/ en Tue, 29 Jul 2025 22:17:44 -0500 Tue, 22 Jul 25 15:47:48 -0500 /issue-landing-page/2016-11-16-ensuring-access-vulnerable-communities-taskforce-report-and-resources <div class="container row"><div class="row"><div class="col-md-8"><div class="outlineContent clearfix"><p><img src="/images/taskforce-ban2.jpg" data-entity-uuid data-entity-type alt width="793" height="286"></p><hr><p>Millions of Americans living in vulnerable rural and urban communities depend upon their hospital as an important, and often only, source of care. However, these communities and their hospitals face many challenges. As the hospital field engages in its most significant transformation to date, many are fighting to survive – potentially leaving their communities at risk for losing access to health care services. Recognizing these challenges and the need for new integrated and comprehensive health care delivery and payment strategies, the AHA Board of Trustees created the Task Force on Ensuring Access in Vulnerable Communities. Comprised of 29 hospital and health system leaders and state hospital association CEOs, the task force held meetings, heard from policymakers and conducted field hearings to speak with hospital and community leaders during a 15-month period.<br><br>The Task Force work is ongoing. This webpage is just one of the many ways AHA will keep you connected to the latest developments and resources as we address the critical issue of ensuring access to health care services.</p><hr><h2><span class="color_aha_blue"><strong>Task Force Report</strong></span></h2><p>The task force report outlines nine emerging strategies that can help preserve access to health care services in vulnerable communities. These strategies will not apply to or work for every community and each community has the option to choose one or more that are compatible with its needs.</p><ul><li><a href="/system/files/content/16/ensuring-access-taskforce-exec-summary.pdf" target="_blank">Executive Summary</a><a href="/system/files/content/16/ensuring-access-taskforce-report.pdf"></a></li><li><a href="/system/files/content/16/ensuring-access-taskforce-report.pdf">Full Report</a></li><li><a href="https://www.youtube.com/watch?v=v2TgJDL9O6o">Release Video</a></li><li><a href="/system/files/content/16/taskforce-charts-rural.pdf">Rural Chart Pack</a></li><li><a href="/system/files/content/16/taskforce-charts-urban.pdf">Urban Chart Pack</a></li></ul><hr><h2><strong class="color_aha_blue">Inpatient/Outpatient Transformation Strategy</strong></h2><ul><li><a href="/system/files/2018-02/inpatient-outpatient-transformation-strategy.pdf">Emerging Strategies to Ensure Access to Health Care Services – Inpatient/Outpatient Transformation</a></li></ul><hr><h2><strong class="color_aha_blue">Social Determinants of Health Strategy</strong></h2><ul><li><a href="/system/files/2018-02/social-determinants-health.pdf">Emerging Strategies to Ensure Access to Health Care Services - Social Determinants</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2017/AHA-community-health-initiatives.pdf">Community Health Initiatives at the ���������� Association</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2017/determinants-health-food-insecurity-role-of-hospitals.pdf">AHA Social Determinants of Health Series - Food Insecurity and the Role of Hospital</a></li><li><a href="http://www.hpoe.org/resources/ahahret-guides/3063">AHA Social Determinants of Health Series - Housing and the Role of Hospitals</a></li></ul><hr><h2><strong class="color_aha_blue">Virtual Care Strategies</strong></h2><ul><li><a href="/system/files/content/17/task-force-virtual-care-strategies.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Virtual Care Strategies</a></li><li><a href="/system/files/content/17/telehealth-case-examples.pdf">Telehealth — Delivering the Right Care, at the Right Place, at the Right Time: Case Examples of AHA Members in Action</a></li></ul><hr><h2><strong class="color_aha_blue">Emergency Medical Center Strategy</strong></h2><ul><li><a href="/system/files/2018-06/task-force-emergency-medical-center.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Emergency Medical Center</a></li><li><a href="/system/files/2018-05/emergency-medical-center-strategy-5-2018-jk.pdf">Comparison: Federal Policy Solutions to Ensure Access to Emergency Services</a></li><li><a href="/2018-05-07-overview-rural-emergency-medical-center-act">The Rural Emergency Medical Center Act of 2018</a></li><li><a href="/letter/2018-05-08-aha-rep-ron-kind-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Action Alert on REMC Act (members-only)</a></li><li><a href="/letter/2018-05-08-aha-rep-ron-kind-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Letter of Support of the REMC Act (Kind)</a></li><li><a href="/letter/2018-05-08-aha-rep-lynn-jenkins-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Letter of Support of the REMC Act (Jenkins)</a></li><li><a href="/press-releases/2018-05-07-aha-applauds-introduction-rural-emergency-medical-center-act-2018">Press Release Applauds Introduction of REMC Act</a></li><li><a href="/letter/2017-05-18-aha-expresses-support-rural-emergency-acute-care-hospital-reach-act-s-1130">AHA Letter of Support Rural Emergency Acute Care Hospital (REACH) Act, S. 1130</a></li></ul><hr><h2 class="color_aha_blue">Indian Health Services Strategy</h2><ul><li><a href="/system/files/2018-01/stategies-to-ensure-access.pdf">Emerging Strategies to Ensure Access to Health Care Services - IHS</a></li><li><a href="/letter/2017-05-26-aha-reps-walden-pallone-re-bipartisan-indian-health-service-task-force">AHA Letter of Support for IHS Task Force (Walden/Pallone)</a></li><li><a href="/letter/2017-05-26-aha-sens-mullin-ruiz-re-bipartisan-indian-health-service-task-force">AHA Letter of Support for IHS Task Force (Mullin-Ruiz)</a></li></ul><hr><h2><strong class="color_aha_blue">Urgent Care Center Strategy</strong></h2><ul><li><a href="/content/17/emerging-strategies-urgent-care-centers.