Senate Finance Amendment Passes - Equity for Rural Providers

Finance Committee Focuses on Physician Payment
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: September 30, 2009

WASHINGTON -- A GOP amendment that would pay rural doctors more money passed by unanimous consent during Tuesday evening's Senate Finance Committee markup.

The amendment, sponsored by ranking Republican Sen. Chuck Grassley of Iowa, would adjust the Geographic Practice Cost Index, or GPCI, helping to level the current payment differential between physicians in rural and urban areas for the same procedures.

The GPCI is part of the formula used by CMS to determine physician payments and reflects regional differences in practice costs, such as rent and employee wages.

"It's getting harder and harder for seniors to find doctors serving in rural areas," Grassley said in a prepared statement. "Part of the problem is Medicare payment policies that shortchange rural states. It's a question of fairness and accuracy to fix the problem of rural physicians getting paid less for performing the same procedures than doctors in other areas."

The amendment would not take money away from physicians practicing in urban areas.

Please click HERE to read this article in its entirety......

Booze, Guns, and the Rise in Rural Suicides

Daily Yonder article by Bill Bishop

Rural and urban suicide rates were about the same in the early 1970s. By the late 1990s, rates of suicide were 54% higher in U.S. rural areas than in U.S. cities.

Attempted and completed suicides take place at higher rates in rural communities, especially in areas that have more bars and taverns than other rural places, according to a new study.

The numbers of suicides were highest among white men.

Suicide rates were higher in both urban and rural places with concentrations of bars and taverns, according to the report by Fred Johnson, Paul Gruenewald and Lillian Remer. The authors speculate that a wide range of factors contributed to higher suicide rates in rural areas, including widespread use of firearms, local economic problems and alcoholism. Three out of four rural suicides involved firearms, according to the report.

Click HERE to read the story in its entirety.

Senate Finance Committee Health Care Proposal

Earlier today, the Senate Finance Committee began marking up the proposed bill that was introduced last week by Chairman Max Baucus (D-Mont). With over 500 proposed amendments to the bill, some interesting debate should ensue the next couple of weeks. To see a list of the proposed amendments, please click HERE.

The Washington Post reports: The bill would expand health coverage to millions without adding to federal budget deficits, and despite criticism of the measure from both parties, it has attracted the support of more moderate Democrats than any other proposal.

After a year-long effort to build a bipartisan consensus around the plan, Baucus has so far been unable to persuade any Republicans to sign on, and fellow Democrats have accused him of wasting his time courting conservative Sens. Charles E. Grassley (Iowa) and Mike Enzi (Wyo.).

The New York Times stated: The chairman of the Senate Finance Committee, Max Baucus, said Monday that he would modify his health care bill to provide more generous assistance to moderate-income Americans, to help them buy insurance.

Side-by-Side Comparison Tool of Major Health Care Reform Proposals

The Kaiser Family Foundation website has an interactive tool where you can compare the current health care reform proposals that are being debated at the national level. Please click HERE for more information.

Senate Finance Committee introduces America's Health Future Act

The long awaited health reform proposal from the Senate Finance Committee was introduced today by Committee Chairman Max Baucus (D-Mont.). The bill would require most invididuals to have health insurance and would require insurance companies to cover any individual, regardless of a pre-exisiting condition. The proposal does not have a public option plan, but instead creates health insurance "exchanges" where individuals may buy insurance. The proposal also creates a system of health "co-ops."

You can access the 220 page document by clicking HERE.

I will be digesting this document along with the H. 3200 (House health reform proposal) and how these will impact rural healthcare in the upcoming days. Keep checking back here for updates.

If you have feedback, comments, concerns, and/or gripes, please feel free to email me at th@coruralhealth.org

Your Voice is Needed to Achieve Health Reform in Rural America

Facing criticism that he has not offered specifics on his health reform strategy, President Obama spoke before a joint session of Congress last night outlining the details of his newly-formed plan. In the speech, the president touched on the importance of health reform for rural America and specifically mentioned one of the National Rural Health Association's (NRHA) long-time member organizations, Geisinger Health System in rural Pennsylvania. He emphasized that rural providers like Geisinger offer “high-quality care at costs below average.” Though only a small component of his speech, the very mention of a rural provider like Geisinger implies his willingness to give rural America a seat at the health reform table.

Now it is our job to remind Obama that ensuring access in rural America is vital to achieving true health reform.

• Join NRHA's Grassroots Working Group and participate in weekly conference calls, get updates on reform progress, and strategize going forward. To join, send a blank e-mail to
join-grassroots@lists.wisc.edu

• Check out the Rural Health Voices blog and the Health Reform page for the latest news from NRHA's government affairs staff in Washington, D.C.

Health Reform by Thanksgiving?

As you all know, on Wednesday night, President Obama spoke to a joint session of Congress outlining his health reform plan. In response to this speech, Max Baucus, Chairman of the Senate Finance Committee said, the health reform bill his committee has been working on all August will be released the middle of next week and the committee has scheduled a mark-up for Monday, September 21st. Given this information, Vice-President Joe Biden has said that the target date to have health care reform completed by is now Thanksgiving Day, whether this will hold or not however, remains to be seen.

The National Rural Health Association (NRHA) has a comprehensive health reform section on their website and information on how the current health reform proposals will impact rural America. I will be including some of the key health reform documents and information here, but you may also access the NRHA site by clicking HERE.

Rural Mental Health Funding Doubtful, Even as Farm Stress Worsens

As stress in the farming sector rises across Colorado and nationwide, some mental health professionals are hoping the federal government will step in to fund mental health services through the 2010 Farm Bill.

But proponents of the Farm and Ranch Stress Assistance Network have just one last chance to convince Congress to fund — and not just authorize — a comprehensive mental health program for the agriculture sector. Its passage looks doubtful at best.

(Please click on the title of this article to read in its entirety)

Obama to Address Joint Session of Congress on Heathcare

The White House is apparently not kidding around with its new strategy to regain the upper hand in the fight over healthcare reform.

President Obama's big speech on healthcare, intended to restart the debate in Congress and nationally, won't be your run of the mill affair. Instead, he's going to address a joint session of Congress -- that is, both the House and the Senate -- next Wednesday, Sept. 9th, in prime-time.

There'll be a lot of pressure on him with this speech, of course. It could end up as a big win, but with the debate having gone badly for Democrats recently, he'll be watched closely on this one. Plus, you can expect Republicans to pitch a fit, and if their claims end up holding water after the address, this could turn out to be a net loss.

Rural State with Much To Gain Under Reform Also Feature Most Vocal Opponents

Rural States With Much To Gain Under Reform Also Feature Most Vocal Opponents
[Sep 02, 2009]

The biggest opponents of a health care overhaul predominantly reside in rural states. The Los Angeles Times reports: "Some of the most vociferous opposition to the proposals before the House and Senate comes from residents of rural states that could benefit most if the present system is revamped. ... Although there is a consensus in Congress for keeping the current employer-based system of medical insurance, that system is riddled with holes in coverage that disproportionately affect rural states."

"In addition, both in the West and South, such states tend to set higher thresholds for Medicaid eligibility, leaving few options for low-income earners who can't afford individual insurance coverage. Moreover, residents of rural states often have lower incomes than those in other parts of the country. It's more difficult to find healthcare providers. And they have little, if any, choice in the private insurance market. ... Given that reality, it may not be surprising that senators from these states have been the most active in the effort to salvage a bipartisan compromise on healthcare" (Oliphant, 9/2).