Representatives Terri Sewell (D-AL) and David McKinley (R-WV), along with Representatives Ann Kuster (D-NH) and Brian Fitzpatrick (R-PA), led the bipartisan reintroduction of the NOPAIN Act (H.R. 3259). The Senate companion bill, S. 586, was introduced earlier this Congress by Senators Shelley Moore Capito (R-WV) and Jeanne Shaheen (D-CA). NRHA is helping advance this legislation alongside our coalition partner Voices for Non-Opioid Choices, also known as Voices, to incentivize the utilization of non-opioid pain management approaches by addressing outdated federal reimbursement policy. You can advocate on behalf of this legislation by visiting the Voices’ action center webpage.

During the Senate Health, Education, Labor, and Pensions (HELP) Primary Health and Retirement Security Subcommittee hearing titled “A Dire Shortage and Getting Worse: Solving the Crisis in the Health Care Workforce,” senators displayed bipartisan support for addressing the nation’s physician shortages. Members of the subcommittee expressed their support for increasing funding for Medicare-supported residency programs and tweaking and expanding those programs to entice medical students to go into primary care practice in medically underserved and rural areas. NRHA is supportive of proposal that prioritize increasing rural residency training slots, as enrolling trainees with rural backgrounds and training residents in rural settings are strategies shown to successfully encourage graduates to practice in rural settings, where health professional shortages are most severe. In NRHA’s fiscal year (FY) 2022 appropriations requests, we urge Congress to expand the Rural Residency Planning and Development Program to support the development of new rural residency programs.

From Modern Healthcare

The steep rise in rural hospital closures over the past decade is hurting many emergency medical service providers, worrying public experts tracking response times.

The average length of ambulance trips increased by 22% among municipally-run, EMS agencies and 10% among privately-owned providers between 2012 and 2018 in locations where a recent rural hospital closure took place, according to a new study from the University of Minnesota School of Public Health.

The actual number of trips those providers made did not change during the study period. But the analysis found rural EMS providers decreased their number of non-emergency and inter-facility transfer trips by 31%. Lead study author Sayeh Nikpay, associate professor in the division of health policy and management at the University of Minnesota School of Public Health, said the drop in planned trips made it harder for EMS providers to dispatch ambulances in a way that ensured communities had adequate coverage.

“Taking someone from the community to a hospital-based clinic is more predictable and has the benefit of bringing people in the community access to their primary care,” Nikpay said.

Nikpay said the burden of hospital closures is particularly acute among municipal EMS providers. While private firms have the option to discontinue providing ambulance services when it no longer is financially viable, municipal agencies are forced to adjust, which Nikpay said often leads to limited resources and personnel that can affect the quality of those services.

“It’s difficult for EMS agencies to retain people, to recruit new people, and the people that are there feel a lot of strain,” Nikpay said.

Researchers said the problems facing rural public EMS agencies is a growing public health concern. It’s putting more wear and tear on their equipment and increasing the “dead time” being spent traveling back to ambulance bases. EMS providers also have less time to restock and maintain vehicles.

Nikpay said the strain on rural EMS providers has only been exacerbated by the pandemic.

Last year, 19 rural hospitals closed, according to figures from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill, the highest number for a single year since the center began tracking. Overall, 180 rural hospitals have closed since 2005, with more than three-fourths occurring since 2010.

Nikpay said the study’s findings suggest policymakers need to also look at ways of supporting EMS providers when addressing issues related to bolstering the country’s rural healthcare system.

“We shouldn’t just be thinking about the hospitals when we talk about rural healthcare, we should also think about the EMS agencies as well,” Nikpay said.

In 2009, the last time federal agencies gave away billions of dollars for broadband, there were two agencies tasked with dispensing roughly $3.5 billion each. They had a year and a half to do what was then considered miracle work pushing that that much money out the door that quickly. Sometimes it wasn’t pretty, but they got it done.

Today, the Federal Communications Commission (FCC) is responsible for dispersing more than three times as much money through E-rate and the Emergency Broadband Benefit (EBB) programs. The money comes with a mandate to act as quickly as possible.

So things are predictably frantic, the rules are not particularly clear, and there’s a lot of wailing and gnashing of teeth about incumbents (the local telecommunications companies that were in place before deregulation in 1996) lining up at the “socialist trough.”

Read more.