Washington – In an effort to improve the quality of health care available to rural Americans, a bipartisan group of four senators introduced legislation that would make improve Medicare reimbursement formulas for rural health care providers. 

The bill is called the Craig Thomas Rural Hospital and Providers Equity Act of 2009, or R-HoPE. It is named after the former senator from Wyoming , a co-sponsor of the original bill who passed away in 2007 after complications from leukemia.

The legislation, introduced late Thursday, is now co-sponsored by Sens. Kent Conrad, D-N.D., Pat Roberts, R-Kan., Tom Harkin, D-Iowa, and John Barrasso, R-Wyo. It is listed as S.1157.

“There is a growing disparity in the quality of health care available to Americans from urban and rural areas, and that is unacceptable. It is our job to update Medicare’s formulas and ensure that quality health care is available to all Americans, regardless of where they make their home,” Senator Conrad said.

“To help shoulder the financial burden of rural health care providers, I am honored to follow in the footsteps of Senator Thomas as Co-Chairman of the Senate Rural Health Caucus to introduce this comprehensive bill,” Senator Roberts said. “Improving access to quality health care is essential to preserving our rural way of life. Rural health care providers have very different needs than their urban counterparts and it is important that we realize health care is not one size fits all. I thank my Senate colleagues for their help on this bipartisan legislation on behalf of our nation’s small communities.”

“In Iowa and throughout the country, the disparity between Medicare reimbursement in rural and urban areas is extremely high.  And this impacts providers and patients alike,” said Harkin, Co-Chair of the Senate Rural Health Caucus.  “Hospitals, physicians, ambulance companies, and home health agencies are all at a disadvantage compared to the same providers in other regions of the country. This bill will help eliminate these inequities so that our Medicare patients will have access to the best services regardless of where they live.”

“This comprehensive, bipartisan legislation will help stabilize our nation’s rural health care infrastructure.  It takes steps to change Medicare payment policies that discriminate against rural hospitals and rural providers in Wyoming and across the country.  The legislation will ensure that rural Medicare patients continue to have access to high quality medical care,” Senator Barrasso said.

Many rural health care providers, including hospitals, clinics and ambulance squads, operate with overall negative Medicare margins, meaning Medicare reimbursements don’t cover the actual costs these providers incur. A recent report by the Medicare Payment Advisory Commission projected that rural hospitals experienced a Medicare shortfall of 5.6 percent of costs in 2007, the last year numbers were available.

R-HoPE would take several steps to improve the financial status of rural providers, including boosting Medicare reimbursement payments to rural hospitals, clinics and ambulance squads, as well as creating a new loan program to assist rural hospitals repair aging buildings.