OPINION:
A single visit to West Virginia is all one needs to understand why our state’s slogan is “Almost Heaven.” As the only state located wholly within the Appalachian Mountains, West Virginia is bursting with towering ridges, rivers, forests, and rolling hills so beautiful that only the divine could compare. However, traversing mountains and winding through country roads creates unique challenges for our health care sector and leads to lengthy commutes for rural patients seeking care. For some living here, it is not uncommon for the nearest hospital to be multiple hours away. Hospitals operating in these sparsely populated areas must be able to meet the needs of their patients with increasingly limited resources and find solutions to problems unique to rural communities.
To better support these hospitals, the Centers for Medicare and Medicaid Services (CMS) has created the Critical Access Hospital (CAH) designation for facilities at least 35 miles from a health care provider that have 25 beds or less. To further address ultra rural communities like the ones dotted throughout West Virginia, CMS has gone one step further by creating the “mountainous terrain exception,” allowing hospitals to qualify as a CAH with only a 15-mile radius from another provider. These designations ensure that the terrain is taken into account when allocating the necessary resources to our hospitals so they can continue providing care by equitably reimbursing them for their costs through Medicare.
However, this exception does not apply to ambulance services, meaning they are still held to the 35-mile radius requirement despite the mountainous terrain. The lack of accommodation for the landscape, drive times, and fuel needed to transport patients to the nearest hospital places undue financial burdens on our already strained healthcare network. Across the country, ambulance services are operating on thin margins. With the added expense of operating in rural communities, services lose money and risk having to reduce operating hours or cease operations altogether, cutting off a critical lifeline for our rural patients.
This Congress, I introduced a bill that corrects this issue by allowing CAHs in mountainous areas to receive fair compensation for their ambulance services. The Preserving Emergency Access in Key Sites (PEAKS) Act is life-saving legislation that will ensure our mountainous hospitals are compensated fairly for the ambulance services they provide to patients by modifying the distance requirement. It’s imperative that all patients, especially those of us who live in unforgiving terrain, can access emergency medical care.
It’s equally important to consider the population these hospitals are serving. Here in West Virginia, a large percentage of our population are elderly and nearly one-fifth of our residents receive Medicare. For our rural hospitals already serving a smaller number of patients, this means their income is very dependent on Medicare reimbursements. This allows them to qualify for the Medicare-dependent hospital program and receive enhanced low-volume Medicare payments through CMS. By reimbursing these hospitals at a higher rate, they can remain financially viable and receive the additional support needed to combat the unique challenges hospitals in rural communities are facing.
With this program and expanded payments set to soon expire, I introduced the Assistance for Rural Community Hospitals (ARCH) Act to extend this funding through 2031. Our rural hospitals are committed to providing the best care they can to the patients they serve, but this is only possible if they have adequate resources and certainty when planning for the future. This legislation will equip these hospitals with the financial support and resources needed to keep their doors open to the communities they serve.
The PEAKS Act and ARCH Act provide crucial support to rural hospitals and will ensure better access to patients seeking quality care. By addressing existing disparities between our Critical Access Hospitals and their ambulance services as well as providing funding certainty and extra support to our Medicare-dependent facilities, we can strengthen our rural health network and foster healthier communities. Every American, regardless of where they live in our country, deserves access to quality, lifesaving medical care. For those of us living in West Virginia, this legislation will improve that access and provide better peace of mind for all here in our “home among the hills.”
• Rep. Carol Miller represents West Virginia’s First Congressional District. Miller serves on the Committee on Ways and Means. Miller’s focus in Congress is creating jobs, diversifying the economy, investing in trade relations, protecting America’s borders, and supporting West Virginia’s energy industries like coal, oil, and gas.
Please read our comment policy before commenting.