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Urgent Care Centers</a></li><li><a href="/content/17/urgent-care-center-discussion-guide.pdf" target="_blank">Is the Urgent Care Center the Right Strategy for your Community</a></li></ul><hr><h2><strong class="color_aha_blue">Global Budgets</strong></h2><ul><li><a href="/system/files/media/file/2019/03/task-force-global-budget-2017.pdf">Emerging Strategies to Ensure Access – Global Budgets</a></li></ul><hr><h2><strong class="color_aha_blue">Community Conversations</strong></h2><ul><li><a href="/content/17/community-conversations-toolkit.pdf">Ensuring Access in Vulnerable Communities: Community Conversations Toolkit</a></li><li><a href="/content/17/taskforcevulncomm-discussionguide.pdf">Discussion Guide for Boards and Hospital Leadership</a></li><li><a href="http://www.hpoe.org/resources/ahahret-guides/3061">A Playbook for Fostering Hospital-Community Partnerships to Build a Culture of Health</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2016/creating-effective-hospital-community-partnerships.pdf">Creating Effective Hospital Community Partnerships to Build a Culture of Health</a></li><li><a href="http://www.healthycommunities.org/Resources/toolkit.shtml#.WYjFtITyt0y">Community Health Assessment Toolkit</a></li><li><a href="/ahahret-guides/2016-06-09-engaging-patients-and-communities-community-health-needs-assessment">Engaging Patients and Communities in the Community Health Needs Assessment Process</a></li><li><a href="http://hospitalsocialmedia.tumblr.com/">A Hospital Leadership Guide to Digital and Social Media</a></li><li><a href="/advancing-health-in-america">Advancing Health in America</a></li><li><a href="/ahahret-guides/2013-01-01-engaging-health-care-users-framework-healthy-individuals-and-communities">AHA Framework for Engaging Health Care Users</a></li><li><a href="/ahahret-guides/2015-01-28-leadership-toolkit-redefining-h-engaging-trustees-and-communities">Leadership Toolkit for Redefining the H: Engaging Trustees and Communities</a></li><li><a href="/system/files/2018-02/leadership-role-nonprofit-health-systems.pdf">The Leadership Role of Nonprofit Health Systems in Improving Community Health</a></li><li><a href="/system/files/2018-02/critical-conversations-to-changing-health-environment.pdf">Critical Conversations on the Changing Health Environment: Physician Engagement</a></li></ul><hr><h2><strong class="color_aha_blue">Frontier Health System</strong></h2><ul><li><a href="/system/files/content/17/task-force-frontier-2017.pdf">Emerging Strategies to Ensure Access — Frontier Health System</a></li></ul><hr><h2><strong class="color_aha_blue">Rural Hospital-Health Clinic Integration</strong></h2><ul><li><a href="/factsheet/2018-08-02-emerging-strategies-ensure-access-health-care-services">Emerging Strategies to Ensure Access — Rural Hospital-Health Clinic Integration</a></li></ul><hr><h2><strong class="color_aha_blue">Other Resources</strong></h2><ul><li><a href="http://www.hpoe.org/Reports-HPOE/2017/improving-care-for-high-need-high-cost-patients.pdf" target="_blank">Improving Care for High-Need, High-Cost Patients</a></li><li><a href="/data-and-insights/presentation-center/ensuring-access" target="_blank">Ensuring Access in Vulnerable Communities PowerPoint Presentation</a></li></ul></div></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title"><a href="/case-studies/2018-02-02-hospitals-and-health-systems-ensuring-access-their-communities">Hospitals and Health Systems Ensuring Access in Their Communities: Downloadable PDF</a></h3></div><div class="panel-body"><p><a href="/case-studies/2018-02-02-hospitals-and-health-systems-ensuring-access-their-communities"><img src="/sites/default/files/inline-images/ensuring-access-case-study-comp-rural-sm_0.jpg" data-entity-uuid="32d51105-e12e-468b-8f23-e4ae7c7aa262" data-entity-type="file" alt="Hospitals and Health Systems Ensuring Access in Their Communities cover" width="319" height="413">This is a compendium of case examples of AHA members from across the country employing the nine emerging strategies recommended by the association’s Task Force on Ensuring Access in Vulnerable Communities.</a></p></div></div></div></div></div> Wed, 16 Nov 2016 00:00:00 -0600 Access to Care in Vulnerable Communities /advancing-health-podcast/2025-07-22-mobilizing-4ms-how-el-camino-health-transforming-age-friendly-care <p>The 4Ms framework that supports age-friendly health care for older patients continues to expand in hospitals and health systems across the nation. In this conversation, Carolyn Bogard, DNP, R.N., director of care coordination and palliative care at El Camino Health, talks about her system’s use of data to harness the passion that care providers feel for improving outcomes and streamlining care delivery for older adults.</p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00:00:01:06 - 00:00:23:22<br> Tom Haederle<br> Welcome to Advancing Health. The 4Ms are the core components of Age-Friendly health systems that aim to improve the quality of care for older adults. Today, we hear from California-based El Camino Health about how its adoption of the forums has produced measurable improvements for the older people it serves. </p> <p> 00:00:23:24 - 00:00:40:20<br> Raahat Ansari<br> Hi everyone. We're here in Chicago at AHA’s Advancing Age-Friendly Care Convening. I'm Raahat Ansari, senior program manager at the ���������� Association. Today I'm here and joined by Carolyn Bogard from El Camino Hospital. Thank you so much for being here with us today. </p> <p> 00:00:40:23 - 00:00:43:19<br> Carolyn Bogard, R.N.<br> Thank you for having me. I'm so excited to be here. </p> <p> 00:00:43:22 - 00:01:06:18<br> Raahat Ansari<br> Great. So we wanted to take some time to understand your Age-Friendly journey and how you implemented the 4M's framework at your organization. And I'll just take a quick moment for those listeners who might be new to this work to explain that the 4Ms is: what matters, medication, mentation and mobility, and applying that care to older adults. So can you tell us how it got started? </p> <p> 00:01:06:20 - 00:01:29:09<br> Carolyn Bogard, R.N.<br> Absolutely. And again, thank you so much for having me and for this opportunity. I'm so proud to talk about the work being done at El Camino Health, and where we're at on our journey. We are still in the beginning phases of our journey and the 4M implementation at El Camino Health - it actually started with the leadership of one nurse. </p> <p> 00:01:29:15 - 00:02:02:08<br> Carolyn Bogard, R.N.<br> This nurse was making advances in her unit to implement an evidence based project, and her passion was really around delivering Age-Friendly care to older adults. And through her work and collaboration with pharmacy and our Epic analysts and other interdisciplinary team members, she was able to advance and roll out the 4M's on this medical unit within El Camino Health. </p> <p> 00:02:02:11 - 00:02:14:15<br> Raahat Ansari<br> It's amazing to hear. I just want to share that we do hear that a lot of organizations get started with this by one single individual championing this work, so I'm super excited to hear that that's the story at your organization. </p> <p> 00:02:14:18 - 00:02:37:21<br> Carolyn Bogard, R.N.