Issue Landing Page / en Mon, 28 Apr 2025 21:07:59 -0500 Fri, 07 Feb 25 20:45:17 -0600 Community Health Improvement Week | Center /center/community-health-improvement-week Sat, 25 May 2024 08:00:00 -0500 Issue Landing Page Sustainability for Health Care - Achieving Your Sustainability Goals /sustainability <div class="raw-html-embed"> </div><div>#main-content p, #main-content ol>li, #main-content ul>li{ font-size:16px }  .BulletCircle ul { list-style: none; /* Remove default bullets */ padding-left: 0px } .BulletCircle ul li { margin-bottom: 7px; line-height: 1.5em; } .BulletCircle ul li::before { content: "●"; font-size: 1em; position: relative; top: 0px; color:#78be20; text-indent: -20px; /* key property */ margin-left: 20px; /* key property */ padding-right:10px } .BulletCircle ul li { text-indent: -40px; /* key property */ margin-left: 30px; /* key property */ } */ </div>.Banner_Title_Overlay_Bar { position: relative; display: block; overflow: hidden; max-width: 1170px; margin: 0px auto 0px auto; } .LogoInsert { position: absolute; top: 0px; height:100%; left:0px; } .LogoInsert img{ max-width:500px; max-height:125px; top:calc(50% - 125px/2); left:calc(100% + 50px); position:absolute; } .LogoInsert h1{ position:absolute; left:0px; bottom:0px; width:500px; opacity:0; margin: 0px; padding: 0; } @media (max-width:640px) { .LogoBG { object-fit: cover; height: 200px; } .LogoInsert img { max-width: 250px; left: calc(100% + 15px); top: calc(50% - 112px/2); background-color: #00584499; padding: 25px; border-radius: 30px 0px; } } @media (max-width:320px) { .LogoBG { height: 150px; } } <header class="Banner_Title_Overlay_Bar"><img class="LogoBG" src="/sites/default/files/2023-03/sustainability-roadmap-web-home-banner-1170x250.jpg" alt="Banner Image - Glass Earth sitting in a hand over tall grass" width="1170" height="264"><div class="LogoInsert"><h1>Sustainability Roadmap for Health Care - Achieving Your Sustainability Goals</h1><img src="/sites/default/files/2023-03/SustainabilityRoadmap_Logo_Hor-white_700x217.png" alt="Sustainability Roadmap for Health Care | Achieving Your Sustainability Goals - Logo" width="700" height="217"></div></header>.shcIntro{ background-color:#78be2022; padding: 5px 50px 15px 50px; margin-bottom:20px; } .shcIntro h2{ color:#005844; text-align:center; } shcIntro ul{ color: grey; } <div class="shcIntro BulletCircle"><h2>Supporting Efficiency Through Sustainability</h2><p>Environmental awareness within the health care sector is growing, benefiting our communities and creating a new avenue for savings. AHA is helping our members - more than 5,000 hospitals and health systems across the country - take meaningful actions to improve the health of all people — and the environment in which they live — by setting a sustainable course for the future.</p><p>Here, you’ll find insights and resources to embrace sustainability in health care across a hospital or health system enterprise – in operations, procurement, purchasing, maintenance and new models of care.</p></div><div class="container sp_CTA1"> @media (min-width:768px) { .sp_CTA1_holder { top: -45px } } @media (max-width:768px) { .sp_CTA1_holder { top: -1px; margin-bottom: 25px } } .sp_CTA1_holder { background-color: #fff; padding: 15px 0; position: relative; overflow: auto; border-radius: 20px 0px; border: 5px solid #78be20; } .sp_CTA1 h3 { color: #002855; font-size: 1.4em; margin: 0px; } .sp_CTA1 span { display: block; margin-top: 10px } .sp_CTA1 span a { color: #9d2235; } .sp_CTA1 span a:hover { color: #d50032; } .sp_CTA1 img { width: 100px; /*max-width: 85%;*/ margin-bottom:10px; } /* changed class to sm so this css will not run */ @media (max-width:768px) and (min-width:361px) { .sp_CTA1 .col-xs-2 { width: 25%; left: 15px } .sp_CTA1 .col-xs-10 { width: 70%; padding-right: 15px } } @media (max-width:360px) { .sp_CTA1 img { margin: auto; display: block } .sp_CTA1 .col-xs-2 { width: 100%; } .sp_CTA1 .col-xs-10 { width: 100%; text-align: center; padding: 0 25px } } .sp_CTA1 span { display: block; margin-top: 10px } .sp_CTA1 a span { margin-top:5px; display:inline-block; color: #d50032; } .sp_CTA1 a:hover span { color: #651d32; } @media (max-width:360px) { .sp_CTA1 img { margin: auto; display: block } .sp_CTA1 .col-xs-2 { width: 100%; } .sp_CTA1 .col-xs-10 { width: 100%; text-align: center; padding: 0 25px } } .sp_CTA1 span { display: inline; /*float: right;*/ font-weight: 700; } <div class="col-sm-10 col-sm-offset-1 sp_CTA1_holder"><div class="col-sm-2"><img src="/sites/default/files/2023-03/sus-map-icons-take-action-300x300.jpg" alt="Hand holding a blowhorn" width="300" height="300"></div><div class="col-sm-10"><h3>Join us July 19, for the 2025 AHA Sustainability Summit</h3><p>At the JW Marriott in Nashville, TN. The 2025 Sustainability Summit is slated to take place right before the <a href="https://leadershipsummit.aha.org/" target="_blank" title="Learn more about the AHA Leadership Summit on
July 20-22, 2025">2025 AHA Leadership Summit</a>.</p><p><a class="btn btn-primary btn-wide ext" href="/sustainability/summit" title="Learn More about the 2025 Sustainability Summit">Learn More</a></p></div></div><div class="col-sm-2"> </div></div><div class="raw-html-embed"> <div class="row"> /* TocMini */ .TocMini { margin: 0px auto 25px; padding-bottom: 5px; color: #005844; letter-spacing: 1.5px; font-weight: 400; font-size: .7em; width: 80%; } .TocMini .TocMiniBar { border: 1px solid #78be20; padding: 5px 10px; overflow: auto; border-radius: 20px 0px; } .TocMini .TocMiniBar .TocMiniGroup a:after { content: "|"; padding: 0 3px 0 6px; color: #253b80; font-weight: 700; } .TocMini .TocMiniBar .TocMiniGroup a:last-child:after { content: ""; } .TocMini .TocMiniGroup { float: right; } .TocMini .TocMiniHome { text-transform: uppercase; color: #005844; font-weight: 700; } .TocMini .TocMiniChild { font-weight: 500; opacity: .9; color: #555; } .TocMini .TocMiniHome:hover, .TocMini .TocMiniChild:hover { text-transform: ; color: #5fa1d0; } .TocMini .TocMiniActive{ font-weight: 700; color: #5fa1d0; } /* TocMini // */ <div class="TocMini"> <div class="TocMiniBar"><a class="TocMiniHome" href="/sustainability" target="_blank" title="Home - Sustainability Roadmap for Health Care">Sustainability Roadmap for Health Care </a> <div class="TocMiniGroup"><a class="TocMiniChild" href="https://www.ashe.org/sustainability" target="_blank" title="ASHE Sustainability for Health Care Facilities">Sustainability for Health Care Facilities</a> <a class="TocMiniChild" href="/sustainability/glossary" target="_blank" title="Glossary">Glossary</a> <a class="TocMiniChild" href="https://www.ashe.org/sustainability/healquest" target="_blank" title="HealQuest">HealQuest<sup>TM</sup></a></div> </div> </div> </div> </div>.shcHighlight h2{ color:#005844; } .shcHighlight span{ font-weight:700; color:#78be20; } <div class="row shcHighlight BulletCircle"><div class="col-md-6"><h2>What is sustainability in health care?</h2><ul><li>In health care, sustainability refers to the implementation of cost-efficient, environmentally friendly practices to support healthy and resilient environments and communities over time.</li><li>Sustainability in health care is based on a simple principle: Everything that humans need for their survival and well-being depends, either directly or indirectly, on the natural environment.</li><li>To pursue sustainability is to create and maintain the conditions under which humans and nature can exist in productive harmony</li></ul></div><div class="col-md-6"><h2>Why and how does environmental sustainability affect health care?</h2><p><span>Problem:</span> The environment contributes to people's wellbeing, contributing to chronic diseases, such as asthma and cancer, or to acute illnesses like heat exhaustion.</p><p><span>Solution:</span> Everyone, including hospitals, needs to be a part of the solution and make changes that will help improve the environment.</p><p><span>Premise:</span> Hospitals can reduce carbon emissions significantly with simple changes, such as reducing surgical waste, reducing toxic chemicals and installing life-saving renewable energy sources.