Recap of Legato's Visit on Capitol Hill

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 experience.

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 Will it be repealed, replaced, overhauled, adjusted?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 My opinion is that the ACA won't be totally repealed and replaced; that just doesn't seem practical.

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.

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Mike's Day 3 Journey Update

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 partisan issue.
  • 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 in place."

Stay tuned to hear Mike discuss their accomplishments.

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Mike's Journey Update

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 conference:

  • 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 settings.
  • 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 your communities.
  • 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 our nation."
  • 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 updates!

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Mike Goes to Washington

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 communities.


Stay tuned for more of Mike's updates!

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