Medicare

Medicare / en Fri, 25 Apr 2025 10:29:13 -0500 Tue, 15 Apr 25 13:22:45 -0500 AHA Supports House Securing Access to Care for Seniors in Critical Condition Act /lettercomment/2025-04-15-aha-supports-house-securing-access-care-seniors-critical-condition-act April 15, 2025The Honorable Kevin Hern U.S. House of Representatives 171 Cannon House Office Building Washington, DC 20515The Honorable Brendan Boyle U.S. House of Representatives 1502 Longworth House Office Building Washington, DC 20515Dear Representatives Hern and Boyle:On behalf of our nearly 5,000 member hospitals and health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and our 2,425 post-acute care members, the �� Association (AHA) is pleased to support the Securing Access to Care for Seniors in Critical Condition Act (H.R. 1924).Long-term care hospitals (LTCHs) play a unique role for Medicare and other beneficiaries by caring for the most severely ill and medically complex patients, who often require extended hospitalization and highly specialized care. LTCHs are critical partners for acute-care hospitals, alleviating capacity for overburdened intensive care units and other parts of the care continuum that would otherwise be further strained without access to LTCHs for these patients.Since implementing the dual-rate payment system in 2016, the volume of LTCH standard-rate cases has fallen by approximately 70% from its peak under the prior system, and the number of LTCH providers has decreased by 20%. At the same time, the average acuity of LTCH patients has risen by 20% or more in that same period, and these patients are increasingly consolidated into a limited number of Diagnosis-Related Groups (DRGs).1 The smaller yet sicker patient population and dwindling reimbursement have created many challenges for LTCHs, as evidenced by the closure of so many of these facilities. The remaining patient pool is notably more acute and costly to treat, resulting in cases increasingly qualifying for high-cost outlier (HCO) payments to compensate for the lack of precision in the DRGs, as so many cases are consolidated into a limited number of DRGs. However, the fixed-loss amount for HCO cases has risen by more than 300% since 2016, forcing LTCHs to take on significant financial losses when caring for these particularly ill patients.For these reasons, the AHA supports legislation that would provide more adequate reimbursement to LTCH providers caring for some of Medicare’s sickest beneficiaries. Thank you for your leadership on these important issues to ensure patients have continued access to this vital care.Sincerely,/s/Lisa Kidder Hrobsky Senior Vice President Advocacy and Political Affairs __________1<a href=/white-papers/2023-12-29-white-paper-medicares-ltch-outlier-policy-needs-reforms-protect-extremely-ill-beneficiaries" target="_blank"> /white-papers/2023-12-29-white-paper-medicares-ltch-outlier-policy-needs-reforms-protect-extremely-ill-beneficiaries</a> Tue, 15 Apr 2025 13:22:45 -0500 Medicare AHA calls on MedPAC to act on physician fee schedule payments following recommendations /news/headline/2025-04-04-aha-calls-medpac-act-physician-fee-schedule-payments-following-recommendations The AHA today <a href="/lettercomment/2025-04-04-aha-comments-medpac-physician-fee-schedule-payment-recommendations">urged</a> the Medicare Payment Advisory Commission to take specific actions on physician fee schedule payments following recommendations the commission made during its March meeting. The AHA urged MedPAC to recommend a full inflationary update to physician payment instead of an update based on a portion of the Medicare Economic Index. Additionally, the AHA called for MedPAC to remove recommendations to update relative value unit calculations and urged the commission to reiterate its concerns about expiring alternative payment model incentive payments.&nbsp; &nbsp; Fri, 04 Apr 2025 16:02:02 -0500 Medicare Chair File: Leadership Dialogue — Importance of Advocacy and Storytelling in Rural Health with Lori Wightman, R.N., CEO of Bothwell Regional Health Center /news/chairpersons-file/2025-03-31-chair-file-leadership-dialogue-importance-advocacy-and-storytelling-rural-health-lori Rural hospitals and health systems face big challenges, but together — with a unified voice — we can work to ensure people living in rural communities get the safe, quality health care they need.In this Leadership Dialogue, I’m joined by Lori Wightman, R.N., CEO of Bothwell Regional Health Center, in Sedalia, Mo. Lori and I discuss working in a “family atmosphere” unique to a rural hospital and navigating the same pressures that face urban hospitals, including workforce shortages and the high costs of labor, supplies and drugs. Rural hospitals also experience severe underpayments by Medicare and Medicaid, and most have “razor-thin” operating margins.Lori describes leading annual advocacy days — where Bothwell board members meet with state legislators (and candidates in election years) — and emphasizes the importance of all team members telling the hospital story.I hope you find our conversation insightful and strategic. Look for future conversations with health care, business and community leaders on making health better as part of the Chair File in 2025. &nbsp;<a href="https://www.youtube.com/watch?v=P0QCVh9HyZ4&amp;embeds_referring_euri=https%3A%2F%2Fwww.aha.org%2F&amp;source_ve_path=OTY3MTQ" target="_blank" title="YouTube: Leadership Dialogue Series: Importance of Advocacy and Storytelling in Rural Health">Watch the Leadership Dialogue on YouTube.