As many of us work to preserve and ideally expand healthcare in our districts, rural communities face unique challenges.  A variety of solutions are needed to keep doors open and services available.  It is our duty to seek new options for providers to consider when making decisions about how best to operate their facilities.
 
The Centers for Medicare & Medicaid Services (CMS) designed a new provider type called the Rural Emergency Hospital (REH).  This model seeks to reduce rural hospital closures through innovative payment reform and a better alignment of outpatient services with the rural community’s healthcare needs.  It is the first new rural provider type since the Critical Access Hospital was established almost 30 years ago.
 
In Pennsylvania, we understand just how important the Critical Access Hospital model is to rural healthcare.  The Department of Health and key stakeholders have been working to better understand the new CMS provider type and create a platform for the commonwealth to participate.
 
My legislation will create a new license category, still under Department of Health oversight like all other hospitals.  In the event that inpatient care is not financially sustainable, the REH model would allow a Critical Access Hospital or a rural hospital with 50 or less beds to enroll as a Rural Emergency Hospital.  In doing so, the hospital will receive the Outpatient Prospective Payment System rate plus 5 percent for REH-covered services.  In addition, the REH would receive a monthly facility payment that increases over time, allowing communities to retain access to critical services such as emergency department services, observation care, and outpatient primary care. 
 
With this bill, the General Assembly could help prevent the formation of care deserts that put rural Pennsylvanians at risk. The REH model offers a sustainable pathway to ensure rural Pennsylvanians continue to receive access to high-quality, affordable healthcare within their communities. Pennsylvania’s rural hospitals are critical infrastructure, and investments in the health and economic success of our commonwealth’s rural communities depends upon investments in strong, financially sustainable hospitals.

The new REH provider type has been adopted in 22 states with over 50 qualifying rural hospitals converting to this model.  I hope you will join me in allowing Pennsylvania to provide this option to our Critical Access Hospitals and rural hospitals, taking a necessary step to help ensure their continued operation.