<br> Oh, thank you so much. Yeah, we're super proud of her. And she continues to be a steadfast advocate for this work and continues to be so passionate about it and deeply involved with rolling out the 4Ms further throughout our health system. We certainly saw the impact in the benefits of rolling out the 4Ms and of this Age-Friendly health initiative. </p> <p> 00:02:37:24 - 00:02:47:22<br> Raahat Ansari<br> Did you see some outcomes and did you have data and what did you do with that data? And I wonder, were you able to share that with your leadership if you needed some help with leadership buy in? </p> <p> 00:02:47:29 - 00:03:26:18<br> Carolyn Bogard, R.N.<br> Yes. One of the things that we helped to do to advance this work, one of the first things is really to pull some of the data. And some of the data already on this unit was around high patient engagement scores and also the volume of older adults within this specific unit. We knew through the Age-Friendly initiative and the work with the IHI and ���������� Association that rolling out the 4Ms within a health system impacts length of stay, readmissions, falls and other patient health outcomes and health system outcomes, too. </p> <p> 00:03:26:21 - 00:03:52:29<br> Carolyn Bogard, R.N.<br> And we were able to bring this information in this data to our chief nursing officer. And we began conversations around how can we expand this initiative throughout our health care organization? So, she was extremely supportive and excited and passionate around this work as well. And then it was a matter of identifying next steps. </p> <p> 00:03:53:03 - 00:03:58:09<br> Raahat Ansari<br> So it was the data that got your chief nursing officer on board. Did I hear that correctly? </p> <p> 00:03:58:09 - 00:04:32:15<br> Carolyn Bogard, R.N.<br> I think it was the data and also her passion around it. And I think what I've seen is there is a lot of health care providers passionate about caring for older adults. And I think the 4M framework really helps to create a platform for where to focus that passion and energy to help produce really tangible outcomes and help to really streamline health care delivery for the older adults in our health systems. </p> <p> 00:04:32:17 - 00:04:43:17<br> Raahat Ansari<br> So I'm hearing a little bit of outcomes across the board. So there were definitely some positive patient outcomes. And from what you just shared right now, there were some positive provider outcomes. </p> <p> 00:04:43:19 - 00:05:21:09<br> Carolyn Bogard, R.N.<br> Well, I think certainly our providers are interested in continuing to advance this work. I think from the pilot phases and initial rollout of the 4Ms and this unit, the nurses in particular in this area found the work to be important and meaningful. And recognized the value that this work can have for their patients. And, you know, one thing that we did within our health system, when we're talking a little bit about scope and spread and how to really expand this work is, where do you begin? </p> <p> 00:05:21:15 - 00:05:52:05<br> Carolyn Bogard, R.N.<br> We had some success on this medical unit within our health system. What nursing leaders, what key stakeholders within the health system do we need to further expand? And we are so thankful to have the executive support that we do. Because our CNO knows exactly who to pull into the conversation. And one of the stakeholders that was really helpful with advancing these conversations is our process improvement adviser. </p> <p> 00:05:52:07 - 00:06:19:20<br> Carolyn Bogard, R.N.<br> And we really started by identifying what problem are we trying to solve, and then really doing a value stream about current processes within our health care organization. And what do we need to do to further expand some of this work? And some of the things that we identified right off the bat is identifying some programmatic leadership. </p> <p> 00:06:19:23 - 00:06:48:24<br> Carolyn Bogard, R.N.<br> Who's in charge of further expanding this, this, health care initiative? And also, where can we get consistent data from? Data can help tell your story and we know that this is an important story to tell, both to our patients and our health system. And we were lucky enough to work with a fantastic data analyst within our health care organization and he helped to develop an Age-Friendly dashboard. </p> <p> 00:06:48:27 - 00:07:29:12<br> Carolyn Bogard, R.N.<br> It's still in the beginning stages because sometimes there's so much data you can get paralyzed. And so we have to really think about what data do we need and how do we act upon the data that we have. Part of the initial data collection was around our patient population. You know, better understanding who are we caring for in our health system, identifying certainly ages and demographics and what service lines are these patients on based on that data that's helping to inform us around which units will we spread to next? </p> <p> 00:07:29:14 - 00:07:45:24<br> Raahat Ansari<br> I think that makes perfect sense. And one question that I want to ask you that I imagine some of our listeners might have of you is do you have any tips that you could share that you used to get that leadership buy in? We all know how important that is to leverage. </p> <p> 00:07:45:27 - 00:08:30:04<br> Carolyn Bogard, R.N.<br> Well, I'm so thankful to have regular and consistent communication with my executive and that alone gives me a pathway to communicate where we need help and what type of support that we need. And through that support and engagement and ongoing communication, we were able to develop a plan. Now, the plan did not develop overnight. It took probably three months from that initial conversation to even get a quorum of nursing directors across the organization in one room, with the process improvement advisory to talk a little bit about Age-Friendly care within our health care organization. </p> <p> 00:08:30:04 - 00:08:35:16<br> Raahat Ansari<br> And that's a success in and of itself, right? And get have all the stakeholders in one room to talk about that. </p> <p> 00:08:35:16 - 00:09:13:09<br> Carolyn Bogard, R.N.