</a><hr><div></div><a href="https://player.captivate.fm/episode/934a92c6-6fc0-4245-b43b-0c44a2bc9ea4" target="_blank" title="Captivate: Leadership Dialogue Series: The Importance of Advocacy and Storytelling in Rural Health">Listen to the Leadership Dialogue on Captivate.</a>&nbsp;<div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript </h2> </summary> 00:00:01:05 - 00:00:23:09 Tom Haederle Welcome to Advancing Health. In the face of today's multiple challenges, every hospital needs support and buy in for its mission of great care. Storytelling - sharing the right kinds of stories with the right audience at the right time - is a great way to build and maintain that support. This is particularly important for rural hospitals and health systems, most of which have razor-thin operating margins. 00:00:23:12 - 00:00:40:10 Tom Haederle In this month's Leadership Dialogue, hosted by the �� Association's 2025 Board Chair Tina Freese Decker, we hear more about the importance of advocacy and of all team members participating in telling the hospital story. 00:00:40:13 - 00:01:07:25 Tina Freese Decker Thank you so much for joining us today. I'm Tina Freese Decker, president CEO for Corewell Health, and I'm also the board chair for the �� Association. Last month we talked about trust and how our hospitals and our health systems can strengthen that trust with our communities and the people that we serve. Our rural hospitals are uniquely positioned to do this, as they are often the largest employers in their towns and communities, and frequently the only local source of care. 00:01:07:27 - 00:01:28:07 Tina Freese Decker Rural health care is about being a family. We take care of each other in our communities as best as possible, and we're here to provide that care close to home, no matter what headwinds that we all face. I recently had the opportunity to attend the �� Association's Rural Conference and you could really feel that sense of family and community in the room. 00:01:28:09 - 00:01:59:15 Tina Freese Decker We work in hospitals in red states and blue states all across the country, but we are all focused on the same thing: helping our neighbors in our communities to be healthier. There are some big challenges that are facing real health care, but together with a unified voice, we can get what we need. As I have traveled around our country meeting with the �� Association's regional policy boards and visiting the rural hospitals and my health system and others, the number one concern that I have heard from our hospitals, our communities, is access. 00:01:59:18 - 00:02:22:28 Tina Freese Decker And that is why it is so integral to the �� Association strategy and it is why it is so important that we come together as a field and that we're united as a field, because these challenges that we are facing are real. So today, I am pleased to have a distinguished leader in rural health care with us to talk about how we can all work together to advocate for the needs of our hospitals. 00:02:23:01 - 00:02:45:09 Tina Freese Decker I'd like to welcome Lori Wightman. She is the CEO of Bothwell Regional Health Center, a 108 bed acute care hospital in Sedalia, Missouri. Laura has served in this role since 2019, but even prior to Bothwell, she worked in real health care as the president of Mercy Hospital Ada in Ada, Oklahoma. So, Lori, welcome. Glad you were able to join us today. 00:02:45:15 - 00:02:46:17 Lori Wightman, R.N. Thank you, Tina. 00:02:46:19 - 00:03:03:20 Tina Freese Decker And I wanted to start out with just telling us a little bit about yourself. I know you started your health care career as a nurse and then you made the shift to administration. Can you tell us about yourself and how you see that family aspect in the hospital and the community in our rural areas? 00:03:03:22 - 00:03:30:01 Lori Wightman, R.N. Sure. Well, my father was a hospital administrator and my mother was a nurse, so I did both. And so it was a natural progression. And I think the foundation that nursing lays gives you all kinds of transferable skills that have been very helpful as I went into hospital administration. My career and dating advice has always been, you can't go wrong with a nurse. 