</p><p><span>Reason:</span> Hospital and health systems engaged in sustainable practices are doing so largely because it aligns with their humanitarian and stewardship mission and vision. Becoming a positive force for environmental health leads to human health and wellbeing.</p></div></div>.shcItems{ border: solid 2px #005844; padding-top: 25px; padding-bottom: 25px; border-radius: 75px 0px; margin-top:50px; margin-bottom:50px; } .shcItems h2{ text-align:center; color:#005844; margin-bottom:50px; } .shcItems h3{ margin:0px; } .shcItems h4{ color:#78be20; } .shcItems .shcItemsLine { border-bottom:solid 1px #78be20; margin-top:25px; margin-bottom:50px; } <div class="row"><div class="col-md-10 col-md-offset-1 shcItems"><div class="row"><div class="col-md-12"><h2>Getting Started</h2></div></div><div class="row"><div class="col-md-12"><div class="col-xs-3 col-md-2"><img src="/sites/default/files/2023-03/sus-map-icons-basics-300x300.jpg" alt="Icon - Blocks" width="300" height="300"></div><div class="col-md-10 BulletCircle"><h3>The Basics</h3><p>“Where do we start?” is a common question when embarking on a sustainability journey. These basic concepts will help guide hospitals, health systems and their staffs as they practice environmental sustainability.</p><ul><li><a href="/sustainability/glossary" title="Sustainability Glossary">Sustainability Glossary</a>, for building effective sustainability communications across your organization.</li><li><a href="https://www.ashe.org/sustainability/guide" target="_blank" title="ASHE Sustainability Guide">ASHE Sustainability Guide</a>, offering step-by-step directions on developing and executing a sustainability program.</li><li><a href="/sustainability/health-care-leaders-guide" title="The Health Care Leader’s Guide to Sustainability and Environmental Stewardship">Health Care Leader's Guide to Sustainability and Environmental Stewardship</a></li></ul></div><div class="col-md-10 col-md-offset-1 shcItemsLine"> </div></div></div><div class="row"><div class="col-md-12"><div class="col-xs-3 col-md-2"><img src="/sites/default/files/2023-03/sus-map-icons-mapping-300x300.jpg" alt="Icon - Map" width="300" height="300"></div><div class="col-md-10 BulletCircle"><h3>Mapping Out Your Path Forward</h3><p>No two organizations embark on the same route to becoming sustainable, however the process for approaching the journey can be similar. Begin with an understanding of what has been done and what needs to be done, and develop and deploy a path forward using these tools.</p><h4>Targeted Tools and Resources:</h4><ul><li><a href="/education-events/financing-sustainability-through-inflation-reduction-act-making-case" target="_blank" title="Financing Sustainability through the Inflation Reduction Act: Making the Case">Financing Sustainability through the Inflation Reduction Act: Making the Case</a></li><li><a href="/sustainability/electrifying-heat-existing-hospital#Electrifying" title="Electrifying Heat in an Existing Hospital">Electrifying Heat in an Existing Hospital</a></li><li><a href="/sustainability/electrifying-heat-existing-hospital#Decarbonization" title="How to Prepare for a Decarbonization Study">How to Prepare for a Decarbonization Study</a></li><li><a href="https://www.ashe.org/decarbonizing-health-care-facilities" target="_blank" title="Decarbonizing health care facilities">Decarbonizing health care facilities</a></li><li><a href="https://www.ashe.org/sustainability/decarbonization-code-overlay" target="_blank" title="Health Care Decarbonization Code Overlay">Health Care Decarbonization Code Overlay</a></li></ul><h4>Opportunities for Change:</h4><ul><li><a href="https://www.ashe.org/opportunities-hospital-sustainability" target="_blank" title="Kickstarting your hospital’s hospital sustainability efforts">Kickstarting your hospital’s hospital sustainability efforts</a></li><li><a href="https://www.ashe.org/energytocare/sustainability-tips/you-win-with-people" target="_blank" title="Engaging people">Engaging people</a></li><li><a href="https://www.ashe.org/hospitals-reduce-their-carbon-footprints-sustainable-solutions" target="_blank" title="Reducing your facility’s carbon footprint with sustainable solutions">Reducing your facility’s carbon footprint with sustainable solutions</a></li></ul><h4>Collaborations:</h4><ul><li><a href="/sustainability/sustainability-accelerator-tool" title="Sustainability Accelerator Tool (SAT)">Sustainability Accelerator Tool (SAT)</a>, developed by the Geneva Sustainability Centre in collaboration to Deloitte. Use it to assess sustainability maturity, track progress and gain insights to accelerate action.</li><li><a href="/community-health-environment" title="Community Health and Environment">Community Health and Environment</a>: The AHA aims to offer resources to support hospitals' efforts to assess, plan for and respond to the impacts of the environment on communities' health.</li></ul></div><div class="col-md-10 col-md-offset-1 shcItemsLine"> </div></div></div><div class="row"><div class="col-md-12"><div class="col-xs-3 col-md-2"><img src="/sites/default/files/2023-03/sus-map-icons-healquest-300x300.jpg" alt="Icon Presentation" width="300" height="300"></div><div class="col-md-10 BulletCircle"><h3>HealQuest<sup>TM</sup></h3><p><a href="https://www.ashe.org/sustainability/healquest" target="_blank" title="HealQuest">HealQuest</a> brings together hospital leaders and cross-functional teams for two-days of hands-on learning to promote cultural changes toward sustainability.</p><h4>4-tier Training Program Offers Guidance on:</h4><ul><li>Culture and accountability</li><li>Uncovering energy opportunities</li><li>Leadership engagement</li><li>Promoting behavior change</li><li>Leadership engagement</li></ul></div></div></div></div></div>.schOffer img { border-radius: 20px 0px; margin-bottom:15px; } .schOffer h2, .schOffer h3{ color: #005844; } .schOffer h2 { text-align: center; margin-bottom: 25px; } .schOffer h3 { margin-top:10px } .schOfferModal:hover h3, .schOfferDirect:hover h3{ color: #78be20; } .schOfferModal h3 a, .schOfferDirect h3 a { color: #005844; } .schOfferModal:hover h3 a, .schOfferDirect:hover h3 a { color: #78be20; } .schOfferModal, .schOfferDirect { border: solid 2px #fff; transition: transform .5s; padding-top: 10px; margin-bottom: 40px; border-radius: 50px 0px; } .schOfferModal:hover { border: solid 2px #005844; transform: scale(1.03); transition: transform 1s; cursor: help; /*https://www.educba.com/cursor-in-html/ */ border-radius: 50px 0px; z-index:100; } .schOfferDirect:hover { border: solid 2px #005844; transform: scale(1.03); transition: transform 1s; border-radius: 50px 0px; z-index:100; } .schOfferModal:hover[data-target="#*"] { color: red; } @media (min-width: 1200px) { .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ flex: auto; width: calc(100%/3 - 2px) /*Safari Fix*/; } } @media (max-width: 1200px) and (min-width:768px) { .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ flex: auto; width: calc(100%/2 - 2px) /*Safari Fix*/; } } <div class="row schOffer"><div class="col-md-12"><h2>Learn How All Levels of Your Organization Contribute to Sustainability</h2></div><div class="row rowEqual_768"><div class="col-md-4 schOfferModal"><div class="row" data-target="#modal-Trustees" data-toggle="modal" title="View for more details"><div class="col-xs-3"><img src="/sites/default/files/2023-03/sus-photo-icons-trustees-300x300.jpg" alt="People around a conference table" width="300" height="300"></div><div class="col-md-9"><h3>Trustees</h3></div><div class="col-md-12"><p>Trustees are uniquely positioned to tackle sustainability in health care by articulating it’s value proposition and strengthening culture using these <a>resources</a>.</p></div></div></div><div class="col-md-4 schOfferModal"><div class="row" data-target="#modal-Executive" data-toggle="modal" title="View for more details"><div class="col-xs-3"><img src="/sites/default/files/2023-03/sus-photo-icons-executives-300z300.jpg" alt="Leaders talking together" width="300" height="300"></div><div class="col-md-9"><h3>Executive Leadership</h3></div><div class="col-md-12"><p>Hospital leaders must navigate a path forward to make health care sustainable a priority. Environmental sustainability can provide near- and long-term financial savings, improve patient care and increase workforce engagement.