Save America’s Rural Hospitals Act

The Save America’s Rural Hospitals Act would tilt Medicare and Medicaid payments more favorably toward rural health providers and reduce regulatory barriers, with the aim of preventing rural hospital closures and preserving access to care in rural communities. It would permanently extend and expand several targeted payment adjustments (for rural hospitals, low-volume hospitals, and Medicare-dependent hospitals), implement wage-index reforms to boost rural payments, extend telehealth and ambulance payment enhancements, and restore state flexibility on CAH designations. The bill also creates new grant programs to help rural hospitals transition to alternative care models (such as rural emergency hospitals) and to support rural health clinics and other rural providers. Several provisions are phased in over time (including a 60-day post-enactment lead time and targeted triggers around 2025 and 2026), with a focus on stabilizing finances and increasing access for rural Medicare beneficiaries. Overall, the bill seeks to stabilize rural provider finances, expand access to emergency and routine care in rural areas, and give rural communities more tools to adapt to changing health-care delivery models, while adding cost and budget considerations that would need to be financed and evaluated in any broader legislative package.