00:03:30:03 - 00:03:57:14 Lori Wightman, R.N. And there's certainly served me well. And you talk about that family atmosphere. That is why I continue to choose rural health care. I've done the CEO position in a suburban hospital, and I sat at our senior leadership team meeting and thinking I was the only one on our senior leadership team that even lived in the area that we served. 00:03:57:17 - 00:04:23:24 Lori Wightman, R.N. Everyone else lived in a different suburb, and I just thought that was strange and disconnected. And, so I returned again then to rural health care because it is like a family. And it's ironic because we just finished revisiting our mission, vision and values. And our new mission statement talks about together we work to provide compassionate and safe care to family, friends, and neighbors. 00:04:23:27 - 00:04:37:07 Lori Wightman, R.N. Invariably, when I met new employee orientation, a significant number of people were born at the hospital. That's why I love rural. It's like that "Cheers" phenomenon where everyone knows your name. 00:04:37:09 - 00:05:01:02 Tina Freese Decker Very true. I used to lead a couple of rural hospitals as well. And like you said, even just walking into a rural hospital it feels like family where everyone there knows your name and of course, protect things from a confidentiality and a privacy perspective, but that feeling that we're all in this together. So I love that your mission statement is about together, that you can make an impact on people's health. 00:05:01:05 - 00:05:13:28 Tina Freese Decker I described a little bit about what it's like to walk into a rural hospital. Can you share a little bit about what is like to be a rural hospital, what it means in today's environment and why it's such a great place to work? 00:05:14:01 - 00:05:47:06 Lori Wightman, R.N. Well, in many ways, rural hospitals are uniquely the same as our suburban or urban counterparts. Forty six million people depend on a rural hospital for their care. So we struggle with the same labor shortages, the cost of labor supplies and drugs is rising faster than our reimbursement. We have all of those same struggles. Unique is that family atmosphere, I think. 00:05:47:06 - 00:06:13:26 Lori Wightman, R.N. And we have multiple generations working at the hospital. Now, you can't say anything bad about anyone because invariably they're somehow related. Or they were best friends in high school, or they used to be married to each other. So I mean, it's unique in that way. We have the same types of struggles that &nbsp;our counterparts do. 00:06:13:28 - 00:06:18:03 Tina Freese Decker What pressures are you feeling the most acutely right now? 00:06:18:06 - 00:06:47:09 Lori Wightman, R.N. Well, you take all of those common challenges that I talked about, and you turn up the volume a little bit. Because for us, 78% of our patients and our volume is governmental payers, so 78% of our business, we're getting reimbursed below cost. You can't make that up in volume. So we rely on all of the governmental programs, you know, disproportionate share all of those things. 00:06:47:09 - 00:06:54:22 Lori Wightman, R.N. And, 340B is doing exactly for us what it was designed to do, save rural hospitals. 00:06:54:25 - 00:07:11:22 Tina Freese Decker Those areas are critical that they remain. And so that we can continue to provide that sustainable, high quality care in our communities and all of our communities. 78% being governmental. It's a huge portion of what we do and what we rely on for access and caring for people. 00:07:11:29 - 00:07:23:15 Lori Wightman, R.N. Right. We are the typical rural hospital. We have razor-thin margins and aging plant of 18 years. 00:07:23:18 - 00:07:31:10 Tina Freese Decker So those are challenges that you're trying to navigate right now with all of the other things that happen. And how is your staffing levels going? Are those going okay? 00:07:31:13 - 00:07:55:12 Lori Wightman, R.N. Have the same labor shortage issues. We still have 22 traveling nurses here, but we have started being very aggressive in a grow your own program. And so as soon as the next month we're going to cut that number in half and then, within six months, we're hoping to have all of contract staff out. 00:07:55:15 - 00:08:02:04 Tina Freese Decker Is that something that you're most proud of, or is there something else that you want to share that you're most proud of from a rural hospital perspective? 00:08:02:06 - 00:08:29:24 Lori Wightman, R.N. I think what I'm most proud of is you get to personally view the impact of your decisions on people. I'm very proud of our all the talented people that we have here, from clinicians to community health workers. All of our physicians get to use all of the things they learned in medical school and residency, because there isn't a lot of subspecialists, so they are working at the top of their license. 