Hospitals continue to face challenges stemming from the Change Healthcare cyberattack. Challenges include:

  • Accessing imaging, forcing the need to reschedule patients
  • Revenue concerns from claims tied up in the clearinghouse
  • Lack of communication, clarity, or usable workarounds from United Healthcare

While our hospitals have invested millions in cybersecurity, we are still vulnerable. The federal government should support a wholistic, coordinated approach to assist hospitals in responding to attacks. We support voluntary cybersecurity goals that are implemented across the health care sector.

Medicare Advantage (MA) plans are taking advantage of patients and hospitals alike. Excessive prior authorization denials, narrow and restrictive networks, misleading marketing to patients and lowered payments to rural hospitals have all made the Medicare Advantage program nearly unworkable. We need Congress to hold Insurers accountable by restricting excessive prior authorization requirements and delay tactics that drive up the cost of care. Congress should demand that Medicare Advantage plans include adequate provider networks.

The workforce shortage has been a growing concern for more than a decade. However, the challenges from the pandemic and growing regulatory burdens have resulted in especially discouraging trends for rural physicians, nurses and behavioral health professionals. Investing in our future health care professional workforce is critical to maintaining access to care in Washington. We ask for support on both short-term and long-term solutions. Specifically:

  • Supporting R. 2389 / S. 1302, Resident Physician Shortage Reduction Act that would create new slots for residents
  • Addressing shortages by increasing the number of residency slots eligible for Medicare funding
  • Supporting R. 6205 / S. 3211, Healthcare Workforce Resilience Act (/), which would allow for unused employment-based visas for nurses and physicians to help address shortages
  • Passing the R. 4942 / S. 665, Conrad State 30 and Physician Access Reauthorization Act to make the program permanent

Investing in nursing schools and faculty, and substantially expanding loan repayment through legislation like the H.R. 7266 / S. 3770, Future Advancement of Academic Nursing Act

Site neutral payment proponents have argued that a service should be paid the same regardless of the setting or patient being treated – meaning that the lowest Medicare payment for a service across all outpatient settings is appropriate for all patients. However, the reality is that care provided in different settings often reflects the patient’s needs. This is an especially important issue for older and sicker patients served by hospitals. It’s not about the “service,” but about the patient who receives the care – this is where the costs can be different and the decision to care for patients in a hospital outpatient department (HOPD) off-campus setting is often based on complexities of a patient’s situation. We urge Congress to oppose site neutral payment policies that would negatively impact the ability of hospitals to treat patients.

Rural hospitals are not only anchors of their local communities, but also critical threads in the fabric of our statewide care delivery system. Rural hospitals need more flexibility to continue to deliver care to their communities. We hope to:

  • Repeal the payment caps on provider-based Rural Health Clinics (RHCs) that limit access to care in rural areas.
  • Rescind the 96-hour rule for critical access hospitals (H.R. 1565, Critical Access Hospital Relief Act). As our urban partners face capacity concerns, rural hospitals need to keep patients longer while a bed can be found. The 96-hour rule puts some hospitals in regulatory jeopardy for challenges outside of their control.
  • Support S. 1571, Rural Hospital Closure Relief Act, which would allow additional rural hospitals to pursue critical access hospital status.

Rural counties, especially those socioeconomically disadvantaged, experience heightened health disparities, leading to increased rates of maternal morbidity and mortality. According to the March of Dimes 2023 “Maternity Care Deserts Report” for Washington, 16.7% of women in Washington had no birthing hospital within 30 minutes, compared to 9.7% of women in the United States. The closure of six hospitals’ OB services in Washington, with three more contemplating the same, further intensifies the maternity care crisis. These closures force pregnant individuals to travel longer distances for essential services and will undoubtedly result in worse outcomes. Maternity providers and emergency department staff can be faced with a sudden patient (parent or baby) emergency at any time.

  • WSHA has submitted a Congressionally Directed Spending (CDS) request to Rep. Schrier and Sen. Murray that would support technical assistance and simulation training to support all rural hospitals (with and without OB) in responding to birthing parent and newborn emergencies. This will greatly improve safety and outcomes for both parents and babies.