</p><p>These <a>resources</a> offer health care leaders actionable information driving positive changes.</p></div></div></div><div class="col-md-4 schOfferDirect"><div class="row"><div class="col-xs-3"><a href="https://www.ashe.org/sustainability" target="_blank" title="ASHE Health Care Facility Management"><img src="/sites/default/files/2023-03/sus-photo-icons-facilities-300x300.jpg" alt="Facility managers with blueprints" width="300" height="300"></a></div><div class="col-md-9"><h3><a href="https://www.ashe.org/sustainability" target="_blank" title="ASHE Health Care Facility Management">Health Care Facility Management</a></h3></div><div class="col-md-12"><p>The American Society for Heath Care Engineering offers an environmental sustainability <a href="https://www.ashe.org/sustainability" target="_blank" title="repository">repository</a>, featuring the Energy to Care program, decarbonization resources and training, for facility management professionals.</p></div></div></div><div class="col-md-4 schOfferModal"><div class="row" data-target="#modal-Resiliency" data-toggle="modal" title="View for more details"><div class="col-xs-3"><img src="/sites/default/files/2023-03/sus-photo-icons-resilience-300x300.jpg" alt="Ambulance in a Hospital Emergency entrance" width="300" height="300"></div><div class="col-md-9"><h3>Resiliency and Preparedness</h3></div><div class="col-md-12"><p>In moments of crisis in a community, hospitals serve as the cornerstone of aid and recovery. Hospitals and health systems can prepare for extreme weather events by deploying proven sustainable and resilient practices. These <a>articles</a> provide best practice case studies of health care facilities deploying resilient solutions.</p></div></div></div><div class="col-md-4 schOfferDirect"><div class="row"><div class="col-xs-3"><a href="https://www.ahrmm.org" target="_blank" title="AHRMM"><img src="/sites/default/files/2023-03/sus-photo-icons-supplies-300x300.jpg" alt="Medial masks" width="300" height="300"></a></div><div class="col-md-9"><h3><a href="https://www.ahrmm.org" target="_blank" title="AHRMM">Supply Chain</a></h3></div><div class="col-md-12"><p>With scope 3 emissions representing the lion’s share of health care emissions, supply chain professionals play a critical role to create and maintain a more resilient and sustainable health care system. Here you’ll find environmental sustainability <a href="https://www.ahrmm.org" target="_blank" title="AHRMM">resources</a> for the health care supply chain.</p></div></div></div><div class="col-md-4 schOfferDirect"><div class="row"><div class="col-xs-3"><a href="https://www.ahe.org" target="_blank" title="AHE"><img src="/sites/default/files/2023-03/sus-photo-environment-300x300.jpg" alt="Gloved hand cleaning a surface" width="300" height="300"></a></div><div class="col-md-9"><h3><a href="https://www.ahe.org" target="_blank" title="AHE">Environmental Services</a></h3></div><div class="col-md-12"><p>The Association for the Health Care Environment offers <a href="https://www.ahe.org" target="_blank" title="resources">resources</a> for environmental services professionals on addressing health care’s environmental impact while providing a clean, safe space for patients, visitors, and staff.</p></div></div></div></div><div>.sp_modal button { background-color: #fff; /*border: solid 0px lightgrey;*/ padding: 10px; overflow: hidden; } .sp_modal button:hover img { opacity: .7; padding: 0px; transform: scale(1.09); transition: transform 1s; /* Animation */ } .sp_modal { margin: 20px auto } .sp_modalWrap { border: 0px solid #fff; } .sp_modalWrap img { width: 100%; } .modal { position: fixed; top: 40%; left: 50%; transform: translate(-50%, -25%); width: 100%; height: 100%; /*! display: inline-block !important; */ } .modal .close { top: .5em; } .sp_modalWrap .modal-body { text-align: left } .modal-backdrop { opacity: 0.5 !important; } .modal-dialog { width: calc(100% - 20px); max-width: 1000px; } .modal-header { text-align: center; background-color: #fff; } .modal-header a.btn { position: absolute; top: 95px; right: 15px; padding: 5px 15px; } /* .modal-header a{ position: absolute; bottom:15px; right: 15px; z-index: 100 } */ .modal-dialog { overflow-y: initial !important; border: solid 2px darkgrey } .modal-body { height: auto; max-height: 50vh; overflow-y: auto; background-color: #f6f6f6; } @media (max-width: 550px) { .modal-header img { width: 70%; float: left; } .modal-header a.btn { position: absolute; top: 65px; right: 15px; padding: 5px 15px; } } @media (max-height: 360px) { .modal { width: 90%; top: 10px; transform: translate(-50%, -0%); /*! display: inline-block !important; */ } .modal-body { height: auto; max-height: 45vh; } } @media (max-width: 990px) and (min-width:640px) { .sp_modal-parent .col-md-3 { width: 33.3%; float: left } } @media (max-width: 639px) and (min-width:414px) { .sp_modal-parent .col-md-3 { width: 50%; float: left } } <div class="modal fade in" id="modal-Trustees" role="dialog"><div class="modal-dialog"><div class="modal-content"><div class="modal-header"><p>×</p><h3>Trustees</h3></div><div class="modal-body"><p>Trustees are uniquely positioned to tackle sustainability in health care by articulating it’s value proposition and strengthening culture using these resources.</p><h4>Resources</h4><ul><li><a href="https://www.ashe.org/financing-energy" target="_blank" title="Business Case">Business Case</a></li><li><a href="https://www.ashe.org/bestpractices" target="_blank" title="Near- and Long-term Project Planning">Near- and Long-term Project Planning</a></li></ul></div></div></div></div><div class="modal fade in" id="modal-Executive" role="dialog"><div class="modal-dialog"><div class="modal-content"><div class="modal-header"><p>×</p><h3>Executive Leadership</h3></div><div class="modal-body"><p>Hospital leaders must navigate a path forward to make health care sustainable a priority. Environmental sustainability can provide near- and long-term financial savings, improve patient care and increase workforce engagement.</p><p>These resources offer health care leaders actionable information driving positive changes.</p><h4>Resources</h4><ul><li><a href="https://www.ashe.org/financing-energy" target="_blank" title="Financing Opportunities and ROI">Financing Opportunities and ROI</a></li><li><a href="https://www.ashe.org/energytocare/sustainability-tips/developing-green-team-key-to-success/sustainability-tips/developing-gree-team-key-to-success" target="_blank" title="Engaging the Workforce">Engaging the Workforce (Green team, organizational structure, etc)</a></li><li><a href="https://www.ashe.org/bestpractices " target="_blank" title="Near- and Long-term Project Planning">Near- and Long-term Project Planning</a></li><li><a href="/sustainability/health-care-leaders-guide" title="The Health Care Leader’s Guide to Sustainability and Environmental Stewardship">Health Care Leader's Guide to Sustainability and Environmental Stewardship</a></li></ul></div></div></div></div><div class="modal fade in" id="modal-Resiliency" role="dialog"><div class="modal-dialog"><div class="modal-content"><div class="modal-header"><p>×</p><h3>Resiliency and Preparedness</h3></div><div class="modal-body"><p>In moments of crisis in a community, hospitals serve as the cornerstone of aid and recovery. Hospitals and health systems can prepare for extreme weather events by deploying proven sustainable and resilient practices. These <a>articles</a> provide best practice case studies of health care facilities deploying resilient solutions.