00:08:29:26 - 00:08:50:21 Lori Wightman, R.N. Just several months ago, one of our critical care physicians diagnosed a case of botulism. Now as an old infection control nurse I get very excited about that because I never thought in my career I would see botulism. But it was diagnosed and treated here and the person's doing well. 00:08:50:23 - 00:09:25:27 Tina Freese Decker Oh, that's wonderful to hear. When you talk about all the different people that are part of health care in rural settings, or also another settings, it's quite amazing to see how many different areas we need to come together to take care of our community. When you think about an even larger scale, from rural hospitals to urban and teaching hospitals and others, how do you think about the whole ecosystem of our field and how we, you know, do we need all of us or and is there a way to form that greater fabric and social connection, or is there something else that we should be doing? 00:09:25:29 - 00:09:50:21 Lori Wightman, R.N. We are all very interconnected and I believe we are all needed. And I especially feel that as an independent hospital, not part of a health system, this is my first independent hospital. I rely on my hospital association more than I ever did when I was working for a health system, because it all comes down to relationships. 00:09:50:21 - 00:10:18:13 Lori Wightman, R.N. And so how do you develop, how do you get yourself in situations where you are meeting and now working with your partners around the state or the region? Because it comes down to relationships, you really need to know who your neighbors are in terms of other hospitals, who you're referring your patients to and develop that working relationship because it is all interconnected. 00:10:18:13 - 00:10:25:06 Lori Wightman, R.N. And we rely on our partners that we refer to, and they rely on us, too. 00:10:25:08 - 00:10:43:23 Tina Freese Decker One of the things I heard you say about the Rural Health Conference that the �� Association just put on, and the value of the �� Association is that we're not alone. And those values of relationships are really critical. So I appreciate that. The �� Association also talks a lot about how do we tell the hospital story. 00:10:43:25 - 00:10:55:15 Tina Freese Decker So how do you engage in advocacy to make sure we're telling that hospital story so that our legislative leaders and others know the value that we're bringing to the community? 00:10:55:17 - 00:11:22:11 Lori Wightman, R.N. Well, we are surrounded by stories. And so the first thing is to always be picking up on what is the story that is surrounding us, and how can we capture that? Because the most effective way is to bring that patient or nurse or physician to the legislator to testify, because they are the most effective way of communicating a message. 00:11:22:18 - 00:11:49:07 Lori Wightman, R.N. You know, the suits can go and talk about data, but nothing is more effective than what I call a real person telling their story and how a decision or a potential decision is going to impact them and how it feels. The other thing we do is every October, it's become tradition. We have Advocacy Day with our board, at our board meeting. 00:11:49:09 - 00:12:21:12 Lori Wightman, R.N. We invite our state elected officials &nbsp;- so people representing us at the state capitol - to come to our board meetings. On election years their challengers also come and I invite the hospital association and they all answer two questions: What do you hope to accomplish in the next legislative session, and what do you think might get in the way? That sets the scene for my board to understand that part of their role in governance is advocacy. 00:12:21:14 - 00:12:29:19 Lori Wightman, R.N. And so I've had two of my board members...almost every legislative session I go and testify on on some bill. 00:12:29:21 - 00:12:50:01 Tina Freese Decker That is really a good idea. Thank you so much for sharing that. Do you have any other final suggestions for us as AHA members, as other hospitals, whether it's rural or urban, that we should think about or do as we think about advocacy and access or also field unity? 00:12:50:03 - 00:13:22:11 Lori Wightman, R.N. You know, having been on the board of two different state hospital associations, I get it. You know, sometimes members can be at odds with each other on a given issue. And my advice to AHA would be to play the role of convener, facilitating conversations between members to better understand each other's position. And if a middle ground can't be reached, then that might be an issue that AHA remains neutral on. 00:13:22:14 - 00:13:34:07 Lori Wightman, R.N. But there are so many issues where we can agree on and that is very much the role and what all of us depend on AHA to play in advocating. 