The Federation of American Hospitals, the national representative of more than 1,000 hospitals and health systems throughout the US, asked Congress to support rural providers by reauthorizing two Medicare payment programs — the Medicare-dependent Hospital program and the Low-Volume Hospital program — before they expire on Oct. 1.

The MDH program and LVH payment programs provide rural hospitals with “financial stability and support they need to prevent closures and ensure continued access to care in rural communities,” FHA President Charles Kahn III stated in an Aug. 30 letter to congressional leaders.

These are “unprecedented times” for rural hospitals, according to Kahn, with escalating operating costs adding to the immense financial pressures rural hospitals already face.

“The nation’s healthcare workforce shortage, in particular, is having a devastating, disproportionate impact on rural hospitals,” the letter stated. “Long-documented recruitment challenges have been exacerbated by an aging healthcare workforce, burnout, price gouging by traveling nurse staffing agencies, competing higher wages in larger cities, and a slowing of visas granted to foreign healthcare workers — all factors that are contributing to higher average payrolls and strained resources.”

The MDH was created in 1989 to help smaller, rural hospitals that have a high share of Medicare patients, according to Fierce Healthcare. The program gives eligible hospitals an additional payment if their costs are higher than the rates in the Inpatient Prospective Payment System. The LVH also offers a payment adjustment for hospitals that have a small volume of Medicare patients.