</p><h4>Resources</h4><ul><li><a href="https://www.hfmmagazine.com/climate_change" target="_blank" title="Climate Change Response and Recovery">Climate Change Response and Recovery</a></li><li><a href="https://www.hfmmagazine.com/articles/4338-resilient-design-ensures-nyc-facility-is-prepared-for-the-unexpected" target="_blank" title="Resilient design">Resilient design</a></li></ul></div></div></div></div></div></div><div class="raw-html-embed"> .SponsorMarketoForm { background-color: ; padding: 5px 25px; border: solid 2px #005844; margin: 50px 15px 0px; border-radius: 75px 0px; } .SponsorMarketoForm h3 { margin: 10x 0 0 0; color: #555; font-size: .7em; text-transform: uppercase; font-weight: 400; letter-spacing: 3px; max-width: 200px; /* Custom for the copy length */ background-color: #fff; padding: 5px 15px; position: relative; top: -35px } .SponsorMarketoForm h2 { color: #005844; } .SponsorMarketoForm .SponsorMarketoFormHolder { background-color: ; padding: 15px; display: block; margin-bottom: 25px; max-width: 700px; overflow: hidden; } .SponsorMarketoFormHolder form { margin: auto; display: inline/* xxxxxxxxxxx */ } /* Marketo Over-ride */ #contactus .mktoForm .mktoFormRow:nth-child(3) { float: left; } /*Center the last row .mktoForm .mktoFormRow:nth-child(4){ margin-left:15%; } */ #contactus .mktoForm label { font-size: 0px; width: 0px !important; } #contactus .mktoForm input { height: 30px } #contactus .mktoForm .mktoButtonRow { float: left; } #contactus .mktoForm .mktoButtonWrap { margin-left: 20px !important; } #contactus .mktoForm .mktoButton { background-color: #005844 !important; border: 1px solid #005844 !important; color: #fff !important; padding: 0.4em 1em; font-size: 1em; background-image: none !important; min-width: 190px; /*margin: 0 15px;*/ border-radius: 4px; /*padding: 10px 20px;*/ transition: all .25s ease-in-out; text-shadow: none; white-space: normal; height: 30px; font-weight: 700 } #contactus .mktoForm .mktoButton:hover { background-color: #fff !important; border: 1px solid #005844 !important; color: #005844 !important; } #contactus .mktoForm .mktoClear { clear: none; } <div class="container spacer" id="contactus"> <div class="row"> <div class="col-md-1">   </div> <div class="col-md-10"> <div class="SponsorMarketoForm"> .FlipFlop { display: flex; flex-wrap: wrap; flex-direction: column-reverse; } .FlipFlop h2 { color: #005844; line-height: 1em !important; font-size: 30px; margin: 10px 0 20px 0; } .FlipFlop .CTAkicker { margin: 0px; color: #555; font-size: 12px; text-transform: uppercase; font-weight: 400; letter-spacing: 3px; } /*special for the Marketo form*/ .SponsorMarketoForm .FlipFlop .CTAkicker { z-index: 1000; margin: 0px; color: #555; font-size: .7em; text-transform: uppercase; font-weight: 400; letter-spacing: 3px; top: -10px; position: relative; background-color: #fff; width: 200px; margin: auto; } <div class="FlipFlop"> <h2>Stay up to date with the latest in Sustainability</h2> <div class="CTAkicker">Connect with us </div> </div> <p>Subscribe to receive email updates from AHA Sustainability.</p> <div class="SponsorMarketoFormHolder">   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 4376); MktoForms2.whenReady(function(form) { if(form.getId() == 4376) { form.onSuccess(function(values, followUpUrl) { form.getFormElem().hide(); document.getElementById("successAndErrorMessages").innerHTML = `<div><p>Thank you for your interest in AHA Sustainability. You are now subscribed.<\/p><\/div>`; return false; }); }; }); <div id="successAndErrorMessages"> </div> </div> </div> </div> <div class="col-md-1">   </div> </div> </div> </div> .mktoForm .mktoRequiredField .mktoAsterix { display: block; font-size: 18px; top: 10px; position: absolute; left: 5px } Wed, 28 Feb 2024 11:00:00 -0600 Issue Landing Page Cybersecurity & Risk Advisory Service /cybersecurity <p>AHA can help hospitals and health systems prepare for and mitigate cyber threats with John Riggi, a recognized expert, as a powerful resource.</p> Thu, 01 Feb 2024 09:32:19 -0600 Issue Landing Page Ensuring Access in Vulnerable Communities - Taskforce Report and Resources /issue-landing-page/2016-11-16-ensuring-access-vulnerable-communities-taskforce-report-and-resources <div class="container row"><div class="row"><div class="col-md-8"><div class="outlineContent clearfix"><p><img src="/images/taskforce-ban2.jpg" data-entity-uuid data-entity-type alt width="793" height="286"></p><hr><p>Millions of Americans living in vulnerable rural and urban communities depend upon their hospital as an important, and often only, source of care. However, these communities and their hospitals face many challenges. As the hospital field engages in its most significant transformation to date, many are fighting to survive – potentially leaving their communities at risk for losing access to health care services. Recognizing these challenges and the need for new integrated and comprehensive health care delivery and payment strategies, the AHA Board of Trustees created the Task Force on Ensuring Access in Vulnerable Communities. Comprised of 29 hospital and health system leaders and state hospital association CEOs, the task force held meetings, heard from policymakers and conducted field hearings to speak with hospital and community leaders during a 15-month period.<br><br>The Task Force work is ongoing. This webpage is just one of the many ways AHA will keep you connected to the latest developments and resources as we address the critical issue of ensuring access to health care services.</p><hr><h2><span class="color_aha_blue"><strong>Task Force Report</strong></span></h2><p>The task force report outlines nine emerging strategies that can help preserve access to health care services in vulnerable communities. These strategies will not apply to or work for every community and each community has the option to choose one or more that are compatible with its needs.</p><ul><li><a href="/system/files/content/16/ensuring-access-taskforce-exec-summary.pdf" target="_blank">Executive Summary</a><a href="/system/files/content/16/ensuring-access-taskforce-report.pdf"></a></li><li><a href="/system/files/content/16/ensuring-access-taskforce-report.pdf">Full Report</a></li><li><a href="https://www.youtube.com/watch?v=v2TgJDL9O6o">Release Video</a></li><li><a href="/system/files/content/16/taskforce-charts-rural.pdf">Rural Chart Pack</a></li><li><a href="/system/files/content/16/taskforce-charts-urban.pdf">Urban Chart Pack</a></li></ul><hr><h2><strong class="color_aha_blue">Inpatient/Outpatient Transformation Strategy</strong></h2><ul><li><a href="/system/files/2018-02/inpatient-outpatient-transformation-strategy.pdf">Emerging Strategies to Ensure Access to Health Care Services – Inpatient/Outpatient Transformation</a></li></ul><hr><h2><strong class="color_aha_blue">Social Determinants of Health Strategy</strong></h2><ul><li><a href="/system/files/2018-02/social-determinants-health.pdf">Emerging Strategies to Ensure Access to Health Care Services - Social Determinants</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2017/AHA-community-health-initiatives.pdf">Community Health Initiatives at the Association</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2017/determinants-health-food-insecurity-role-of-hospitals.pdf">AHA Social Determinants of Health Series - Food Insecurity and the Role of Hospital</a></li><li><a href="http://www.hpoe.org/resources/ahahret-guides/3063">AHA Social Determinants of Health Series - Housing and the Role of Hospitals</a></li></ul><hr><h2><strong class="color_aha_blue">Virtual Care Strategies</strong></h2><ul><li><a href="/system/files/content/17/task-force-virtual-care-strategies.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Virtual Care Strategies</a></li><li><a href="/system/files/content/17/telehealth-case-examples.pdf">Telehealth — Delivering the Right Care, at the Right Place, at the Right Time: Case Examples of AHA Members in Action</a></li></ul><hr><h2><strong class="color_aha_blue">Emergency Medical Center Strategy</strong></h2><ul><li><a href="/system/files/2018-06/task-force-emergency-medical-center.