00:13:34:09 - 00:14:02:15 Tina Freese Decker There's a lot that binds us together. Like you said, we're all caring for our neighbors and our communities, and that's the most critical piece of it. And we have to keep that front and center with every decision that we make and every action that we do. Well, Lori, thank you so much for being with us today on this AHA podcast, for sharing your expertise in rural health care and for talking about some new ideas that all of us can take forward to ensure that we're telling the hospital story in the best way possible. 00:14:02:18 - 00:14:21:09 Tina Freese Decker So while I know that we have our work ahead of us, I know that I continue to be energized every time I speak with committed and passionate hospital leaders like Lori. Again, appreciate your work that you do every single day for the neighbors and for the people in your community that you serve. We'll be back next month for another Leadership Dialogue conversation. 00:14:21:13 - 00:14:23:01 Tina Freese Decker Have a great day. 00:14:23:03 - 00:14:31:13 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </details> </div> Mon, 31 Mar 2025 10:49:30 -0500 Medicare HHS announces restructuring plan /news/headline/2025-03-27-hhs-announces-restructuring-plan The Department of Health and Human Services March 27 announced a series of actions as part of a department-wide restructuring. The department said the moves would not impact critical services.&nbsp; The plan includes a reduction of its workforce by 10,000 employees and consolidating the 28 divisions of the agency to 15, including a new Administration for a Healthy America. The new division combines the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health into a single entity.&nbsp; The agency said the changes would make it “more responsive and efficient while ensuring that Medicare, Medicaid, and other essential health services remain intact.”&nbsp; For more details on the plan, view the HHS <a href="https://www.hhs.gov/about/news/hhs-restructuring-doge.html">announcement</a>. Thu, 27 Mar 2025 15:37:45 -0500 Medicare Senate Letter from AHA, Other Organizations in Support of Conrad State 30 and Physician Access Reauthorization Act S.709 /lettercomment/2025-03-27-senate-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act <div class="container"><div class="row"><div class="col-md-8">March 26, 2025<div class="row"><div class="col-md-6">The Honorable David Valadao US House of Representatives 2465 Rayburn House Office Building Washington D.C., 20515</div><div class="col-md-6">The Honorable Brad Schneider US House of Representatives 300 Cannon House Office Building Washington D.C., 20515</div></div><div class="row"><div class="col-md-6">The Honorable Don Bacon US House of Representatives 2104 Rayburn House Office Building Washington D.C., 20515</div><div class="col-md-6">The Honorable Sylvia Garcia US House of Representatives 2419 Rayburn House Office Building Washington D.C., 20515</div></div></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/senate-letter-from-aha-other-organizations-in-support-of-conrad-state-30-and-physician-access-reauthorization-act-s709-3-26-2025.pdf" target="_blank">Download the Senate Letter PDF</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/lettercomment/2025-03-27-house-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act" target="_blank">Read the House Letter</a></div></div></div><div class="row"><div class="col-md-8">Dear Senators Klobuchar, Collins, Rosen, and Tillis:On behalf of the 45 undersigned organizations, we are writing to strongly support the introduction of the Conrad State 30 and Physician Access Reauthorization Act (S. 709).The healthcare workforce is under increasing strain. The aging U.S. population is increasing demand for healthcare services while also contributing to physician attrition. At the same time, reimbursement challenges in Medicare, along with insufficient investment in graduate medical education, have made the practice of medicine more difficult and constrained the pipeline of new doctors. These challenges are particularly acute in rural and underserved communities, where workforce shortages have led to severe access issues. Today, more than 80 million Americans lack adequate access to primary care, exacerbating health disparities across the country.Confronting this challenge will require a comprehensive approach from Congress. A key part of the solution is leveraging international medical graduates (IMGs). One in five physicians in the U.S. is foreign-born, and these doctors play an essential role in filling workforce shortages in areas and specialties that struggle to recruit and retain physicians. These include geriatric medicine, interventional cardiology, nephrology, neurology, and critical care medicine, where IMGs are disproportionately represented. The Conrad 30 program is an effective tool for incentivizing U.S.