U.S. Rep. Hinson Addresses Medicare Reimbursement and Workforce Challenges in Rural Health
U.S. Representative Ashley Hinson engaged with rural healthcare providers during a roundtable at Emplify Health by Gundersen West Union Hospital to address challenges in Medicare reimbursements for Rural Health Clinics (RHCs). RHCs, situated in underserved nonurban areas, provide essential outpatient primary and preventive care but face limitations in billing, as current Medicare rules allow reimbursement only for physician services, excluding those rendered by registered nurses (RNs). This restriction impacts patient care delivery efficiency, given the shortage of physicians and the significant Medicare-eligible population in rural regions.
The discussion highlighted that RNs support physicians by conducting initial patient evaluations, which helps providers like physician assistants focus on more complex care needs. However, Medicare’s reimbursement scheme does not compensate for the RN’s role, making this collaborative care model financially challenging to sustain. Representative Hinson is proposing legislation to enable RHCs to bill for both RN and physician services, aiming to improve care quality and provider capacity.
Additional issues explored included the closure of local pharmacies, transportation barriers to medication access, and challenges in specialist referrals—all factors that negatively affect healthcare outcomes and inflate costs in rural communities. Innovative solutions like mobile pharmacies were considered but deemed difficult to implement due to regulatory constraints on controlled substances.
Workforce recruitment and retention emerged as key concerns, with difficulties attracting healthcare professionals to rural areas compounded by limited childcare access and non-traditional work schedules. Initiatives such as loan repayment programs for rural practitioners and local efforts to enhance childcare capacity through educational programs and wage adjustments were discussed as means to improve workforce stability.
Overall, the roundtable underscored the intertwined nature of reimbursement policies, healthcare delivery models, infrastructure, and workforce issues in rural healthcare. Representative Hinson reaffirmed her commitment to prioritizing rural health concerns, emphasizing continued dialogue with stakeholders to support sustainable improvements in access and quality of care.