Posted on February 14, 2017
All is normal in Washington, D.C.
Normally chaotic, that is. I recently returned from joining the
National Rural Health Association's (NRHA) Public Policy
Institute to advocate for the needs of rural healthcare
organizations. It was a productive and educational
Of course, the elephant (no political pun intended) in the room
was the future of the Affordable Care Act (ACA). Will it be
repealed, replaced, overhauled, adjusted?
The takeaway for me is that the words "repeal" and "replace"
have negative political connotations. Consensus among rural
healthcare leaders and members of Congress is that there are
positive aspects of the ACA, as well as areas that need
improvement. One concern, of course, is making sure that short-term
changes don't take away access for patients. Another is that costs
are higher than anyone would prefer. My opinion is that the ACA
won't be totally repealed and replaced; that just doesn't seem
The healthcare industry leaders in my delegation (Rural Wisconsin
Health Cooperative) focused on issues such as making sure
the 340B program remains, as well as its impact on sustainability
for rural hospitals throughout the nation. Leaders such as Black River Memorial Hospital, CEO
Mary Beth White-Jacobs explained how the revenue received from this
program helped the hospital meet community needs such as hospice
and homecare programs.
Robert Van Meeteren, CEO of Reedsburg Area Medical Center
educated members of Congress on the importance of fixing the CMS
96-hour rule and its current impact on rural hospitals. Watching
people's responses, I genuinely felt that the real-life stories
helped legislators see the true face of those who may be affected
by their decisions. They learned how a rural hospital's success is
not simply about providing healthcare, but it's also the foundation
for the economic stability of the entire community.
Thank you to NRHA and to RWHC, for allowing me to join this
important event. And thank you for helping me understand the issues
in even more depth, thus allowing our team at Legato to use this
knowledge in helping you achieve your business goals and
effectively compete in the marketplace.
Posted on February 8, 2016
Today Mike was at Capitol Hill where Senators spoke about these
issues surrounding rural health:
- Senator Al Franken discussed how rural healthcare is not a
- Senator Shelley Moore Capito focused on deploying broadband in
West Virginia to increase access to care through telemedicine. She
also discussed her fight against opioid addiction, which
unfortunately also is prevalent in rural America.
- Senator Shelly Moore Capito says, "We are definitely going to
repeal the ACA, but not until we have an even stronger replacement
Stay tuned to hear Mike discuss their accomplishments.
Posted on February 7, 2017
Mike Goes to Washington Part 2
Mike Milligan is at the Rural Health Policy Institute and while
he's always a vocal advocate for rural healthcare, he's also
actively listening. Here are some highlights from the
- According to Andrew C. Adair, J.D., Government Relations
Representative, American Academy of Family Physicians, MACRA is
here to stay. "MACRA is not affiliated with the ACA directly, and
has strong bi-partisan support. Legislatively, it's not going
anywhere. However, there is some uncertainty regarding how nominee
HSS Secretary Tom Price will refine it."
- According to J.R. Greene, Chief Executive Officer, Psychiatric
Medical Care, if Medicare Advantage plans continue to expand, or
Medicare is privatized, CAHs will need additional financial
support to survive.
- Heather Dimeris, Deputy Associate Administrator, Federal Office
of Rural Health Policy, advocates that telehealth can
provide the same quality of care as many inpatient
- Sen. Heidi Heitkamp states, "We cannot leave rural healthcare
behind." She encourages us to think for the future and look at all
options: different payment models, telemedicine, "But CMS
needs to get out of the way with its over restrictive rules."
- Rep. Evan Jenkins encourages everyone to hold Congress
accountable, not just on the Hill visits this week, but year
round. He suggests advocates keep the pressure on, invite
legislators to your hospitals, and organize grass roots efforts in
- Brian C. Tabor, Executive Vice President, Indiana Hospital
Association, discussing Medicaid expansion and Indiana's HIP 2.0
program states, "I love to see innovative solutions to finding the
delicate balance of providing access to care for all people, while
understanding the tremendous cost impact for our communities and
- Sen. Cory Gardner touts the merits of telemedicine in rural
healthcare, explaining that it provides access to quality
healthcare, reduces over utilization, and lowers costs for
hospitals and patients.
Stay tuned for more of Mike's
Posted on February 6, 2017
On Feb 7-9, 2017, NRHA will host the
largest rural advocacy event in the United States at what may be
the country's most critical turning point. Legato's own Mike
Milligan will be at the event, advocating for rural healthcare as
part of the National Rural Health Association Policy Institute.
Among other topics, attendees will be discussing the future of the
Affordable Care Act (ACA), Medicaid program, and the recently
passed MACRA. Mike is learning firsthand about the impact on rural
patients and providers, while representing the voice of hospitals
and clinics facing uncertainty.
Each day we will provide you with
updates on Mike's journey.
2/6/2017 National Rural Health
Association Policy Institute Update: Mike has arrived in
DC! But he didn't wait until landing to begin the conversation. In
fact, Mike sat next to Michigan Senator, Debbie Stabenow and
Wisconsin Senator, Tammy Baldwin on his flight and they discussed
how rural hospitals are the economic engines of their
Stay tuned for more
of Mike's updates!