Q: What is the Rural Health Transformation program?
A: Congress beefed up federal dollars to expand access to health care services in rural communities in the health and tax law signed in July by President Trump. The Rural Health Transformation program was designed to improve access to care, improve health outcomes, prioritize new and emergency technologies, strengthen local and regional partnerships, enhance economic opportunity, prioritize data and technology driven solutions and outline strategies to manage long-term financial solvency and operating models of rural hospitals. I led efforts in the U.S. Senate to support this initiative and add $50 billion in new federal spending to boost resources for Americans in underserved areas by keeping critical health care services available close to home.
The Rural Health Transformation program will make $10 billion available annually for five years. The law specifies 50% of the $10 billion must be distributed equally among states, so every state will get a minimum of $100 million annually for the five years. The other 50% will be distributed based on state applications reviewed by the Centers for Medicare and Medicaid Services (CMS).
This month, I joined Iowa’s federal delegation to support Iowa’s application – called “Healthy Hometowns” – that seeks $1 billion in funding from the Rural Health Transformation program over the next five years. CMS, the federal agency administering the program, is expected to announce awards by Dec. 31.
Iowa’s proposal outlines six specific initiatives to enhance the health care infrastructure and improve health care outcomes, including investments in telehealth, medical equipment and care for uninsured Iowans; recruiting and retaining top-tier health care professionals; increasing access to cancer screening and treatment; coordinating multidisciplinary care teams to stretch resources and support community care professionals; providing seamless access to health records across the state to support continuity of care; and bringing emergency care to rural residents with mobile health and high-risk transport support teams.
Q: What other initiatives are you leading to address disparities in rural health care?
A: This month, I completed my annual 99 county meetings for the 45th year in a row. Health care ranks among the top issues that come up at my meetings, no matter if I’m touring a factory, visiting a school or holding an open town meeting. I also regularly meet with Iowans who come to Washington to discuss health care to inform my work at the policymaking table. Throughout my years serving Iowans in the Senate, I’ve cut my teeth on health care policy as the former chairman and current member of the Senate Finance Committee, which has oversight and legislative jurisdiction over federal health care programs, including Medicare and Medicaid. As you would expect, I’ve leveraged my seniority to go to the mat for Iowans, from allowing local pharmacists to get reimbursed for health care services, such as health and wellness screenings, immunizations and diabetes management, to improving maternal and child health services.
I also spearheaded adoption of the voluntary Rural Emergency Hospital (REH) program to help rural communities who face workforce shortages and financial hardship keep their hometown hospital doors open. Signed into law five years ago, the program gives rural hospitals the flexibility to keep their doors open by focusing on 24/7 emergency care and outpatient services. For several years, I’ve led the charge to ensure this program is working as intended to preserve access to essential health care in rural areas. So far, 42 rural hospitals in 17 states have transitioned to this model and I’m working to get feedback from participating hospitals to better understand their challenges to help smooth the process for other rural hospitals across the country.
Earlier this year, I welcomed action by CMS to fill 10 available spaces in its Rural Community Hospital Demonstration program. Last year, I pushed the Biden administration to fill these openings and will keep up the pressure to ensure Iowa continues to get physician residency slots to support our medical workforce in communities across the state.
From pushing for affordable hearing aids through the bipartisan Over-the-Counter Hearing Aids Act to expanding Medicare coverage for telehealth services that make it easier for patients to connect with their doctors, I’ll continue listening to Iowans and leading the way in Washington to keep access to quality health care close to home as a steadfast advocate for Rural America.