Today, U.S. Senator Patty Murray (D-WA) joined in a letter with 31 other U.S.
Senators to U.S. Department of Health and Human Services Secretary Kathleen Sebelius
and Acting Comptroller General of the United States of the General Accounting
Office Gene Dodaro asking that they work to ensure sufficient rural
representation on the National Health Care Workforce Commission and the
Independent Payment Advisory Board. These boards were created as part of
the new health insurance reform law. In the letter, the Senators
expressed concern that rural families have not been adequately represented on
other health care advisory boards to date and requested that the unique needs
of these rural Americans be addressed in health reform.
“As
we move toward implementation of the Patient Protection and Affordable Care
Act, we ask that particular attention be given to ensure sufficient rural
representation on the National Health Care Workforce Commission and the
Independent Payment Advisory Board,” the Senators wrote in their letter. “Given
the key role of these new Boards, membership must be carefully selected to
protect and strengthen Medicare beneficiaries’ access to services in rural
areas… The Commission needs rural representatives who understand these
rural workforce challenges and have knowledge of promising strategies for
health workforce training, recruiting, and practice in rural America.”
The National Health Care
Workforce Commission is charged with analyzing, coordinating, and recommending
to Congress and the Administration national strategies to meet the demand for
health care services in a reformed health care system. This Commission
was created as part of the Workforce section of the law, which Senator Murray, helped write to ensure there are enough
qualified professionals to provide needed health care services. The
Independent Payment Advisory Board will provide recommendations to Congress
regarding health care delivery and outcomes, including promotion of integrated
care, care coordination, prevention and wellness, and quality improvement for
the Medicare program.
As
a senior member of the U.S. Senate Health, Education, Labor, and Pensions
Committee Senator Murray worked to ensure that support for rural families was
not overlooked in health insurance reform. The law ensures rural
Americans stable and secure health care by improving access to quality
healthcare services, investing in the healthcare workforce, eliminating
discrimination for pre-existing conditions and health status, and establishing
credits for rural small businesses. Senator Murray also worked to protect the
health care choices of rural Americans by providing for more affordable choices
and competition among insurance companies in health insurance reform.
A
copy of the letter follows:
May
6, 2010
The
Honorable Kathleen Sebelius
Secretary
U.S.
Department of Health and Human Services
200
Independence Ave., SW
Washington,
DC 20201
The
Honorable Gene L. Dodaro
Acting Comptroller General of the United States
General
Accounting Office
441 G St., NW
Washington,
DC 20548
Dear
Madam Secretary and Mr. Dodaro:
Thank
you for your contributions to the historic health reform legislation. As
we move toward implementation of the Patient Protection and Affordable Care
Act, we ask that particular attention be given to ensure sufficient rural
representation on the National Health Care Workforce Commission and the
Independent Payment Advisory Board. More than 60 million Americans live
in rural areas, and we believe the inclusion of the rural perspective will help
ensure that the unique needs of these Americans are addressed in health reform.
The
National Health Care Workforce Commission is charged with analyzing,
coordinating, and recommending national strategies to meet the demand for
services in a reformed health care system. These strategies will be
especially important for rural areas, which face unique challenges in building
and maintaining their health care workforce. For example, while 20
percent of the American population lives in rural areas, only nine percent of
all physicians and 12 percent of all pharmacists practice in rural
communities. Rural areas average only about 30 dentists per 100,000
residents, while urban areas average approximately twice that number.
Shortages of nurses and allied health professionals are also pervasive.
Low population density, long distance travel, less exposure to health
occupations among children, and insufficient numbers of clinical training
sites for health professional students contribute to these shortages, which are
only expected to worsen in the coming years. The Commission needs rural
representatives who understand these rural workforce challenges and have
knowledge of promising strategies for health workforce training, recruiting,
and practice in rural America.
Rural
areas are also generally older than their urban counterparts, and rural
residents comprise about 27 percent of Medicare beneficiaries. This means
that Medicare is a lifeline for rural communities and the backbone of the rural
health system. We are pleased that the Independent Payment Advisory Board
will provide crucial recommendations to improve health care delivery and
outcomes, including promotion of integrated care, care coordination, prevention
and wellness, and quality improvement.
Although the law requires a balance
between urban and rural membership on the Board, we are concerned that there is
a precedent of insufficient rural representation in MedPAC, which often has
only one or two rural representatives. This underrepresentation exists
despite the fact that the statute governing MedPAC requires the same balance as
is called for on the Independent Payment Advisory Board. Given the key
role of the new Board, membership must be carefully selected to protect and
strengthen Medicare beneficiaries’ access to services in rural areas, including
the unique circumstances of Critical Access Hospitals. Moreover, rural
communities provide very high-quality health care, despite low Medicare
reimbursements. Many cost-saving innovations are underway in rural
America, and the Board needs informed rural experts so that the Medicare can
respond to rural needs and also learn from rural successes.
Thank
you again for your leadership and your attention to the need for rural
representation on the Commission and the Board.
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