<br> Definitely. And when we had these initial conversations, everyone had different thoughts and ideas and opinions and observations about what was going well within the organization and what could be improved. And following that, we completed an A3, which is really a, you know, a systematic way to tackle a problem. And through input in discussion and these observations from all the nurse leaders, we were really able to see what areas are we doing well in and what areas can we improve in. </p> <p> 00:09:13:12 - 00:09:39:05<br> Carolyn Bogard, R.N.<br> And because we did have the 4M framework already rolled out on one unit, we weren't starting from scratch. We already had a pilot unit that implemented the 4Ms and was successful with that. So it was really more about building upon that success. Now we're at a spot as we think a little bit more about spread and scale across the organization. </p> <p> 00:09:39:08 - 00:09:51:03<br> Carolyn Bogard, R.N.<br> How do we dive a little bit deeper into each M, and how do we gain further engagement from members of the interdisciplinary team? </p> <p> 00:09:51:06 - 00:10:05:06<br> Raahat Ansari<br> And I do hear another challenge from some organizations about breaking down those silos and having that those interdisciplinary conversations. Any advice that you could share and how you successfully made that happen at your organization? </p> <p> 00:10:05:09 - 00:10:29:19<br> Carolyn Bogard, R.N.<br> Oh, yeah. Thank you so much for that question. And I would just add, being here at this forum, it's just so fantastic because even just today, I learned different ideas from different folks within the community. So one of the areas that we talked about was how do we get that buy-in and collaboration from members of the interdisciplinary team? </p> <p> 00:10:29:21 - 00:11:04:27<br> Carolyn Bogard, R.N.<br> Being that it's, you know, pharmacy or rehab services, case management, social worker, even our physicians, and certainly one of the best practices that was identified is really trying to find a champion in each area. And in my experience and observations, I have seen some passion out there about delivering high quality care to our older adult patient population. So at least within my health system, I don't have to look too far for individuals that are interested in advancing this work. </p> <p> 00:11:05:00 - 00:11:32:02<br> Raahat Ansari<br> When we started this work, that provider re-engagement and that spark, that passion that really was reignited when providers were working towards implementing the 4Ms framework into a patient care plan - that was something we were not expecting to see. So I really appreciate that you're saying that it's not hard to find, because we have seen that in real life when we have new teams come and join the action </p> <p> 00:11:32:02 - 00:11:50:00<br> Raahat Ansari<br> communities a little unsure of what to expect, what they're going to get out of it. And come two, three months into this, we've got a whole host of providers from all different disciplines who are really excited and passionate about being able to implement this work with their patients. So just wanted to highlight that point. Thank you for bringing that up. </p> <p> 00:11:50:06 - 00:12:08:15<br> Carolyn Bogard, R.N.<br> Oh you're welcome. And actually to your exact point, I have been part of the action community intermittently, throughout a number of years based on various jobs that I've had. And I get it. Caring for older adults, it is a passion of mine and it's such a privilege to be able to continue to be part of this work. </p> <p> 00:12:08:18 - 00:12:46:11<br> Carolyn Bogard, R.N.<br> But I would even think 5 to 7 years ago, people were just better understanding the importance of delivering high quality, reliable care to older adults. And even in that short period of time, I feel as if I have seen some reinvigoration in interest into this real specialty area of medicine. It's fantastic because it really does take a village, and an interdisciplinary team to provide holistic care to our patients, certainly within the hospital setting, but also across the care continuum. </p> <p> 00:12:46:14 - 00:13:03:09<br> Raahat Ansari<br> And so what I'm hearing is you have nailed it at this at this one site, you are done and done. Just kidding. Because that work is never done, right? But you've made some really good strides at one care site and you're moving to expand to other care sites within your organization. And that is fantastic news and something to celebrate. </p> <p> 00:13:03:11 - 00:13:05:06<br> Raahat Ansari<br> Thank you again for being here with us today. </p> <p> 00:13:05:09 - 00:13:08:05<br> Carolyn Bogard, R.N.<br> Thank you. It's been an honor and a pleasure. </p> <p> 00:13:08:07 - 00:13:16:18<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Tue, 22 Jul 2025 15:47:48 -0500 Access to Care in Vulnerable Communities /news/headline/2025-06-16-cms-expands-tribal-health-care-access-approving-medicaid-state-plan-amendments-6-states <p>The Centers for Medicare & Medicaid Services June 13 <a href="https://www.cms.gov/newsroom/press-releases/cms-expands-tribal-health-access-approval-medicaid-state-plan-amendments-minnesota-new-mexico-oregon">announced</a> it approved state plan amendments to expand Medicaid access to care for tribal communities in six states: Minnesota, New Mexico, Oregon, South Dakota, Washington and Wyoming. The approvals allow the Indian Health Service and tribal clinics to provide Medicaid clinic services in homes, schools and other community locations. </p> Mon, 16 Jun 2025 15:15:52 -0500 Access to Care in Vulnerable Communities /fact-sheets/2025-06-13-rural-hospitals-risk-cuts-medicaid-would-further-threaten-access <div class="container"><div class="row"><div class="col-md-8"><p>Medicaid, which covers over 16 million people in rural communities, helps address barriers to health care and sustain rural hospitals. But many in Congress are considering Medicaid cuts that would have a devastating impact on rural hospitals and patients.</p><p><span><strong>The One Big Beautiful Bill Act (H.R. 1) would result in 1.8 million individuals in rural communities losing their Medicaid coverage by 2034. In addition, select Medicaid provisions in H.R. 1 would result in a $50.4 billion reduction in federal Medicaid spending on rural hospitals over 10 years.</strong></span><a href="#fn1"><sup>1</sup></a> See the chart on the next page for a state-by-state breakdown of rural spending and coverage losses.</p><h2>Rural Hospitals Are Already Struggling:</h2><ul class="red"><li class="red"><span><strong>48%</strong></span> of rural hospitals operated at a financial loss in 2023.