The Senate Finance Committee held a May 16 hearing, “Rural Health Care: Supporting Lives and Improving Communities,” which explored challenges and opportunities related to rural health care delivery, with a particular focus on the factors that contribute to the closure of rural hospitals. The committee heard testimony from several witnesses, including Lori Rodefeld, Med, director of graduate medical education (GME) development at the Wisconsin Collaborative for Rural GME.
Throughout the hearing, several committee members expressed concerns regarding rural health care workforce shortages and their impact on patients’ access to care. In a key exchange, Sen. Chuck Grassley (R-Iowa) highlighted concerns with the distribution of GME slots provided by Section 126 of the Consolidated Appropriations Act, 2021 (P.L. 116-260), contending that not enough of these slots have been allocated to rural hospitals [refer to Washington Highlights, Jan. 13, 2023]. In her response, Rodefeld asserted that the language of the statute has allowed these positions to go to urban hospitals that have reclassified as rural referral centers, thereby disadvantaging rural hospitals in the application process. She also outlined concerns that the Centers for Medicare & Medicaid Services’ reliance on hospitals’ health professional shortage area designation to award slots has prevented some rural hospitals from qualifying, citing the example of a rural hospital in Wisconsin that has failed to receive slots under Rounds 1 or 2 of the distribution because of this methodology. “Gatekeeping programs that are successful out of this process is kind of unfair,” she stated. “They are still rural hospitals. They are still doing a great job of recruiting residents and retaining them in their communities.”