Representative Bradley Byrne

Representing the 1st District of Alabama

Byrne Calls for Rural Hospital Relief


Jul 16, 2018
Press Release

Congressman Bradley Byrne (R-AL) recently partnered with a bipartisan group of Members of Congress in urging Health and Human Services Secretary Alex Azar to fix the Medicare Area Wage Index, which severely hurts Alabama’s hospitals.

Click here to read the letter.

The letter was led by Representatives Byrne, Terri Sewell (D-AL), John Duncan (R-TN), and Diane Black (R-TN). It was signed by 46 members of the House from states affected by this issue.

Alabama has the lowest Medicare reimbursement rate in the country.  Based in large part on the Wage Index, seventy-five percent of Alabama’s hospitals are operating at a loss with an average median operating margin of negative 6.5 percent. The problem is worse in rural Alabama, where hospitals have a median operating margin of negative 12.2 percent.  Unless changes are made to the Wage Index formula, the problem will continue to get worse and additional Alabama hospital closure is likely.

Congressman Byrne said: "We are facing a medical crisis in rural America. For too long, the Medicare Area Wage Index has been gamed by hospitals in very affluent parts of the country at the expense of rural America.  Congress granted CMS wide authority to administer the Wage Index, and it is time the system be reformed in order to ensure continued access to hospital care for those in rural Alabama and rural areas throughout the United States."

Congresswoman Terri Sewell stated:  “Rural hospitals are facing a crisis, and in Congress, we need to work across the aisle to find solutions that improve health care access,” said Rep. Sewell. “In Alabama’s rural Black Belt, hospitals have struggled to keep their doors open for decades, and constituents are facing decreasing access to care as a result of inadequate reimbursements for hospitals. Today’s letter calls on this Administration to provide relief for rural hospitals in the most underserved areas across the country by ensuring they receive fair reimbursement for the vital services they provide.”

Congressman Diane Black stated: “As a registered nurse, I know that protecting our quality of life and public health in Tennessee goes hand-in-hand with ensuring that our hospitals get a fair deal from Washington. The current area wage index formula discriminates against rural hospitals like those across my district while letting hospitals in the wealthiest neighborhoods of California and Massachusetts cash in on this flawed payment model. Tennessee’s healthcare providers bring lifesaving care to neighbors across the state every day. It isn’t asking too much to insist that they receive a proper reimbursement for the services they perform, and I am grateful that Secretary Azar has given us the opportunity to address this flawed system."

Congressman Duncan stated: “In the past decade, every state has faced a hospital closure, including over 120 rural hospitals, and a number of states have no rural hospitals at all.  This wage index is one of the key culprits behind these hospital closures that are causing this alarming, restricted access to care.”

Recently, during a meeting of the House Education and the Workforce Committee, Congressman Byrne questioned Health and Human Services Secretary Alex Azar about the challenges facing Alabama’s rural hospitals and secured a pledge from Secretary Azar to help address the issue.  Click here for more information.