<a href="#fn2"><sup>2</sup></a></li><li class="red"><span><strong>92</strong></span> rural hospitals have closed their doors or been unable to continue providing inpatient services over the past 10 years.<a href="#fn3"><sup>3</sup></a></li><li class="red">Rural hospitals lose money on several <span><strong>critical service lines</strong></span>, including behavioral health, pulmonology, obstetrics, and burns and wounds.<a href="#fn4"><sup>4</sup></a></li></ul><h2>Medicaid is Critical to Rural Hospitals:</h2><ul class="red"><li class="red"><span><strong>16.1 million</strong></span> people living in rural communities are covered by Medicaid.<a href="#fn5"><sup>5</sup></a></li><li class="red">In nine states, <span><strong>over 50%</strong></span> of the Medicaid population lives in rural communities: Montana, South Dakota, Wyoming, Mississippi, Vermont, Kentucky, North Dakota, Alaska and Maine.<a href="#fn6"><sup>6</sup></a></li><li class="red"><span><strong>47%</strong></span> of rural births in the U.S. are covered by Medicaid.<a href="#fn7"><sup>7</sup></a></li><li class="red"><span><strong>65%</strong></span> of nursing home residents in rural counties are covered by Medicaid.<a href="#fn8"><sup>8</sup></a></li></ul><h2>Medicaid Already Pays Rural Hospitals Far Less Than the Cost of Care:</h2><ul class="red"><li class="red">Medicaid paid rural hospitals <span><strong>approximately 63 cents on the dollar</strong></span> for inpatient obstetrics care in 2024.<a href="#fn9"><sup>9</sup></a><ul class="red"><li class="red">There has been a <span><strong>16%</strong></span> decline in rural counties with hospital-based obstetric care services over the last decade.<a href="#fn10"><sup>10</sup></a></li></ul></li><li class="red">Similarly, Medicaid payments covered approximately just <span><strong>70%</strong></span> of costs for behavioral health services in hospital settings, which include substance use disorder treatment.<a href="#fn11"><sup>11</sup></a></li></ul><hr><table><thead><tr><th>State</th><th>10-Year Rural Medicaid Coverage Loss Through 2034</th><th>10-Year Federal Rural Hospital Impact Through 2034</th></tr></thead><tbody><tr><td>United States</td><td>-1.8M</td><td>-$50.4B</td></tr><tr><td>Alabama</td><td>-15.4K</td><td>-$265M</td></tr><tr><td>Alaska</td><td>-17.2K</td><td>-$382M</td></tr><tr><td>Arizona</td><td>-41.1K</td><td>-$905M</td></tr><tr><td>Arkansas</td><td>-51.1K</td><td>-$1,109M</td></tr><tr><td>California</td><td>-134.9K</td><td>-$2,057M</td></tr><tr><td>Colorado</td><td>-28.4K</td><td>-$835M</td></tr><tr><td>Connecticut</td><td>-8.0K</td><td>-$135M</td></tr><tr><td>Delaware</td><td>-6.5K</td><td>-$174M</td></tr><tr><td>District of Columbia</td><td>0K</td><td>$0M</td></tr><tr><td>Florida</td><td>-7.9K</td><td>-$210M</td></tr><tr><td>Georgia</td><td>-17.6K</td><td>-$540M</td></tr><tr><td>Hawaii</td><td>-24.9K</td><td>-$507M</td></tr><tr><td>Idaho</td><td>-17.2K</td><td>-$362M</td></tr><tr><td>Illinois</td><td>-53.8K</td><td>-$2,014M</td></tr><tr><td>Indiana</td><td>-64.6K</td><td>-$1,139M</td></tr><tr><td>Iowa</td><td>-37.7K</td><td>-$2,666M</td></tr><tr><td>Kansas</td><td>-5.3K</td><td>-$306M</td></tr><tr><td>Kentucky</td><td>-142.3K</td><td>-$4,012M</td></tr><tr><td>Louisiana</td><td>-79.0K</td><td>-$1,875M</td></tr><tr><td>Maine</td><td>-32.7K</td><td>-$640M</td></tr><tr><td>Maryland</td><td>-8.6K</td><td>-$267M</td></tr><tr><td>Massachusetts</td><td>-6.3K</td><td>-$81M</td></tr><tr><td>Michigan</td><td>-68.2K</td><td>-$2,008M</td></tr><tr><td>Minnesota</td><td>-36.2K</td><td>-$1,065M</td></tr><tr><td>Mississippi</td><td>-19.3K</td><td>-$1,529M</td></tr><tr><td>Missouri</td><td>-51.4K</td><td>-$1,522M</td></tr><tr><td>Montana</td><td>-22.3K</td><td>-$1,076M</td></tr><tr><td>Nebraska</td><td>-13.2K</td><td>-$375M</td></tr><tr><td>Nevada</td><td>-10.1K</td><td>-$230M</td></tr><tr><td>New Hampshire</td><td>-12.6K</td><td>-$753M</td></tr><tr><td>New Jersey</td><td>-5.7K</td><td>$0M</td></tr><tr><td>New Mexico</td><td>-55.2K</td><td>-$1,380M</td></tr><tr><td>New York</td><td>-70.9K</td><td>-$1,125M</td></tr><tr><td>North Carolina</td><td>-82.0K</td><td>-$2,988M</td></tr><tr><td>North Dakota</td><td>-7.0K</td><td>-$61M</td></tr><tr><td>Ohio</td><td>-86.0K</td><td>-$2,497M</td></tr><tr><td>Oklahoma</td><td>-51.1K</td><td>-$2,372M</td></tr><tr><td>Oregon</td><td>-83.6K</td><td>-$1,979M</td></tr><tr><td>Pennsylvania</td><td>-55.0K</td><td>-$1,131M</td></tr><tr><td>Rhode Island</td><td>0K</td><td>$0M</td></tr><tr><td>South Carolina</td><td>-5.1K</td><td>-$410M</td></tr><tr><td>South Dakota</td><td>-12.2K</td><td>-$95M</td></tr><tr><td>Tennessee</td><td>-16.3K</td><td>-$726M</td></tr><tr><td>Texas</td><td>-19.9K</td><td>-$1,047M</td></tr><tr><td>Utah</td><td>-7.4K</td><td>-$327M</td></tr><tr><td>Vermont</td><td>-11.3K</td><td>-$233M</td></tr><tr><td>Virginia</td><td>-55.5K</td><td>-$1,655M</td></tr><tr><td>Washington</td><td>-49.3K</td><td>-$1,997M</td></tr><tr><td>West Virginia</td><td>-30.0K</td><td>-$664M</td></tr><tr><td>Wisconsin</td><td>-30.1K</td><td>-$607M</td></tr><tr><td>Wyoming</td><td>-1.6K</td><td>-$33M</td></tr></tbody></table><p><span><strong>Source:</strong></span> Modeling of select H.R. 1 Medicaid provisions conducted by Manatt Health Strategies, LLC. This analysis accounts for the following H.R. 1 Medicaid provisions: (1) mandatory community engagement (work) requirements, (2) increasing frequency of eligibility redeterminations for certain individuals, (3) ban on new or increased provider taxes, (4) revising the payment limit for state directed payments (SDPs), (5) reduction in the expansion FMAP in states providing coverage to certain undocumented immigrants and (6) the repeal of rules relating to eligibility and enrollment in Medicaid, CHIP, the Medicare Savings Programs (MSPs) and the Basic Health Program (BHP).</p><p><span><strong>Notes:</strong></span> State values will not sum to national totals due to rounding. Rural Medicaid coverage losses are based on the geographical distribution of Medicaid enrollees. Rural hospital impacts are based on the geographical distribution of Medicaid hospital expenditures.