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State Lawmakers Focus on Future of Rural Health

February 14, 2024

HAP and Pennsylvania’s hospital community today called on state lawmakers to take action to support rural hospitals and the communities they serve.

This afternoon, the Pennsylvania Senate Majority Policy Committee hosted a hearing at Penn Highlands Mon Valley Hospital focused on the challenges surrounding rural health care.

During her testimony, HAP President and CEO Nicole Stallings emphasized the critical role rural hospitals play in their communities, the unique challenges they face, and steps to ensure these facilities can remain anchors within their communities.

“The shared goal of everyone in this room is for all rural Pennsylvanians to be able to live vibrant, healthful lives,” Stallings said. “To do so, they need access to high-quality primary care for both their physical and mental health needs.”

Among the key takeaways from today’s hearing:

  • Economic role:  Rural hospitals play a vital role in their communities, supporting more than 69,500 jobs and paying $4.4 billion in salaries during fiscal year 2022.
    • Vibrant health systems are essential to recruit businesses to Pennsylvania, Stallings said.
  • Critical shortage:  According to HAP’s recent workforce survey, rural hospitals are trying to fill 28 percent of their nursing support staff positions and 26 percent of their registered nurses, compared to 19 percent and 14 percent statewide.
  • Funding for care:  Inadequate reimbursement models create a disparity in the cost of care and the amount rural hospitals receive to provide it.
    • Rural hospitals serve a large majority of Medicare and Medicaid patients, which pay 84 and 81 cents on the dollar, respectively, for the cost of delivering care.
  • Key issues:  As discussions continue over long-term strategies to support rural health care, policymakers can help immediately by overhauling outdated hospital regulations, urgently developing a path forward upon this year’s conclusion of the Pennsylvania Rural Health Model pilot, defining the “rural emergency hospital” designation, and investing in broadband, the workforce, and other sustainable models of care, panelists noted.
  • Quotable:  “We play a significant role in attracting businesses and industry to spur economic development and without hospitals, many small towns would not exist,” Steven Fontaine, CEO, Penn Highlands Healthcare, said in testimony. “Having a hospital nearby is a sign of community vitality.”

“Creating programs that encourage physicians and providers to practice in rural settings is one essential solution that will support closing the serious access to care gaps that persist today,” Elizabeth Piccione, MD, president, UPMC Horizon and Jameson, said in testimony.

HAP and the Pennsylvania hospital community continue to emphasize the importance of supporting rural health. This month, HAP published its report focused on the issues that are top of mind for rural hospital leaders, including workforce, post-acute coordination, reimbursement, regulatory burdens, and the demand for emergency medical services.

Additionally, American Hospital Association has unveiled its 2024 rural advocacy agenda, which aims to support the sustainability of our nation’s rural hospitals.

Today’s hearing and a link to prepared remarks from the panelists are available online.



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