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Secretaries cite regulatory flexibilities, financial reviews and pilot programs as tools to blunt rural hospital and EMS strain
Summary
Department of Health testimony to the House Appropriations Committee emphasized exception processes, financial review of ownership changes and loan‑repayment incentives as tools to maintain rural hospital services and shore up EMS readiness.
Lawmakers pressing the Department of Health about hospital closures, maternity‑care deserts and emergency medical services heard that the administration is using several tools — regulatory exceptions, change‑of‑ownership financial review and workforce programs — to try to preserve rural access to care.
Secretary Deborah Bogan said the department reviews exception requests from rural hospitals and has used an exception process in several cases to provide regulatory flexibility. She said the department is also reviewing hospital regulations with an eye toward changes that could ease rural hospital operations and is promoting loan‑repayment programs and J‑1 visa assistance as workforce strategies to retain clinicians in small hospitals.
Federal demonstration wind‑down and state response: Bogan noted the Pennsylvania Rural Health Model (PARM), a Centers for Medicare and Medicaid Innovation demonstration, concluded its main performance period on Dec. 31, 2024, with a two‑year Medicare wind‑down. She said 16 of the 18 PARM hospitals remain open and that state teams are working with rural health stakeholders to design simpler programs that could be scaled to more facilities.
Change‑of‑ownership financial reviews: The department described a review process developed for long‑term‑care transactions that requires audited financial statements and supported denying some change‑of‑ownership applications when financial concerns existed. Bogan said the department could consider applying similar scrutiny for hospitals during ownership changes.
EMS pressures and funding: Committee members asked about EMS closures and overcrowding. Bogan described a small Bureau of EMS staff, new hires for EMS financial management and a multi‑stakeholder work group that will issue recommendations this year on emergency‑department overcrowding, workforce and regional coordination. She said state MSOF (Medical Services Operating Fund) balances and fee collections are being reallocated to support EMS agencies and that the department is pursuing training and readiness investments.
Why it matters: Legislators from rural districts stressed that closures and service loss have immediate effects on access to urgent care, maternal services and routine primary care. The secretaries agreed to provide additional details on exception requests, hospital regulatory reviews and EMS funding plans.