</p><hr><h3>End Notes</h3><ol class="redol"><li class="redol" id="fn1">Modeling of select H.R. 1 Medicaid provisions conducted by Manatt Health Strategies, LLC. This analysis accounts for the following H.R. 1 Medicaid provisions: (1) mandatory community engagement (work) requirements, (2) increasing frequency of eligibility redeterminations for certain individuals, (3) ban on new or increased provider taxes, (4) revising the payment limit for state directed payments (SDPs), (5) reduction in the expansion FMAP in states providing coverage to certain undocumented immigrants and (6) the repeal of rules relating to eligibility and enrollment in Medicaid, CHIP, the Medicare Savings Programs (MSPs) and the Basic Health Program (BHP).</li><li class="redol" id="fn2">AHA analysis of RAND Hospital Cost Report data.</li><li class="redol" id="fn3">AHA analysis of data from Cecil G. Sheps Center for Health Services Research.</li><li class="redol" id="fn4">AHA analysis of industry benchmark data from Strata Decision Technology LLC.</li><li class="redol" id="fn5">Kaiser Family Foundation (KFF).</li><li class="redol" id="fn6">KFF.</li><li class="redol" id="fn7">AHA analysis of data from CDC Wonder.</li><li class="redol" id="fn8">Rural Policy Research Institute.</li><li class="redol" id="fn9">AHA analysis of industry benchmark data from Strata Decision Technology LLC.</li><li class="redol" id="fn10">University of Minnesota Rural Health Research Center.</li><li class="redol" id="fn11">AHA analysis of industry benchmark data from Strata Decision Technology LLC.</li></ol></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/06/Rural-Hospitals-at-Risk-Cuts-to-Medicaid-Would-Further-Threaten-Access.pdf" target="_blank" title="Click here to download the Rural Hospitals at Risk: Cuts to Medicaid Would Further Threaten Access fact sheet PDF.">Download the Fact Sheet PDF</a></div><a href="/system/files/media/file/2025/06/Rural-Hospitals-at-Risk-Cuts-to-Medicaid-Would-Further-Threaten-Access.pdf" target="_blank" title="Click here to download the Rural Hospitals at Risk: Cuts to Medicaid Would Further Threaten Access fact sheet PDF."><img src="/sites/default/files/inline-images/Page-1-Rural-Hospitals-at-Risk-Cuts-to-Medicaid-Would-Further-Threaten-Access.png" data-entity-uuid="6f149817-91d2-41db-87af-39570c6b7b4f" data-entity-type="file" alt="Rural Hospitals at Risk: Cuts to Medicaid Would Further Threaten Access fact sheet page 1." width="695" height="900"></a></div></div></div> ul.red { list-style: none; } ul.red li.red::before { content: "\2022"; color: #9d2235; font-weight: bold; display: inline-block; width: 1em; margin-left: -1em; } ol.redol li.redol::marker { color: #9d2235; font-weight: bold; } h2 { color: #003087; } h3 { color: #9d2235; } table, th, td { border: 1px solid; } th { color: #ffffff; background-color: #003087; } Mon, 16 Jun 2025 00:00:00 -0500 Access to Care in Vulnerable Communities /news/headline/2025-05-21-aha-expresses-support-legislation-streamlining-prior-authorization-requirements-under-ma-plans <p>The AHA May 21 voiced support to <a href="/lettercomment/2025-05-21-aha-senate-letter-supporting-improving-seniors-timely-access-care-act" title="senate">Senate</a> and <a href="/lettercomment/2025-05-21-aha-house-letter-supporting-improving-seniors-timely-access-care-act" title="house">House</a> sponsors of the Improving Seniors’ Timely Access to Care Act, legislation that would reduce the variation in prior authorization methods used for Medicare Advantage plans. Specifically, the bill would establish an electronic prior authorization standard to streamline approvals; reduce the time a health plan is allowed to consider a prior authorization request; require MA plans to report on their use of prior authorization, including the use of artificial intelligence in prior authorization and the rate of approvals and denials; and encourage MA plans to adopt policies that adhere to evidence-based guidelines. </p> Wed, 21 May 2025 15:06:02 -0500 Access to Care in Vulnerable Communities /news/perspective/2025-05-16-continuing-fight-protect-medicaid-and-access-247-hospital-care-patients-and-communities <p>Three key House committees — Energy and Commerce, Ways and Means, and Agriculture — after long debates and discussions this week advanced their portions of a massive reconciliation bill aimed at realizing President Trump’s legislative agenda.</p><p>The Energy and Commerce Committee, which was instructed to reduce deficits by $880 billion, approved widespread changes to the Medicaid program that, if enacted, would be a devastating blow to the health and well-being of our nation’s most vulnerable citizens and communities.</p><p>Many of the policies will not make the Medicaid program work better for the 72 million Americans who rely on it. They include babies and children, people with disabilities, the elderly, and nursing home patients. They also are many hard-working people, including farmers, ranchers, veterans and single moms. In fact, these policies will result in displacing millions of Americans from insured status to uninsured, putting their health and financial stability at serious risk.</p><p>There is no avoiding the real-life consequences these proposals will create for hospitals’ and health systems’ ability to deliver 24/7 care and services to all patients across the country, not just Medicaid beneficiaries. Some hospitals, especially those in rural or underserved communities, could be forced to close. Many others would have to significantly reduce services. Other impacts could be longer waiting times to receive care, more crowded emergency departments, and hospitals not being able to invest in technology and advancements for clinical care.</p><p>Earlier this week, we sent a <a href="/system/files/media/file/2025/05/aha-house-statement-on-full-committee-markup-of-budget-reconciliation-text-testimony-5-13-2025.pdf" target="_blank" title="AHA Statement to Energy and Commerce Committee">statement</a> to the Energy and Commerce Committee detailing our position on several provisions included in the legislative package. Specifically, we expressed our concerns that the bill restrains and diminishes provider taxes and state directed payment programs that are vital to the financial stability of hospitals and health systems and help them deliver essential services to Medicaid beneficiaries, since Medicaid historically and chronically underpays for the cost of caring for the millions of Americans that rely on the program.  </p><p>Some politicians and other stakeholders have mislabeled these programs and financing mechanisms as “waste, fraud and abuse.” They are nothing of the sort. The truth is the proposed changes to these programs are not real reform.