-trained international physicians to work in these high-need areas.Over the last 30 years, the program has facilitated placement of approximately 20,000 physicians in communities that otherwise might not have had access to health care. The program has also demonstrated success at retaining physicians beyond the three-year commitment. However, misaligned incentives and outdated policies are jeopardizing the future success of the program.The Conrad State 30 and Physician Access Reauthorization Act would make necessary updates to strengthen the program. In addition to gradually increasing the number of available waivers per state if certain thresholds are met, it also clarifies and improves the waiver process for both physicians and employers by making clear the transition period between receiving a waiver and beginning work. These commonsense changes will improve program efficiency and help ensure that more IMGs can pursue opportunities in underserved areas.One of the strengths of the Conrad 30 program is its flexible design, which allows each state to tailor the program to meet its specific healthcare needs. This reauthorization will reinforce that flexibility while providing needed clarity and incentives to attract and retain more highly qualified physicians. As workforce shortages worsen, Congress must act with urgency to advance this legislation and strengthen one of the most successful programs for addressing healthcare workforce shortages.Thank you again for your leadership on this important issue. We look forward to working with you to advance this bill and ensure that the Conrad 30 program continues to serve as a healthcare and economic lifeline for communities in need.Sincerely,Alliance for Headache Disorders Advocacy Ambulatory Surgery Center Association American Academy of Family Physicians American Academy of Neurology American Academy of Physical Medicine and Rehabilitation American Association of Child and Adolescent Psychiatry American Association of Neuromuscular &amp; Electrodiagnostic Medicine American Brain Coalition American College of Obstetricians and Gynecologists American College of Physicians American College of Radiology American College of Rheumatology American College of Surgeons American Gastroenterological Association American Geriatrics Society �� Association American Medical Association American Psychiatric Association American Society of Anesthesiologists American Society of Neuroradiology Anxiety and Depression Association of America Association for Advancing Physician and Provider Recruitment (AAPPR) Association of Clinicians for the Underserved (ACU) Association of American Medical Colleges Association of University Professors of Neurology College of American Pathologists Bobby Jones Chiari &amp; Syringomyelia Foundation Dystonia Medical Research Foundation Federation of ��s (FAH) Hope for HIE Hydrocephalus Association Infectious Diseases Society of America International Bipolar Foundation M-CM Network Miles for Migraine MLD Foundation NANOS (North American Neuro- opthalmology Society) National Ataxia Foundation The Niskanen Center Phelan-McDermid Syndrome Foundation Physicians for American Healthcare Access (PAHA) Premier Inc. Society of Hospital Medicine The Society of Thoracic Surgeons SynGAP Research Fund dba CURE SYNGAP1 &nbsp;</div></div></div> Thu, 27 Mar 2025 13:13:34 -0500 Medicare House Letter from AHA, Other Organizations in Support of Conrad State 30 and Physician Access Reauthorization Act (H.R.1585) /lettercomment/2025-03-27-house-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act <div class="container"><div class="row"><div class="col-md-8">March 26, 2025<div class="row"><div class="col-md-6">The Honorable David Valadao US House of Representatives 2465 Rayburn House Office Building Washington D.C., 20515</div><div class="col-md-6">The Honorable Brad Schneider US House of Representatives 300 Cannon House Office Building Washington D.C., 20515</div></div><div class="row"><div class="col-md-6">The Honorable Don Bacon US House of Representatives 2104 Rayburn House Office Building Washington D.C., 20515</div><div class="col-md-6">The Honorable Sylvia Garcia US House of Representatives 2419 Rayburn House Office Building Washington D.C., 20515</div></div></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/house-letter-from-aha-other-organizations-in-support-of-conrad-state-30-and-physician-access-reauthorization-act-h-r585-letter-3-26-2025.pdf" target="_blank">Download the House Letter PDF</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/lettercomment/2025-03-27-senate-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act" target="_blank">Read