In an op-ed for the Des Moines Register, J.D. Scholten, a member of the Iowa House of Representatives, sheds light on the mental health crisis impacting rural communities and explains how “’site-neutral’ legislation now being advocated by some policymakers could undermine the good work that’s happening in our nation’s capital and put an even greater strain on rural mental health providers.”
Scholten warns:
Site-neutral policies would standardize reimbursement rates to providers, regardless of where care is provided. This top-down model ignores the true drivers of rising healthcare costs — like inflation, skyrocketing drug costs, and worker shortages — and instead seeks to mandate prices. Similar to price freezes under President Richard Nixon, which caused farmers and ranchers to stop shipping their products to market, site-neutral policies could force hospitals and health systems to cut services and possibly close entirely.
That outcome would exacerbate rural America’s mental health crisis. Hospital outpatient programs are often the first point of contact and the only option for continuing mental healthcare in rural areas. Nearly two-thirds of rural counties do not have a psychiatrist, and more than 8 in 10 do not have a psychiatric nurse practitioner.
Scholten continues:
Over 30% of rural hospitals, including 22 in Iowa, are at risk of closing. These healthcare systems are more likely to operate on small and even negative margins. Hospitals’ expenses grew twice as fast as Medicare reimbursement rates between 2019 and 2022. Reducing reimbursement rates through proposed site-neutral policies would force systems to cut programs, and inevitably “non-critical” services, like mental health, will be the first to go … Residents here often travel an hour or more to receive mental health services, so reducing points of access to care will only exacerbate our current crisis and the result is predictable — less access to mental health services at a time when the need is greatest.
Rather than pursuing site-neutral cuts, “Washington should be doing all it can to make mental health resources more available. To their credit, many lawmakers have made this a priority. Unfortunately, the one-size-fits-all reimbursement proposals now being pushed with site-neutral legislation would cause healthcare providers to cut programs where they are needed most, stifling access to life-saving care for rural Americans. Policymakers should rethink this misguided approach,” Scholten concludes.
To read the full op-ed in the Des Moines Register, CLICK HERE.
About the Coalition to Protect America’s Healthcare
The Coalition to Protect America’s Healthcare was formed to protect access to the best quality care for all Americans. We are a community of more than two million people who recognize the important role hospitals play in communities all over America, and advocate on their behalf to elected officials in Washington. The coalition represents the interests of the community, children’s, teaching, public, religious, rehabilitation, behavioral health, and long-term care hospitals, and their patients. More information is available at protecthealthcare.org.