</p><p>Most states likely would be unable to close the financing gap created by further limiting their ability to tax providers; as a result, they may need to make significant cuts to their Medicaid programs, including reducing eligibility, eliminating or limiting benefits, and further reducing the chronic Medicaid underpayment rates for providers. In addition, states could address financial losses by limiting or eliminating nonmandatory benefits for all Medicaid beneficiaries, such as prescription drug coverage, clinic services, certain behavioral health services, home and community-based services, and physical and occupational therapy.</p><p>While the legislation advanced out of committee, it still has a long way to go before crossing the finish line. The full House of Representatives could consider the package as soon as next week. And in the Senate — where some Republicans have already expressed concern about various House proposals — there would likely be changes to the bill should it pass the House.</p><p><strong>That means that we still have opportunities to influence the debate and the final package. </strong>We will continue to work with lawmakers to help them understand the impact these reductions will have on patients and the hospitals that care for them and their communities. Meanwhile, the <a href="https://strengthenhealthcare.org/" target="_blank" title="Coalition to Strengthen America's Healthcare">Coalition to Strengthen America’s Healthcare</a>, of which the AHA is a founding member, continues to run TV and digital advertisements targeted to key stakeholders. This week, the Coalition launched its <a href="https://strengthenhealthcare.org/new-coalition-ad-mom-highlights-impact-of-medicaid-cuts-on-americas-seniors/" target="_blank" title="Coalition to Strengthen America’s Healthcare newest ad.">newest ad</a> in its Faces of Medicaid campaign, telling the story of a family navigating the threat of limited health care options if Congress decides to make cuts to Medicaid.</p><p>We appreciate your efforts already in sharing with your lawmakers the negative consequences some of the proposals would have on the patients and communities you serve.<strong> It’s more important than ever to continue to share those stories as every vote in the House and Senate matters with slim majorities in both chambers of Congress.</strong> And visit AHA’s Action Center <a href="/advocacy/action-center" target="_blank" title="AHA's Action Center Webpage">webpage</a> for the latest resources to assist your efforts.</p><p>Tomorrow wraps up <a href="/ahia/get-involved/national-hospital-week" target="_blank" title="National Hospital Week webpage">National Hospital Week</a>. Throughout the week, we have been amplifying stories about the amazing work the women and men of America’s hospitals and health systems do every day to care for patients and support communities. Please take 30 seconds to watch this <a href="/ahia/get-involved/national-hospital-week" target="_blank" title="National Hospital Week Video">video</a> posted on our National Hospital Week page that shares some of this incredible and inspiring work.</p><p>One simple line from the video says, “People count on us.” That’s a powerful message. And it’s one lawmakers need to hear again and again as they consider changes that could affect hospitals’ ability to provide 24/7 care and services to people and communities across the country. </p> Fri, 16 May 2025 08:18:38 -0500 Access to Care in Vulnerable Communities /news/headline/2025-04-22-aha-issues-support-legislation-strengthen-ltch-reimbursement <p>The AHA voiced <a href="/lettercomment/2025-04-15-aha-supports-house-securing-access-care-seniors-critical-condition-act" title="senior act">support</a> for the Securing Access to Care for Seniors in Critical Condition Act (H.R.1924), legislation that would provide reimbursement for long-term care hospitals. In comments to the bill’s sponsors, Reps. Kevin Hern, R-Okla., and Brendan Boyle, D-Pa., the AHA highlighted declines in the number of LTCH standard-rate cases, providers and reimbursement. Smaller, yet sicker patient populations have also become a challenge for LTCHs.  </p> Tue, 22 Apr 2025 14:58:52 -0500 Access to Care in Vulnerable Communities /role-hospitals-uconn-health-community-outreach-program-improves-access-mammograms <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-04/ths-uconn-mammogram-700x532.jpg" data-entity-uuid data-entity-type="file" alt="UCONN Health. A patient is escorted to a mammogram screening" width="700" height="532" class="align-left"></p></div><p>The benefits of screening for breast cancer are well documented; for example, having regular mammograms can lower the risk of dying from breast cancer. Saving lives is the impetus behind a community outreach and engagement program led by UConn Health, based in Farmington, Conn.</p><p>As part of this UConn Health program, community health workers attend events in the community and at other UConn Health offices to share educational information about prevention and screening for breast cancer. They also help people who are uninsured or underinsured schedule mammogram screenings and follow-up appointments.</p><p>During a presentation at a local YWCA literacy group in New Britain, Conn., community health worker Rosa Agosto spoke with Vanessa Neira, a New Britain resident with a history of breast cancer in her family. At the time, Neira did not have insurance, so Agosto helped Neira connect with the UConn Health free mammogram program. Neira’s mammogram detected a “concerning spot,” but follow-up testing ruled out cancer. Neira remains grateful for support from the UConn Health team.</p><p>Agosto emphasizes that lack of insurance “should not be a barrier to mammograms, and here at UConn Health we are proud to be able to provide assistance to those who need mammograms, so they have access to early diagnosis, interventions and treatment.”</p><p>“To tell a woman with no insurance we can offer her a free mammogram can be life changing,” adds Kim Hamilton, program coordinator, community outreach and engagement, at UConn Health.