WASHINGTON, D.C. – U.S. Senators Amy Klobuchar (D-MN), Chuck Grassley (R-IA), and Cory Gardner (R-CO) have introduced bipartisan legislation to help rural hospitals stay open to provide emergency care and outpatient services. The Rural Emergency Acute Care Hospital (REACH) Act would create a new Rural Emergency Hospital classification under Medicare to strengthen support for hospitals that maintain an emergency room and provide outpatient services but do not provide the inpatient beds that many hospitals are struggling to maintain.

“Our rural hospitals are essential institutions in communities across Minnesota. They don’t just provide vital health services, they employ thousands of doctors, nurses, pharmacists and other health care workers,” Klobuchar said. “Millions of people depend on keeping these hospitals open. Our bipartisan legislation will help ensure that rural Minnesotans and Americans across the country have access to medical care when and where they need it most.”

Under Medicare, many rural hospitals are designated as Critical Access Hospitals, meaning they have to maintain a certain amount of inpatient beds as well as an emergency room. Many hospitals struggle to attract enough inpatients to keep their Critical Access Hospital status. When they close their doors, it often means a community loses its emergency services. Studies show that proximity to an emergency room often means the difference between life and death. 

The REACH Act provides hospitals with a new option – enhanced support for key emergency and outpatient services. Rural Emergency Hospitals would maintain some protocols despite no longer supporting inpatient services, such as being able to rapidly move a patient to a larger hospital elsewhere that offers more services.

Sixty percent of trauma deaths in the United States occur in rural areas, where only 15 percent of the population is represented.  This reflects in part the accelerating pace of rural hospital closures and challenges faced by many other hospitals that are struggling to keep their doors open – hospitals that could benefit from the REACH Act.

Last month, Klobuchar introduced bipartisan legislation with Senators Susan Collins (R-ME) and Heidi Heitkamp (D-ND) to boost the number of doctors able to work in rural America. The Conrad State 30 & Physician Access Act would allow international doctors to remain in the U.S. upon completing their residency under the condition that they practice in underserved areas, such as rural communities. Currently doctors from other countries working in America on J-1 visas are required to return to their home country after their residency has ended for two years before they can apply for another visa or green card. The Conrad 30 program allows doctors to stay in the U.S without having to return home if they agree to practice in an underserved area for three years. The “30” refers to the number of doctors per state that can participate in the program. The senators’ legislation extends the Conrad 30 program until 2021, improves the process for obtaining a visa, and allows for the program to be expanded beyond 30 slots if certain thresholds are met, while still protecting small states. The bill also allows the spouses of doctors to work and provides worker protections to prevent the doctors from being mistreated. A version of the bill was included as an amendment in the comprehensive immigration bill that passed the Senate in 2013.