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What to Know: The Rural Hospital Support Act

HAP-supported legislation would update federal programs that help rural hospitals

April 06, 2022

U.S. senators today introduced legislation that would help ensure rural hospitals avoid closure and maintain outstanding care in Pennsylvania and across the nation

The Rural Hospital Support Act, introduced by U.S. Senators Bob Casey (D–Scranton) and Chuck Grassley (R–Iowa), would extend and modernize critical federal programs that rural hospitals rely on to serve their communities. The legislation is an important step to maintain access for people in rural areas, Senator Casey said.

“Every American deserves reliable access to health care,” Senator Casey said in a statement. “Rural hospitals can be the difference between life and death in many parts of the U.S. Often, a rural hospital means not only safe, dependable access to health care and emergency health needs, but economic safety and stability for an entire community.”

Here's what you need to know about the Rural Hospital Support Act:

  • Background:  Rural hospitals play an essential role in their communities, often caring for patients who are older, sicker, and poorer compared to national averages, and who are more likely to be covered by Medicare and Medicaid. The facilities face unique financial challenges due to insurance, patient volume, and patient acuity 
  • Essential support:  The legislation updates federal designations and systems that support rural hospitals, including:
    • Making permanent the enhanced low-volume Medicare adjustment for small rural prospective payment system hospitals. This supports hospitals in smaller communities that often have costs outpacing revenue
    • Updating the year sole community hospitals and Medicare-dependent hospitals can base their operating costs from Fiscal Year 2012 to Fiscal Year 2016, ensuring reimbursement is tied to more recent cost data
    • Making permanent the Medicare-Dependent Hospital program, which ensures eligible rural hospitals are reimbursed for their costs
  • Quotable: “This legislation takes an important step to maintain that lifeline, especially for older adults and lower income Americans. I will continue to work to bring federal funding to rural communities and make sure older Americans have the health care support they need no matter where they live,” Senator Casey said

HAP joins the American Hospital Association and other leading health care organizations to support the Rural Hospital Support Act.

HAP is committed to supporting Pennsylvania’s rural hospitals to ensure they remain anchors within their communities. This includes advocating for policies and legislation that support their health care workforce and new models of care. During 2019, HAP supported the creation of Pennsylvania’s Rural Health Model, which provides financial stability for rural hospitals and rewards innovative approaches to delivering health care.

For additional information about the Rural Hospital Support Act, contact Kate Slatt, HAP’s vice president, innovative payment and care delivery.




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