</p><p><a class="btn btn-primary" href="https://today.uconn.edu/2024/10/uconn-health-community-programs-helping-under-insured-and-uninsured-with-breast-cancer-screenings" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 21 Apr 2025 13:50:56 -0500 Access to Care in Vulnerable Communities /role-hospitals-southeast-colorado-hospital-district-taking-skies-how-doctor-cares-patients-rural-colorado <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-04/ths-southeast-colorado-hospital-district-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Southeast Colorado Hospital District. Rural landscape under cumulus cloud-filled sky" width="700" height="532" class="align-left"></p></div><p>Many daily commutes are on the ground — car, train, bikes — but what if you took to the air? Charles Frankum, M.D., has spent over two decades flying himself to some of the most remote hospitals in Colorado and Kansas, including the <a href="https://www.sechosp.org" target="_blank">Southeast Colorado Hospital District</a> in Springfield, Colo. His daily four-hour commute in his plane showcases the need and complexity of providing critical medical care to rural communities.</p><p>Frankum's journey as a pilot-doctor began in 2003, driven by the need for an efficient way to reach multiple rural hospitals. His efforts have been crucial in towns like Springfield, where the Southeast Colorado Hospital District serves as a vital health care hub. “[Frankum] comes in once a month, and just since I’ve been here the last couple of years, I know numerous people he has found cancers on or snipped polyps off of,” said Heather Burdick, chief nursing officer and nursing home administrator at the Southeast Colorado Hospital District. “His work not only saves lives but also strengthens the health care systems in these small towns.”</p><p>“My work makes it so that only one person has to travel instead of all these other people having to travel,” said Frankum, “and it allows some very rural hospitals to turn their wheels and do procedures in their town.” Frankum’s efforts, and those of many other traveling physicians, ensure that residents of these rural areas receive the medical attention they need without having to travel long distances.</p><p><a class="btn btn-primary" href="https://www.rmpbs.org/blogs/housing-transportation/charles-frankum-colorado-doctor-pilot" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 03 Apr 2025 11:57:53 -0500 Access to Care in Vulnerable Communities /lettercomment/2025-03-27-aha-letter-opposing-physician-led-and-rural-access-quality-care-act-hr2191 <p>March 25, 2025</p><p>The Honorable Morgan Griffith<br>U.S. House of Representatives<br>2110 Rayburn House Office Building<br>Washington, DC 20515</p><p>Dear Representative Griffith:</p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the ���������� Association (AHA) writes to express our opposition to H.R. 2191, the Physician Led and Rural Access to Quality Care Act.</p><p>Rural hospitals are essential access points for care, economic anchors for their communities, and the backbone of our nation’s rural communities. These hospitals have maintained their commitment to ensuring local access to high-quality, affordable care despite continued financial and workforce challenges. The AHA strongly supports legislation that would enable rural hospitals across the nation to better care for their communities. However, we believe that H.R. 2191 is misguided legislation that would skew the health care marketplace in favor of physicians who self-refer patients to hospitals they own and would destabilize rural health care while failing to improve access to quality care.</p><p>H.R. 2191 would result in additional gaming of the Medicare program, jeopardize patient access to emergency care, potentially harm sicker and lower-income patients, and severely damage the ability of 24/7 full-service community hospitals to provide care in rural areas.</p><p>Physician self-referral — whether in rural, suburban or urban communities — is the antithesis of fair competition. The problematic practice allows physicians to steer their most profitable cases to facilities they own — facilities that often call 9-1-1 to handle their emergencies and are often located in the most affluent areas. By performing the highest-paying procedures for the best-insured patients, physician-owners inflate health care costs and drain essential resources from community hospitals, which depend on a balance of services and patients to provide indispensable treatment, such as behavioral health and trauma care. By increasing the presence of these self-referral arrangements, H.R. 2191 would only further destabilize community care.</p><p>Since the Medicare Modernization Act of 2003, Congress has supported ending the egregious and costly practice of physician self-referral to hospitals they own. Current law represents a 15-year compromise that (1) allows existing physician-owned hospitals (POHs) to continue to treat Medicare patients, (2) permits the expansion of those physician-owned hospitals that meet communities’ needs for additional hospital capacity and treat low-income patients, and (3) prohibits Medicare from covering services in any new physician-owned hospitals established after Dec. 31, 2010. Congress established these guardrails to protect the Medicare program from overutilization, patient steering and the harmful patient selection practices that POHs employ.</p><p>Data have shown time and time again that POHs select only the healthiest and most profitable patients, serving lower proportions of Medicaid, dual eligible and uncompensated care than full-service acute care hospitals. The <a href="https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/costestimate/amendreconprop.pdf" target="_blank" title="Congressional Budget Office Website">Congressional Budget Office</a>, the <a href="https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/Mar05_SpecHospitals.pdf" target="_blank" title="Medicare Payment Advisory Commission">Medicare Payment Advisory Commission</a> and the <a href="https://public-inspection.federalregister.gov/2023-16252.pdf" target="_blank" title="Center for Medicare & Medicaid Services">Centers for Medicare & Medicaid Services</a> all have concluded that physician self-referral leads to greater per capita utilization of services and higher costs for the Medicare program, among other negative impacts.</p><p>For these reasons, the AHA strongly opposes the expansion of POHs — by either creating new categories of exceptions or allowing existing POHs to expand — and cannot support H.R. 2191. Congress should maintain current law, preserve the ban on physician self-referrals to new physician-owned hospitals, and retain restrictions on the growth of existing physician-owned hospitals, regardless of location.</p><p>Sincerely,</p><p>/s/</p><p>Lisa Kidder Hrobsky<br>Senior Vice President, Advocacy and Political Affairs</p> Thu, 27 Mar 2025 10:36:14 -0500 Access to Care in Vulnerable Communities