the Senate Letter</a></div></div></div><div class="row"><div class="col-md-8">Dear Representatives Valadao, Schneider, Bacon, and Garcia:On behalf of the 45 undersigned organizations, we are writing to strongly support the introduction of the Conrad State 30 and Physician Access Reauthorization Act (H.R. 1585).The healthcare workforce is under increasing strain. The aging U.S. population is increasing demand for healthcare services while also contributing to physician attrition. At the same time, reimbursement challenges in Medicare, along with insufficient investment in graduate medical education, have made the practice of medicine more difficult and constrained the pipeline of new doctors. These challenges are particularly acute in rural and underserved communities, where workforce shortages have led to severe access issues. Today, more than 80 million Americans lack adequate access to primary care, exacerbating health disparities across the country.Confronting this challenge will require a comprehensive approach from Congress. A key part of the solution is leveraging international medical graduates (IMGs). One in five physicians in the U.S. is foreign-born, and these doctors play an essential role in filling workforce shortages in areas and specialties that struggle to recruit and retain physicians. These include geriatric medicine, interventional cardiology, nephrology, neurology, and critical care medicine, where IMGs are disproportionately represented. The Conrad 30 program is an effective tool for incentivizing U.S.-trained international physicians to work in these high-need areas.Over the last 30 years, the program has facilitated placement of approximately 20,000 physicians in communities that otherwise might not have had access to health care. The program has also demonstrated success at retaining physicians beyond the three-year commitment. However, misaligned incentives and outdated policies are jeopardizing the future success of the program.The Conrad State 30 and Physician Access Reauthorization Act would make necessary updates to strengthen the program. In addition to gradually increasing the number of available waivers per state if certain thresholds are met, it also clarifies and improves the waiver process for both physicians and employers by making clear the transition period between receiving a waiver and beginning work. These commonsense changes will improve program efficiency and help ensure that more IMGs can pursue opportunities in underserved areas.One of the strengths of the Conrad 30 program is its flexible design, which allows each state to tailor the program to meet its specific healthcare needs. This reauthorization will reinforce that flexibility while providing needed clarity and incentives to attract and retain more highly qualified physicians. As workforce shortages worsen, Congress must act with urgency to advance this legislation and strengthen one of the most successful programs for addressing healthcare workforce shortages.Thank you again for your leadership on this important issue. We look forward to working with you to advance this bill and ensure that the Conrad 30 program continues to serve as a healthcare and economic lifeline for communities in need.Sincerely,Alliance for Headache Disorders Advocacy Ambulatory Surgery Center Association American Academy of Family Physicians American Academy of Neurology American Academy of Physical Medicine and Rehabilitation American Association of Child and Adolescent Psychiatry American Association of Neuromuscular &amp; Electrodiagnostic Medicine American Brain Coalition American College of Obstetricians and Gynecologists American College of Physicians American College of Radiology American College of Rheumatology American College of Surgeons American Gastroenterological Association American Geriatrics Society �� Association American Medical Association American Psychiatric Association American Society of Anesthesiologists American Society of Neuroradiology Anxiety and Depression Association of America Association for Advancing Physician and Provider Recruitment (AAPPR) Association of Clinicians for the Underserved (ACU) Association of American Medical Colleges Association of University Professors of Neurology College of American Pathologists Bobby Jones Chiari &amp; Syringomyelia Foundation Dystonia Medical Research Foundation Federation of ��s (FAH) Hope for HIE Hydrocephalus Association Infectious Diseases Society of America International Bipolar Foundation M-CM Network Miles for Migraine MLD Foundation NANOS (North American Neuro- opthalmology Society) National Ataxia Foundation The Niskanen Center Phelan-McDermid Syndrome Foundation Physicians for American Healthcare Access (PAHA) Premier Inc. Society of Hospital