Health Care
Critical Access
Access to Critical Services and Supporting the Health Care Workforce
One of Montana's most pressing health care problems is a shortage of nurses and other health professionals – particularly in rural areas. To help alleviate these problems, we need to ensure that rural health care providers get a fair shake. That means making Medicare payments more equitable for rural providers, from hospitals to home health to physicians. It means making sure that Medicare reimbursement for physician care is sufficient to keep providers in our communities, serving their patients. And it means building on the progress of the Critical Access Hospital program and the Flex Grant.
The 2003 Medicare bill made significant progress in these areas. The bill not only added prescription drug coverage for seniors, but also contained many provider payment provisions critical to rural health care providers in Montana. The rural health funding increases in the bill were the largest package ever passed by Congress. These payment changes – which provide about $70 million in new funding to Montana hospitals and $45 million in new funds to Montana doctors – are important for maintaining access to care in Montana. For the last couple of years, I have worked to extend these provisions important to rural health providers.
I was proud to have authored the legislation establishing Critical Access Hospitals (CAH) in 1997. This program allows small, rural hospitals proper reimbursement for their services as well as flexibility on Medicare regulations designed for larger facilities. The Critical Access Hospitals has helped reverse a two-decade long trend that closed hundreds of rural hospitals. Today, about 70% of all Montana facilities are Critical Access Hospitals, and over 1000 exist nationwide. The Medicare prescription drug bill made several important expansions and provided reimbursement increases for this critical program. I’m also pleased this legislation reauthorized the Rural Hospital Flexibility Grant Program (Flex Grant), which helps ensure that Montana facilities have the resources to switch to Critical Access Hospitals status. It also provides grant funding to strengthen the rural health care safety net. This year my Medicare bill went a step further, it established a demonstration project to allow states to test new ways to better coordinate hospital, nursing home, home health and other critical health care services in rural areas. This provision works to ensure that seniors and all rural residents receive the medical services they need and that rural providers will be fairly reimbursed for that care.
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