation stronger and our citizens healthier. This has never been more apparent than the last few years of the COVID-19 pandemic.

Hospitals and health systems across the country are facing unprecedented challenges, including extraordinary pressure on the workforce, caring for sicker and more medically complex patients, and managing skyrocketing expenses for labor, supplies, drugs and equipment. All of these factors combine to threaten access to care for patients.

In addition, there are several challenges unique to rural hospitals and the 46 million people — 14% of all Americans — living in rural communities across the U.S. that they serve.

A new AHA report released this week highlights the variety of causes that resulted in 136 rural hospital closures from 2010 to 2021, and a record 19 closures in 2020 alone. These include many longstanding pressures, such as low reimbursement, staffing shortages, low patient volume and regulatory barriers, as well as the continued financial challenges associated with the COVID-19 pandemic. The report also outlines several pathways for rural hospitals to achieve financial sustainability, including additional federal support, flexible models of care, decreased regulatory burden, partnership arrangements and state Medicaid expansion.

Recognizing that the network of providers serving rural Americans is financially fragile and more dependent on Medicare funds due to the high percentage of Medicare patients who live in rural areas, some of these providers — Medicare-dependent Hospitals, Low-volume Adjustment and Sole Community Hospitals — receive higher per patient payments from Medicare to help offset potential financial challenges associated with being rural, geographically isolated and low volume. That additional support has made a significant difference in their ability to provide continued access to care.

But without action from Congress, the MDH and enhanced LVA programs will expire in just three weeks, on Sept. 30, 2022. We must not let that happen.

We are strongly urging Congress to extend these critical programs  before the Sept. 30 deadline. We have expressed support for the Rural Hospital Support Act (S.4009), which would make the MDH and LVA programs permanent, and the Assistance for Rural Community Hospitals Act (H.R.8747), which would extend the programs for five years.

These programs are crucial to allowing rural hospitals to remain essential access points for care, economic anchors for communities and the backbone of our nation’s rural public health infrastructure. See videos from rural hospital leaders discussing the importance of these programs and why they must be extended. You can lend your voice to these efforts by sending a message to your senators and representatives.

Throughout the next few months, we’ll continue to highlight for the public and policymakers the challenges hospitals and health systems are facing and the need for additional federal support to ensure hospitals can always be there, ready to care for their patients and communities.

Watch for a report next week highlighting new data, as well as hospital and health system leaders sharing their stories with the media about the real-world impact of these challenges and how they could jeopardize access to care in communities across the country.

Sharing your organization’s story will be pivotal in our efforts to secure additional federal support for our field. Please consider sharing your story with us by contacting us here.

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