Medicine The Society of Thoracic Surgeons SynGAP Research Fund dba CURE SYNGAP1</div></div></div> Thu, 27 Mar 2025 12:45:25 -0500 Medicare Senate Finance Committee holds confirmation hearing for CMS administrator nominee Mehmet Oz /news/headline/2025-03-14-senate-finance-committee-holds-confirmation-hearing-cms-administrator-nominee-mehmet-oz The Senate Finance Committee March 14 held a confirmation <a href="https://www.finance.senate.gov/hearings/hearing-to-consider-the-nomination-of-mehmet-oz-of-pennsylvania-to-be-administrator-of-the-centers-for-medicare-and-medicaid-services-vice-chiquita-brooks-lasure-resigned">hearing</a> on Mehmet Oz's nomination for administrator of the Centers for Medicare &amp; Medicaid Services. Oz, a doctor and former television show host, indicated that some of his priorities in the position, if confirmed, would be to reduce health care spending by improving poor health, increasing use of technology, incentivizing providers, and stopping wasteful spending, fraud and abuse. The committee will soon schedule a vote on whether to advance his nomination to the full Senate. &nbsp; Fri, 14 Mar 2025 15:17:03 -0500 Medicare MedPAC report to Congress details FY 2026 recommendations /news/headline/2025-03-14-medpac-report-congress-details-fy-2026-recommendations The Medicare Payment Advisory Commission March 13 released its March <a href="https://www.medpac.gov/wp-content/uploads/2025/03/Mar25_MedPAC_Report_To_Congress_SEC.pdf">report </a>to Congress that includes recommendations for hospital and other Medicare payment systems for fiscal year 2026. Among the recommendations, MedPAC urged Congress to update the base payment rate for hospitals by current law plus 1%. &nbsp; “An update above current law is necessary given the combination of providers’ continued financial pressures, and almost two decades of sustained and substantial negative Medicare margins,” AHA wrote in a January <a href="/2025-01-10-aha-comments-advance-medpac-january-2025-meeting">letter</a> to MedPAC. “Simply put, even after the recommended payment update, Medicare’s payments to hospitals would remain inadequate.”&nbsp; Fri, 14 Mar 2025 15:06:06 -0500 Medicare CMS Innovation Center to end four payment models early /news/headline/2025-03-13-cms-innovation-center-end-four-payment-models-early The Centers for Medicare &amp; Medicaid Services March 12 <a href="https://www.cms.gov/newsroom/fact-sheets/cms-innovation-center-announces-model-portfolio-changes-better-protect-taxpayers-and-help-americans" target="_blank">announced</a> that it will end four payment models early, terminating each by the end of 2025. The models are <a href="https://www.cms.gov/priorities/innovation/innovation-models/primary-care-first-model-options" target="_blank">Primary Care First</a>, <a href="https://www.cms.gov/priorities/innovation/innovation-models/esrd-treatment-choices-model" target="_blank">End-Stage Renal Disease Treatment Choices</a>, <a href="https://www.cms.gov/priorities/innovation/innovation-models/making-care-primary" target="_blank">Making Care Primary</a> and <a href="https://www.cms.gov/priorities/innovation/innovation-models/md-tccm" target="_blank">Maryland Total Cost of Care</a>. CMS also is considering reductions to the <a href="https://www.cms.gov/priorities/innovation/innovation-models/integrated-care-for-kids-model" target="_blank">Integrated Care for Kids</a> model.In addition, the CMS Innovation Center will no longer implement the <a href="https://www.cms.gov/priorities/innovation/innovation-models/medicare-two-dollar-drug-list-model" target="_blank">Medicare $2 Drug List</a> or Accelerating Clinical Evidence models. Thu, 13 Mar 2025 14:33:10 -0500 Medicare House bill reintroduced extending Medicare-dependent hospital and low-volume adjustment programs /news/headline/2025-03-04-house-bill-reintroduced-extending-medicare-dependent-hospital-and-low-volume-adjustment-programs The AHA voiced support for the <a href="https://drive.google.com/file/d/1hkKfqOreDeQl1odhv-6b-eS-K7jpUodh/view" title="RCHA">Assistance for Rural Community Hospitals Act</a>, legislation reintroduced March 3 by Reps. Carol Miller, R-W.Va., and Terri Sewell, D-Ala., that would extend the Medicare-dependent hospital and low-volume adjustment programs for five years each.&nbsp;“These payments allow MDHs greater financial stability and leave them better able to serve their patients and communities,” AHA <a href="/lettercomment/2025-03-04-aha-comments-assistance-rural-community-hospitals-act-hr-1805" title="comment letter">wrote</a> in comments to Miller and Sewell. “The current, improved low-volume adjustment better accounts for the relationship between cost and volume, helps level the playing field for low-volume providers, and improves access to care in rural areas.”&nbsp; Tue, 04 Mar 2025 15:16:45 -0600 Medicare