News Releases

Lawmakers Face Important Healthcare Issues Upon Return From Summer Recess

Congress is currently on summer recess, but when they return in September, they’ll have a lot to accomplish before the end of the year, including addressing significant issues that affect hospitals and the care they provide. Priorities for hospitals this fall include policies impacting their workforce, reimbursement, and telehealth. The Center encourages members of Congress to take action to support community hospitals.

Prevent Damaging Cuts to Hospitals

On Jan. 1, 2025, the Medicaid Disproportionate Share Hospital (DSH) payment reductions are scheduled to be implemented. The Medicaid DSH program provides essential financial assistance to hospitals that treat some the most vulnerable populations, including children, disabled, and elderly. Currently, Medicaid only pays approximately 87 cents for every dollar of care provided to our most vulnerable populations. The $8 billion in payment reductions would severely impact hospitals and potentially decrease access to care for patients.

Reject Site-Neutral Payment Proposals

Site-neutral payments are when Medicare pays the same rate for a service regardless of the setting where the service is provided. Due to a variety of factors, from regulatory requirements to the breadth of services they offer, hospitals cost more to operate than other sites like medical office buildings. Currently, Medicare only reimburses hospitals approximately 82 cents for every dollar of care provided. In Ohio, hospitals lost more than $257 million on Medicare services in 2022. Proposals for site-neutral payments are expected to impose billions of dollars in additional Medicare payment cuts for services provided by hospital outpatient departments. These proposals could reduce patient access to vital healthcare services, especially in rural and other medically underserved communities.

Protect America’s Healthcare Workers

Violence in the healthcare setting is a significant and growing problem, and has implications that go beyond the injuries sustained by the workforce. Hospitals report that workplace violence and intimidation make it more difficult for clinical staff to provide quality patient care as nurses and physicians cannot provide attentive care when they are afraid for their personal safety. Additionally, the healthcare workforce continues to face workforce shortages and retention issues due to trauma experienced on the job.

Congress should pass the bipartisan Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768), which would provide federal protections from workplace violences for hospital workers, similar to the laws that protect airport and airline workers.

Hold Commercial Health Plans Accountable

Some health plan practices are threatening patient access to care, contributing to clinician burnout and adding excessive administrative costs and burden to the healthcare system. Particularly problematic is the excessive use of prior authorizations to delay or deny care and delay payments to hospitals. The AHA reports that Medicare Advantage (MA) prior authorization requests increased by 9 million between 2019 and 2022. MA insurers fully or partially denied 3.4 million prior authorization requests in 2022, which is a larger share of denied prior authorization requests by MA plans compared to previous years.

Increased regulatory oversight of health plans is needed along with comprehensive reform and simplification to streamline prior authorization requirements and processes and monitor for abusive payment denials and delays.

Permanently Adopt Telehealth and Hospital-at-Home Waivers

Congress established a series of waivers expanding access to care for millions of Americans through telehealth and the hospital-at-home program during the pandemic and corresponding public health emergency. A solution that provides support for those with mobility limitations or living in rural areas, telehealth expansions should be permanently adopted and the telehealth workforce expanded. Additionally, Congress should pass the Hospital Inpatient Services Modernization Act (H.R. 8206/S.4350), which would extend the hospital-at-home waiver for five years, through 2029. More than 300 hospital-at-home programs exist across the U.S. and there have been signs that more communities would develop programs, which are an innovative way for Medicare and Medicaid patients to receive acute-care services in their homes.

To communicate with your state representatives and share your support of these issues, visit house.gov. You can find additional resources on these issues by visiting the American Hospital Association’s Action Center.

For more on The Center for Health Affairs' advocacy activities, click here.