2023 Federal Public Policy Agenda
Every day, hospitals across Washington state provide critical, lifesaving care to each person who walks through the door, 24 hours a day, 7 days a week. These critical care services are only available through hospitals. Hospitals are faced with unprecedented challenges in delivering care to their communities, including a workforce shortage, increasing costs of supplies, drugs, energy and food, as well as caring for an aging population. Hospitals in Washington State remain very full with highly complex patients who are often managing chronic illnesses.
We need your help. Washington’s hospitals are committed to ensuring local access to high quality, affordable health care in the face of unprecedented financial, capacity and workforce challenges. Statewide, hospitals had more than $2.1 billion in operating losses last year. These losses are not sustainable. Hospitals are spending down reserves every day just to maintain services. We need action from Congress to help our hospital so that we can continue to care for our community.
The Washington State Hospital Association’s federal public policy agenda guides the association’s congressional and regulatory advocacy activities. This agenda identifies public policies that enable hospitals and health systems to meet the challenges they face in serving the health needs of their communities.
WSHA’s public policy advocacy is focused on the following areas:
- Ensuring access to high-quality services in all areas of the state
- Educating and training an adequate supply of health care professionals
- Enhancing equitable care
- Taking steps toward a commonsense approach to health care regulation that ensures accountability while allowing for flexibility to support a transforming health care system
Advance access to high-quality services
WSHA is committed to preserving access to high-quality health care services in communities – from the largest to the smallest – across our state. To achieve this goal, we must protect vital federal programs that provide coverage to Washington state residents and ensure adequate payment for services.
- Protecting and improving funding for Medicare and Medicaid
- Preserving the 340B program and slowing the growth of the cost of prescription drugs
- Establishing a temporary payment program targeted to hospitals for difficult to discharge patients who are stuck in the hospital inappropriately
- Protecting against site neutral policy cuts that do not reflect the access to care provided by hospital outpatient departments
- Addressing payment delays and unnecessary denials by commercial insurers
- Promote access to behavioral health services, including innovative payment structures
- Creating a new “metropolitan anchor hospital” designation
Specific to rural hospitals:
- Eliminating the 96-hour physician certification requirement for critical access hospitals
- Restoring adequate payment rates to provider based Rural Health Clinics
- Designing a delivery system that fits the circumstances of unique communities, including alternative payment models for rural communities
- Removing regulatory burdens, such as the 96-hour length-of-stay rule
Grow the workforce
Investing in an adequate supply of health care professionals and other staff is critical to maintaining access to care. A major investment in training new physicians, nurses and other health care professionals is needed. At the same time, we must support and retain our existing workforce by reducing administrative burdens that take caregivers away from the bedside and contribute to burnout.
In the long-term, this means addressing shortages by increasing the number of residency slots eligible for Medicare funding while rejecting cuts to graduate medical education (GME), growing the number of primary care residency training programs, supporting allied health professionals including behavioral health, and supporting efforts to increase diversity in the workforce. It also requires investment in nursing schools and faculty and substantially expand loan repayment.
In the short-term, this means strengthening the National Health Service Corps, the Teaching Health Centers program, nurse workforce development programs, and the Conrad State 30 J-1 Visa Program and expediting visas for foreign-trained workers. It also means expanding licensing reciprocity through proposals such as the TREAT Act.
Enhance equitable care
WSHA is committed to supporting the delivery of equitable health care services via policy and funding initiatives aimed at addressing structural inequities in our health care system and society. We stand for providing care in an equitable, coordinated manner; we stand for focusing on prevention and wellness; and we stand for putting our patients and their families at the center of care. This includes support for proposals specifically aimed at addressing structural inequity in the health system:
- Expanding access and insurance coverage
- Supporting rural health care
- Adopting public policies aimed at improving maternal and child health outcomes with a focus on eliminating racial and ethnic inequity
- Promoting approaches to account for social risk factors in quality measurement programs
- Standardizing approaches to collecting and exchanging demographic and health-related social need data across federal agencies
- Increasing diversity in the health workforce
Ensure commonsense regulations
WSHA is committed to working toward commonsense regulations that protect patient safety and enhance quality while not overburdening providers. The regulatory compliance burden is growing in hospitals, requiring additional staff and resources that often do not add value to patient care. The COVID-19 Public Health Emergency provided an opportunity to reevaluate the utility of many regulations that do not support access to patient centered care. Hospitals and the health systems provided high-quality services under extreme stress with a significantly slimmed-down regulatory structure.
WSHA endorses efforts by the American Hospital Association to maintain the streamlined regulatory structure and identify additional regulatory barriers that should be eliminated.