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Lankford Fights to Protect Rural Health Care for Oklahomans

CLICK HERE to watch Lankford’s opening statements on YouTube.

CLICK HERE to watch Lankford’s opening statements on Rumble.

CLICK HERE to watch Lankford’s Q&A on YouTube.

CLICK HERE to watch Lankford’s Q&A on Rumble.

WASHINGTON, DC – Senator James Lankford (R-OK) today participated in Senate Finance Committee hearing entitled, “Rural Health Care: Supporting Lives and Improving Communities,” in which he stressed the importance of protecting rural health care for Oklahomans.    

Witnesses at today’s hearing included: Keith J. Mueller, Ph.D., Gerhard Hartman Professor of Health Management and Policy and Director, Rural Policy Research Institute (RUPRI); Lori Rodefeld, MS, Director of GME Development, WI Collaborative for Rural Graduate Medical Education (WCRGME); Michael Topchik, Executive Director, Chartis Center for Rural Health; and Jeremy P. Davis, MHA, President and Chief Executive Officer, Grande Ronde Hospital.

Lankford introduced the Rural Hospital Closure Relief Act, which would support financially vulnerable rural hospitals facing risk of closure. He remains a strong advocate for addressing health care access deficiencies in rural Oklahoma and around the nation. Lankford announced a huge win for rural hospital access in Oklahoma and around the nation after the Centers for Medicare and Medicaid Services (CMS) announced its Rural Emergency Hospital (REH) rule. The rule, among other things, redefined a “primary” road for purposes of establishing the distance a hospital must be from another hospital to receive CMS’ Critical Access Hospital (CAH) designation, making it easier for some Oklahoma rural hospitals to stay open.

Opening Remarks

[Rural health care] is a very significant issue for Oklahoma, just like it is for your state. My state is 4 million people—2 million of those live in urban areas and 2 million of those live in rural areas. And, so we understand full well what it means to have the critical needs for hospitals in rural areas there.

We have 40 Critical Access Hospitals. We have three Rural Emergency Hospitals. We’ve seen several rural facilities close over the last few years. In fact, one of the reports done by Chartis, one of our witnesses here, shows that about a third of Oklahoma’s rural hospitals are at risk of closure, which ranks Oklahoma as the state with the fourth highest number of potential closures in the United States.

So this particular hearing is incredibly important to us in Oklahoma. Rural health care, though, I do want to remind everyone it’s not just hospitals—it encompasses the entirety of the health ecosystem, from access to healthy foods, local pharmacies, the independent family physician practices, emergency room access, ambulances or air ambulance, insurance coverage, insurance networks. All of them are part of that ecosystem, and are all vital access that we spent some time talking about.

I would argue several things. Some of the issues that we face in rural health care deal with things like physician practices and hospitals and the administrative burdens that they face. 

Rural providers in hospitals have fewer resources to be able to maintain those practices, and they drown in some of the administrative paperwork. So what we can do to be able to help them actually put more people take care of patients and fewer people back office is helpful to them.

Nursing homes have a very difficult time caring for patients, but rural nursing homes have some of the most difficult times where they’re dominantly funded by Medicaid in their community, and they treat a higher level of acuity. So there are some very real challenges for rural nursing homes.

The pharmacies and the reimbursements, they have some reimbursements that are lower reimbursement than the actual purchase of the drugs that they stock. But the rural pharmacies, especially independent pharmacies, are often the only health care provider in the community that they have immediate access to. So allowing that rural pharmacist to be able to thrive is incredibly important in rural America.

Most importantly, we deal with the issue of patients. Rural patients have an even harder time finding in network providers, especially as more and more rural hospitals stop accepting Medicare Advantage, which we’ve had some of our rural providers do in the area. 

Or, when there’s a requirement for pre-authorization for certain testing, and you already drove 45 minutes to be able to get there. You meet with your doctor and say, ‘We need to do a test,’ but you’ve got to come back again before we can get authorization. [It] just discourages them from ever getting that test again. It works out well for the insurer. It does not work out well for the patient in rural America.

So these are the issues that we’ve got to be able to deal with—proper oversight of Medicare Advantage and the networks in rural America, the long term solutions, the physician fee schedule that we continue to be able to talk about, the PBM reform legislation that this committee has passed overwhelmingly, we need to be able to move because that is an issue for rural independent pharmacies.

That’s very significant that we should be able to get…We have got out of this committee, we need to be able to get across the floor and be able to get that resolved.

Dealing with some of the CMS rules that are out there, which are, I believe, a threat to rural nursing homes with some of the staff requirements that are there that are going to actually pull RNs away from hospitals that are already struggling to be able to maintain their RNs, to maintain some of the new rules for CMS, may make for an even greater challenge for survival for some of those rural nursing homes.

Senator Durbin and I have worked on a bill, the Rural Hospital Closure Relief Act. That’s one that we want to be able to work through in trying to deal with the critical access hospitals. We have a lot of issues, around the community health centers. Those FQHCs have been a real solution for us in Oklahoma and a lot of rural areas and what we continue to be able to do with that.

So I would just say patients that are in rural Oklahoma should not be punished for living in rural Oklahoma. They should have access there that is consistent and also to be able to face the unique issues that they have in rural America, to be able to both live and thrive there.

And for all of us that like to eat food and wear clothes, we really need folks in rural America that are in agriculture, and if we cut off access to health care to them, then we’re also going to lose access to a lot of the rest of our economy.