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Emergency Medical Center</a></li><li><a href="/system/files/2018-05/emergency-medical-center-strategy-5-2018-jk.pdf">Comparison: Federal Policy Solutions to Ensure Access to Emergency Services</a></li><li><a href="/2018-05-07-overview-rural-emergency-medical-center-act">The Rural Emergency Medical Center Act of 2018</a></li><li><a href="/letter/2018-05-08-aha-rep-ron-kind-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Action Alert on REMC Act (members-only)</a></li><li><a href="/letter/2018-05-08-aha-rep-ron-kind-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Letter of Support of the REMC Act (Kind)</a></li><li><a href="/letter/2018-05-08-aha-rep-lynn-jenkins-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Letter of Support of the REMC Act (Jenkins)</a></li><li><a href="/press-releases/2018-05-07-aha-applauds-introduction-rural-emergency-medical-center-act-2018">Press Release Applauds Introduction of REMC Act</a></li><li><a href="/letter/2017-05-18-aha-expresses-support-rural-emergency-acute-care-hospital-reach-act-s-1130">AHA Letter of Support Rural Emergency Acute Care Hospital (REACH) Act, S. 1130</a></li></ul><hr><h2 class="color_aha_blue">Indian Health Services Strategy</h2><ul><li><a href="/system/files/2018-01/stategies-to-ensure-access.pdf">Emerging Strategies to Ensure Access to Health Care Services - IHS</a></li><li><a href="/letter/2017-05-26-aha-reps-walden-pallone-re-bipartisan-indian-health-service-task-force">AHA Letter of Support for IHS Task Force (Walden/Pallone)</a></li><li><a href="/letter/2017-05-26-aha-sens-mullin-ruiz-re-bipartisan-indian-health-service-task-force">AHA Letter of Support for IHS Task Force (Mullin-Ruiz)</a></li></ul><hr><h2><strong class="color_aha_blue">Urgent Care Center Strategy</strong></h2><ul><li><a href="/content/17/emerging-strategies-urgent-care-centers.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Urgent Care Centers</a></li><li><a href="/content/17/urgent-care-center-discussion-guide.pdf" target="_blank">Is the Urgent Care Center the Right Strategy for your Community</a></li></ul><hr><h2><strong class="color_aha_blue">Global Budgets</strong></h2><ul><li><a href="/system/files/media/file/2019/03/task-force-global-budget-2017.pdf">Emerging Strategies to Ensure Access – Global Budgets</a></li></ul><hr><h2><strong class="color_aha_blue">Community Conversations</strong></h2><ul><li><a href="/content/17/community-conversations-toolkit.pdf">Ensuring Access in Vulnerable Communities: Community Conversations Toolkit</a></li><li><a href="/content/17/taskforcevulncomm-discussionguide.pdf">Discussion Guide for Boards and Hospital Leadership</a></li><li><a href="http://www.hpoe.org/resources/ahahret-guides/3061">A Playbook for Fostering Hospital-Community Partnerships to Build a Culture of Health</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2016/creating-effective-hospital-community-partnerships.pdf">Creating Effective Hospital Community Partnerships to Build a Culture of Health</a></li><li><a href="http://www.healthycommunities.org/Resources/toolkit.shtml#.WYjFtITyt0y">Community Health Assessment Toolkit</a></li><li><a href="/ahahret-guides/2016-06-09-engaging-patients-and-communities-community-health-needs-assessment">Engaging Patients and Communities in the Community Health Needs Assessment Process</a></li><li><a href="http://hospitalsocialmedia.tumblr.com/">A Hospital Leadership Guide to Digital and Social Media</a></li><li><a href="/advancing-health-in-america">Advancing Health in America</a></li><li><a href="/ahahret-guides/2013-01-01-engaging-health-care-users-framework-healthy-individuals-and-communities">AHA Framework for Engaging Health Care Users</a></li><li><a href="/ahahret-guides/2015-01-28-leadership-toolkit-redefining-h-engaging-trustees-and-communities">Leadership Toolkit for Redefining the H: Engaging Trustees and Communities</a></li><li><a href="/system/files/2018-02/leadership-role-nonprofit-health-systems.pdf">The Leadership Role of Nonprofit Health Systems in Improving Community Health</a></li><li><a href="/system/files/2018-02/critical-conversations-to-changing-health-environment.pdf">Critical Conversations on the Changing Health Environment: Physician Engagement</a></li></ul><hr><h2><strong class="color_aha_blue">Frontier Health System</strong></h2><ul><li><a href="/system/files/content/17/task-force-frontier-2017.pdf">Emerging Strategies to Ensure Access — Frontier Health System</a></li></ul><hr><h2><strong class="color_aha_blue">Rural Hospital-Health Clinic Integration</strong></h2><ul><li><a href="/factsheet/2018-08-02-emerging-strategies-ensure-access-health-care-services">Emerging Strategies to Ensure Access — Rural Hospital-Health Clinic Integration</a></li></ul><hr><h2><strong class="color_aha_blue">Other Resources</strong></h2><ul><li><a href="http://www.hpoe.org/Reports-HPOE/2017/improving-care-for-high-need-high-cost-patients.pdf" target="_blank">Improving Care for High-Need, High-Cost Patients</a></li><li><a href="/data-and-insights/presentation-center/ensuring-access" target="_blank">Ensuring Access in Vulnerable Communities PowerPoint Presentation</a></li></ul></div></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title"><a href="/case-studies/2018-02-02-hospitals-and-health-systems-ensuring-access-their-communities">Hospitals and Health Systems Ensuring Access in Their Communities: Downloadable PDF</a></h3></div><div class="panel-body"><p><a href="/case-studies/2018-02-02-hospitals-and-health-systems-ensuring-access-their-communities"><img src="/sites/default/files/inline-images/ensuring-access-case-study-comp-rural-sm_0.jpg" data-entity-uuid="32d51105-e12e-468b-8f23-e4ae7c7aa262" data-entity-type="file" alt="Hospitals and Health Systems Ensuring Access in Their Communities cover" width="319" height="413">This is a compendium of case examples of AHA members from across the country employing the nine emerging strategies recommended by the association’s Task Force on Ensuring Access in Vulnerable Communities.</a></p></div></div></div></div></div> Wed, 16 Nov 2016 00:00:00 -0600 Issue Landing Page Advocacy Issue: Enhanced Premium Tax Credits /advocacy/advocacy-issues/enhanced-premium-tax-credits <div class="container"><div class="row"><div class="col-md-8"><p>The federal government offers enhanced premium tax credits (EPTCs or tax credits) to help some individuals and families purchase insurance on the health insurance marketplaces. These 2021 tax credits — due to expire in 2025 — have resulted in an additional 10 million people gaining coverage through the health insurance marketplaces and others receiving assistance paying their health insurance costs.</p><h2>AHA Position</h2><p>In support of the health of our patients and communities, as well as the stability of the entire health care system, the AHA urges Congress to extend the enhanced premium tax credits.</p><div class="row"><div class="col-md-6"><p><a href="/system/files/media/file/2025/04/Protect-Access-to-Care-Reject-cuts-to-the-Medicaid-program-and-premium-hikes-on-working-families.pdf" target="_blank" title="Click here to download the Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families PDF."><img src="/sites/default/files/inline-images/Protect-Access-to-Care-Reject-cuts-to-the-Medicaid-program-and-premium-hikes-on-working-families.png" data-entity-uuid="c001b8d1-d304-46e2-900b-524456f65c4c" data-entity-type="file" alt="Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families. If Congress cuts Medicaid, hospitals would see significant imparts that vary by policy: Per Capita Caps for All Medicaid Population: 1-Year National Hospital Impact in 2026 -$47.6 billion; 10-Year National Hospital Impact through 2024: -$468.1 billion. Per Capita Caps for Expansion Population: 1-Year National Hospital Impact in 2026 -$18.9 billion; 10-Year National Hospital Impact through 2024: -$199.9 billion. Eliminate Enhanced FMAP for Expansion Population: 1-Year National Hospital Impact in 2026 -$32 billion; 10-Year National Hospital Impact through 2024: -$360.6 billion. Reduce FMAP Statutory Floor to 45%: 1-Year National Hospital Impact in 2026 -$7.3 billion; 10-Year National Hospital Impact through 2024: -$78.4 billion. Limit Provider Taxes to 5%: 1-Year National Hospital Impact in 2026 -$3 billion; 10-Year National Hospital Impact through 2024: -$32.8 billion. If the Enhanced Premium Tax Credits (EPTCs) expire: 2.2 million individuals are at risk of becoming uninsured in 2026; 4 million individuals are facing higher costs due to loss of Marketplace coverage in 2026; $705 average per person increase in annual premiums in 2026; -$28.2 billion reduction in spending on hospitals over 10 years." width="695" height="900"></a></p></div></div><h2>Key Resources</h2><ul><li><span><strong>NEW:</strong></span> <a href="/fact-sheets/2025-04-14-protect-access-care-reject-cuts-medicaid-program-and-premium-hikes-working-families">Infographic: Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families.