Grassley "Tweener" Hospitals Bill Receives Boost in House of Representatives

Press Release

A bipartisan bill from Sen. Chuck Grassley that would help four "tweener" hospitals in Iowa and many others nationwide received a boost via inclusion in a hospitals bill from the House of Representatives Ways and Means Committee. The Iowa hospitals are St. Anthony Regional Hospital in Carroll, Grinnell Regional Medical Center in Grinnell, Skiff Medical Center in Newton, and Iowa Lakes Regional Healthcare in Spirit Lake.

"A lot of Iowans live in areas where a big hospital isn't available," Grassley said. "Maintaining access to a local hospital is part of a strong quality of life and keeping people in good health. I'm glad to see the inclusion of these "tweener' provisions in a major House bill, and I look forward to moving the provisions forward."

The House Ways and Means Committee released the Helping Hospitals Improve Patient Care Act of 2016 (H.R. 5273) this week. In January, the Senate approved the Rural Community Hospital Demonstration Extension Act of 2015 without objection. The bill from Grassley and colleagues extends a Medicare demonstration program that helps rural hospitals in sparsely populated states keep their doors open.

Initiated in 2004 by Grassley when he was chairman of the Finance Committee, the Rural Community Hospital Demonstration Program is a five-year program created to help rural hospitals in the country's 10 most sparsely populated states. These hospitals are called "tweeners" because they don't qualify for Critical Access status and wouldn't be viable under the current Medicare hospital prospective payment system. The program was renewed for another five years in 2010 and expanded to include 20 of the most sparsely populated states. This program provides participating hospitals and tests the feasibility and advisability of a cost-based payment model for acute-care inpatient services.

Eligible hospitals must be located in a rural area and within one of the 20 most sparsely populated states (Alaska, Arizona, Arkansas, Colorado, Idaho, Iowa, Kansas, Maine, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah, and Wyoming); must have fewer than 51 inpatient beds; must offer 24-hour emergency care services; and are not eligible for designation as a Community Access Hospital.

Approximately 35 hospitals have participated in this program since its inception. Currently, there are 23 hospitals participating in the Rural Community Hospital Demonstration Program.

Grassley also is the author of the Rural Emergency Acute Care Hospital (REACH) Act, which would give eligible hometown hospitals a lifeline to help keep their doors open. It would create a new option of hospital to provide emergency medicine and outpatient services without the existing pressure to maintain inpatient beds that can be hard to fill.

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