</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-enhanced-premium-tax-credits">Fact Sheet: Enhanced Premium Tax Credits</a></li></ul></div><div class="col-md-4"><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-10c0ed7bf8933e7f5902f6bc3b52f4ba3a78480ff200bc69731d2acdb7cb133a resource-block"> <h3>Latest Enhanced Premium Tax Credit Advocacy and News</h3> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2025-04-14-take-action-urge-lawmakers-reject-medicaid-cuts-protect-access-care" hreflang="en">TAKE ACTION: Urge Lawmakers to Reject Medicaid Cuts, Protect Access to Care</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-14T12:15:37-05:00">Apr 14, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2025-04-14-protect-access-care-reject-cuts-medicaid-program-and-premium-hikes-working-families" hreflang="en">Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families.</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-14T10:10:24-05:00">Apr 14, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/news/blog/2025-02-27-blog-3-ways-not-extending-enhanced-premium-tax-credits-would-hurt-patients-rural-communities" hreflang="en">Blog: 3 Ways Not Extending the Enhanced Premium Tax Credits Would Hurt Patients in Rural Communities</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-27T22:58:48-06:00">Feb 27, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/2025-02-27-fact-sheet-expiration-enhanced-premium-tax-credits" hreflang="en">Fact Sheet: Expiration of the Enhanced Premium Tax Credits</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-27T13:48:48-06:00">Feb 27, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/advocacy/advocacy-issues/enhanced-premium-tax-credits" hreflang="en">Advocacy Issue: Enhanced Premium Tax Credits</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-07T20:45:17-06:00">Feb 7, 2025</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/topics/enhanced-premium-tax-credit-eptc">More on Enhanced Premium Tax Credit</a></div> </section> </div> </p></div></div></div> .meta.custom-lock-position { position: relative; top: 0px; right: inherit; display: block; float: right; } Fri, 07 Feb 2025 20:45:17 -0600 Issue Landing Page Advocacy Issue: Medicaid /advocacy/advocacy-issues/medicaid <div class="container"><div class="row"><div class="col-md-8"><p>The Medicaid program is the largest single source of health care coverage in the United States, covering nearly half of all children, many low-income elderly and disabled individuals, and working adults in low-wage jobs. Congress is currently considering policy options that could collectively reduce federal spending for the Medicaid program by trillions of dollars over the next 10 years — including limits on states’ ability to generate funding for the state share of the costs.</p><h2>AHA Position</h2><p>AHA urges Congress to reject reductions to the Medicaid program that would not only strip access to health care from some of the most vulnerable populations but also destabilize hospitals and health systems, leading to a loss of services that would impact patients and communities nationwide.</p><div class="row"><div class="col-md-6"><p><a href="/system/files/media/file/2025/04/Whats-at-Stake-Medicaid-covers-the-people-you-know.pdf" target="_blank" title="Click here to download the What's at Stake: Medicaid covers the people you know PDF."><img src="/sites/default/files/inline-images/Whats-at-Stake-Medicaid-covers-the-people-you-know.png" data-entity-uuid="01c577ea-dcda-41cc-8c50-1f1e1bfd8db4" data-entity-type="file" alt="What's at Stake: Medicaid covers the people you know. The majority of U.S. residents with Medicaid coverage are children. 39% of children are covered by Medicaid. Medicaid protects access to care for rural communities. Among Medicaid beneficiaries, 47% of children and 18% of adults live in rural communities. Medicaid supports access to essential obstetrics care, behavioral health services, and primary care. 41% of births in the U.S. are covered by Medicaid. Medicaid provides access to care for low-income seniors. 13.7 million seniors in the U.S. are dually eligible for Medicare and Medicaid. Fact: Medicaid chronically underpays for services. Without supplemental payments, Medicaid fee-for-services payments nationally paid 58 cents for every dollar that hospitals spend caring for Medicaid patients, and Medicaid managed care organizations paid 65 cents. Protect Access to Care: The AHA urges Congress to reject reductions to the Medicaid program that would threaten health care access for patients." width="695" height="900"></a></p></div><div class="col-md-6"><p><a href="/system/files/media/file/2025/04/Protect-Access-to-Care-Reject-cuts-to-the-Medicaid-program-and-premium-hikes-on-working-families.pdf" target="_blank" title="Click here to download the Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families PDF."><img src="/sites/default/files/inline-images/Protect-Access-to-Care-Reject-cuts-to-the-Medicaid-program-and-premium-hikes-on-working-families.png" data-entity-uuid="c001b8d1-d304-46e2-900b-524456f65c4c" data-entity-type="file" alt="Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families. If Congress cuts Medicaid, hospitals would see significant imparts that vary by policy: Per Capita Caps for All Medicaid Population: 1-Year National Hospital Impact in 2026 -$47.6 billion; 10-Year National Hospital Impact through 2024: -$468.1 billion. Per Capita Caps for Expansion Population: 1-Year National Hospital Impact in 2026 -$18.9 billion; 10-Year National Hospital Impact through 2024: -$199.9 billion. Eliminate Enhanced FMAP for Expansion Population: 1-Year National Hospital Impact in 2026 -$32 billion; 10-Year National Hospital Impact through 2024: -$360.6 billion. Reduce FMAP Statutory Floor to 45%: 1-Year National Hospital Impact in 2026 -$7.3 billion; 10-Year National Hospital Impact through 2024: -$78.4 billion. Limit Provider Taxes to 5%: 1-Year National Hospital Impact in 2026 -$3 billion; 10-Year National Hospital Impact through 2024: -$32.8 billion. If the Enhanced Premium Tax Credits (EPTCs) expire: 2.2 million individuals are at risk of becoming uninsured in 2026; 4 million individuals are facing higher costs due to loss of Marketplace coverage in 2026; $705 average per person increase in annual premiums in 2026; -$28.2 billion reduction in spending on hospitals over 10 years." width="695" height="900"></a></p></div></div><h2>Key Resources</h2><ul><li><span><strong>NEW:</strong></span> <a href="/fact-sheets/2025-04-14-whats-stake-medicaid-covers-people-you-know">Infographic: What's at Stake: Medicaid covers the people you know.</a></li><li><span><strong>NEW:</strong></span> <a href="/fact-sheets/2025-04-14-protect-access-care-reject-cuts-medicaid-program-and-premium-hikes-working-families">Infographic: Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families.</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-medicaid">Fact Sheet: Medicaid</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-medicaid-provider-taxes">Fact Sheet: Medicaid Provider Taxes</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-medicaid-hospital-payment-basics">Fact Sheet: Medicaid Hospital Payment Basics</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-capita-caps-medicaid-program">Fact Sheet: Per Capita Caps in the Medicaid Program</a></li></ul></div><div class="col-md-4"><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-e8443adcf0e1a201fd8763a360b6f4ab292c73cf4cc66d4875eb029c4bcb2fd2 resource-block"> <h3>Latest Medicaid Advocacy and News</h3> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/news/headline/2025-04-16-dozen-house-republicans-send-letter-opposing-medicaid-cuts" hreflang="en">A dozen House Republicans send letter opposing Medicaid cuts </a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-16T16:02:11-05:00">Apr 16, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/news/headline/2025-04-15-new-aha-resources-demonstrate-impacts-potential-medicaid-cuts-expiration-enhanced-premium-tax-credits" hreflang="en">New AHA resources demonstrate impacts of potential Medicaid cuts, expiration of enhanced premium tax credits </a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-15T14:51:58-05:00">Apr 15, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2025-04-14-take-action-urge-lawmakers-reject-medicaid-cuts-protect-access-care" hreflang="en">TAKE ACTION: Urge Lawmakers to Reject Medicaid Cuts, Protect Access to Care</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-14T12:15:37-05:00">Apr 14, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2025-04-14-whats-stake-medicaid-covers-people-you-know" hreflang="en">What's at Stake: Medicaid covers the people you know.</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-14T10:42:17-05:00">Apr 14, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2025-04-14-protect-access-care-reject-cuts-medicaid-program-and-premium-hikes-working-families" hreflang="en">Protect Access to Care: Reject cuts to the Medicaid program and premium hikes on working families.</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-14T10:10:24-05:00">Apr 14, 2025</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/topics/medicaid">More on Medicaid</a></div> </section> </div> </p></div></div></div> .meta.custom-lock-position { position: relative; top: 0px; right: inherit; display: block; float: right; } Fri, 07 Feb 2025 08:45:00 -0600 Issue Landing Page The Budget Reconciliation Process – Resource Page /issue-landing-page/2025-02-07-budget-reconciliation-process-resource-page <h2>Reconciliation State of Play: 119th Congress</h2><p>This year, House and Senate Republicans are expected to use the budget reconciliation process to pass key agenda items on taxes, energy and border security, and they may look to health measures to pay for this legislation. Reconciliation is a complicated budget tool that gives Congress a fast-track mechanism to avoid the Senate filibuster and pass partisan legislation.</p><p>The following resources provide more details on the reconciliation process:</p><ul><li><a href="/fact-sheets/2025-02-07-fact-sheet-budget-reconciliation-101">AHA Fact Sheet: Budget Reconciliation 101</a></li><li><a href="https://www.youtube.com/watch?v=uVv3BlL8jwE&t=54s" target="_blank" title="YouTube: Budget Reconciliation">AHA Video: Understanding Budget Reconciliation</a></li><li><a href="https://crsreports.congress.gov/product/pdf/R/R44058" target="_blank">CRS Report: The Reconciliation Process: Stages of Consideration</a></li><li><a href="https://crsreports.congress.gov/product/pdf/RL/RL30862" target="_blank">CRS Report: The Reconciliation Process: The Senate’s Byrd Rule</a></li></ul> Fri, 07 Feb 2025 08:12:54 -0600 Issue Landing Page Advocacy Issue: Hospital-at-Home Waivers /advocacy/advocacy-issues/2024-11-01-advocacy-issue-hospital-home-waivers <div class="container"><div class="row"><div class="col-md-8"><h2><span>The Issue</span></h2><p>The hospital-at-home (H@H) model — where patients receive acute level care in their homes, rather than in a hospital — has emerged as an innovative and promising approach to provide high quality care to patients in the comfort of their homes. Since the start of the program, Congress has extended the waivers twice. First in 2022 (Consolidated Appropriations Act of 2023) for two years and then again in 2024 (H.R. 10545 the American Relief Act) for 90 days. Both extensions received no score from the Congressional Budget Office. Congressional action is needed to extend the waivers for this program, which are now set to expire March 31, 2025.</p><h2><span>AHA Position</span></h2><p>The AHA supports the Hospital Inpatient Services Modernization Act to extend the H@H waiver for five years.</p><p>Hospitals and health systems see H@H programs as a safe and innovative way to care for patients in the comfort of their homes. This kind of care is well suited for medium acuity patients who need hospital level care but are considered stable enough to be safely monitored from home. Rather than staying three days or longer in the hospital, these patients can be treated safely by their doctor and a team of medical professionals along with the patient’s support system at home.</p><p>A long-term extension will not only provide additional time to continue gathering data on quality improvement, cost savings, and patient experience, but will also provide much needed stability for new programs and may ease state concerns about updating Medicaid policies to allow for coverage of these services.</p><h2><span>Key Resources</span></h2><ul><li><a href="/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program">Fact Sheet: Extending the Hospital-at-Home Program</a></li><li><a href="/infographics/2024-08-06-infographic-understanding-hospital-home-program">Infographic: Understanding the Hospital At Home Program</a></li><li><a href="/news/perspective/2024-10-18-taking-action-extend-telehealth-and-hospital-home-programs">Perspective: Taking Action to Extend Telehealth and Hospital-at-home Programs</a></li><li><a href="/action-needed-contact-lawmakers-important-issues-facing-hospitals-and-health-systems">ACTION NEEDED: Contact Lawmakers on Important Issues Facing Hospitals and Health Systems</a></li><li><a href="/news/headline/2024-10-01-cms-report-finds-hospital-home-program-safe-effective">CMS report finds hospital-at-home program safe, effective</a></li></ul></div><div class="col-md-4"><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-1c49b00d8afc7c7a627f551fcde577126194b712c388c1528b7d4db7d1af638f resource-block"> <h3>Latest Hospital-at-Home Advocacy and News</h3> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2025-02-07-contact-your-lawmakers-and-urge-them-extend-key-health-care-policies-set-expire-next-month" hreflang="en">Contact Your Lawmakers and Urge Them to Extend Key Health Care Policies Set to Expire Next Month</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-07T15:04:02-06:00">Feb 7, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program" hreflang="en">Fact Sheet: Extending the Hospital-at-Home Program</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-01-26T16:08:20-06:00">Jan 26, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/279" hreflang="en">Member</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/special-bulletin/2024-12-21-congress-passes-bill-funding-government-current-levels-march-extending-key-health-care-provisions" hreflang="en">Congress Passes Bill Funding Government at Current Levels into March, Extending Key Health Care Provisions to Expire</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-12-21T09:54:45-06:00">Dec 21, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/special-bulletin/2024-12-21-house-passes-bill-funding-government-current-levels-march-extending-key-health-care-provisions-due" hreflang="en">House Passes Bill Funding Government at Current Levels into March, Extending Key Health Care Provisions Due to Expire at End of Year</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-12-21T08:06:22-06:00">Dec 21, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/279" hreflang="en">Member</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2024-11-13-aha-asks-congressional-leadership-fund-hospitals-protect-health-care-workers" hreflang="en">AHA Asks Congressional Leadership to Fund Hospitals, Protect Health Care Workers</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-11-13T14:05:33-06:00">Nov 13, 2024</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/topics/hospital-home">More on Hospital at Home</a></div> </section> </div> </p></div></div></div>.meta.custom-lock-position { position: relative; top: 0px; right: inherit; display: block; float: right; } Fri, 01 Nov 2024 08:57:06 -0500 Issue Landing Page Advocacy Issue: Telehealth Waivers /advocacy/advocacy-issues/2024-10-31-advocacy-issue-telehealth-waivers <div class="container"><div class="row"><div class="col-md-8"><h2><span>Background</span></h2><p>At the outset of the COVID-19 pandemic, the federal government moved quickly to ensure hospitals and health systems were able to leverage telehealth services to respond efficiently and effectively to a wave of unprecedented need. These actions included the Centers for Medicare & Medicaid Services (CMS) waiving certain regulatory requirements and Congress providing significant legislative support to ensure hospitals and health systems could rapidly deploy virtual services.</p><p>Given current health care challenges, including major clinician shortages, telehealth holds tremendous potential to leverage geographically dispersed provider capacity to support patient demand.</p><h2><span>AHA Take</span></h2><p>The telehealth flexibilities granted resulted in significant benefits to patient care and are needed now more than ever to ensure patients’ continued access to high-quality care. Currently, there is a patchwork of temporary waivers for telehealth services that, barring further action, will expire in March 2025. If this occurs, we risk a telehealth “cliff” that would negatively impact patient access in all communities.</p><p>Recognizing both the immediate and potential long-term benefits of telehealth, we urge Congress, CMS and other executive agencies to take action to make critical telehealth flexibilities permanent.</p><h2><span>Key Resources</span></h2><ul><li><a href="/fact-sheets/2025-02-07-fact-sheet-telehealth" target="_blank">Fact Sheet: Telehealth Overview</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-telehealth-waivers">Fact Sheet: Telehealth Waivers</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-2025-telehealth-advocacy-agenda">Fact Sheet: 2025 Telehealth Advocacy Agenda</a></li><li><a href="/news/perspective/2024-10-18-taking-action-extend-telehealth-and-hospital-home-programs">Perspective: Taking Action to Extend Telehealth and Hospital-at-home Programs</a></li><li><a href="/testimony/2024-09-18-aha-statement-legislative-proposals-be-considered-energy-and-commerce-committee-sept-18">AHA Statement on Legislative Proposals to be Considered Before Energy and Commerce Committee On Sept. 18</a></li><li><a href="/2024-08-12-aha-comments-340b-drug-pricing-program-irf-payments-physician-fee-schedule-and-telehealth">AHA Comments on 340B Drug Pricing Program, IRF Payments, Physician Fee Schedule and Telehealth</a></li><li><a href="/lettercomment/2024-04-09-aha-letter-support-telehealth-modernization-act-hr-7623">AHA Letter of Support for the Telehealth Modernization Act (H.R. 7623)</a></li></ul></div><div class="col-md-4"><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-ff80f325016f73e774d2effe7e42f0a61ea73b97cbac18c28ac07237d4287776 resource-block"> <h3>Latest Telehealth Advocacy and News</h3> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2025-02-07-fact-sheet-telehealth" hreflang="en">Fact Sheet: Telehealth</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-21T16:41:00-05:00">Apr 21, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/news/headline/2025-04-04-senators-reintroduce-bipartisan-bill-expanding-telehealth-services" hreflang="en">Senators reintroduce bipartisan bill expanding telehealth services </a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-04-04T16:03:33-05:00">Apr 4, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/news/headline/2025-02-14-dea-and-hhs-delay-implementation-buprenorphine-final-rule" hreflang="en">DEA and HHS delay implementation of buprenorphine final rule</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-14T16:03:43-06:00">Feb 14, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2025-02-07-contact-your-lawmakers-and-urge-them-extend-key-health-care-policies-set-expire-next-month" hreflang="en">Contact Your Lawmakers and Urge Them to Extend Key Health Care Policies Set to Expire Next Month</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-07T15:04:02-06:00">Feb 7, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2025-02-07-fact-sheet-telehealth-waivers" hreflang="en">Fact Sheet: Telehealth Waivers</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-07T12:45:00-06:00">Feb 7, 2025</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/topics/telehealth">More on Telehealth</a></div> </section> </div> </p></div></div></div>.meta.custom-lock-position { position: relative; top: 0px; right: inherit; display: block; float: right; } Thu, 31 Oct 2024 13:33:55 -0500 Issue Landing Page Advocacy Issue: Rural MDH and LVA Programs /advocacy/advocacy-issues/2024-10-31-advocacy-issue-rural-mdh-and-lva-programs <div class="container"><div class="row"><div class="col-md-8"><h2><span>The Issue</span></h2><p>Medicare pays most acute-care hospitals under the inpatient prospective payment system (IPPS). Some of these hospitals receive additional support from Medicare to help address potential financial challenges associated with being rural, geographically isolated and low volume. These programs are Medicare-dependent Hospitals (MDHs), Low-volume Adjustment (LVA) and Sole Community Hospitals (SCHs).</p><p><span><strong>Without action from Congress, the MDH and enhanced LVA programs will expire March 31, 2025. As a result, millions of rural Americans are at risk of losing access to care.</strong></span></p><h3><span>Why are these programs important?</span></h3><p>The network of providers that serves rural Americans is financially fragile and more dependent on Medicare revenue due to the high percentage of Medicare beneficiaries who live in rural areas. Rural residents also on average tend to be older, have lower incomes and higher rates of chronic illness than urban counterparts. This greater dependence on Medicare may make certain hospitals more financially vulnerable. Indeed, Medicare only pays 82% of hospital costs on average according to our latest analysis. Additionally, nearly 150 rural hospitals have closed or converted to other provider types since 2010. These designations protect the financial viability of small, rural hospitals to ensure they can continue providing patients access to care.</p><p> </p><h2><span>AHA Position</span></h2><p>The Rural Hospital Support Act (S.335) includes the following important AHA-supported policies to ensure access to care:</p><ul><li>Permanently extends the MDH program and adds an additional base year that hospitals may choose for calculating payments.</li><li>Permanently extends the enhanced LVA program, which would continue to allow hospitals more than 15 miles from another IPPS hospital and have fewer than 3,800 annual total discharges to be eligible.</li><li>Adds a base year that SCHs may select for calculating their payments</li></ul><p>The Assistance for Rural Community Hospitals Act helps rural hospitals continue to serve their patients and communities by extending the current MDH and LVA programs by five years and will soon be reintroduced in the House.</p><h2><span>Key Resources</span></h2><ul><li><a href="/fact-sheets/2022-08-30-fact-sheet-rural-hospital-support-act-s4009-assistance-rural-community">Fact Sheet: Rural Hospital Support Act & the Assistance for Rural Community Hospitals Act</a></li></ul></div><div class="col-md-4"><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-b4670907adf4c83fb2f2f0a60c86631878419a8cfd56dc9ffd6da519c781ba5b resource-block"> <h3>Latest Rural Issues Advocacy and News</h3> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/news/chairpersons-file/2025-03-31-chair-file-leadership-dialogue-importance-advocacy-and-storytelling-rural-health-lori" hreflang="en">Chair File: Leadership Dialogue — Importance of Advocacy and Storytelling in Rural Health with Lori Wightman, R.N., CEO of Bothwell Regional Health Center</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-03-31T10:49:30-05:00">Mar 31, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/lettercomment/2025-03-27-house-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act" hreflang="en">House Letter from AHA, Other Organizations in Support of Conrad State 30 and Physician Access Reauthorization Act (H.R.1585)</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-03-27T12:45:25-05:00">Mar 27, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/lettercomment/2025-03-27-aha-letter-opposing-physician-led-and-rural-access-quality-care-act-hr2191" 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