Blackburn, Kustoff Introduce Rural Health Agenda to Ease Financial Strain for Rural Hospitals, Expand Access to Urgent Care, and Strengthen Recruiting

Blackburn, Kustoff Introduce Rural Health Agenda to Ease Financial Strain for Rural Hospitals, Expand Access to Urgent Care, and Strengthen Recruiting
March 26, 2026
WASHINGTON, D.C. –
Today, U.S. Senator
Marsha Blackburn
(R-Tenn.), co-chair of the Senate Rural Health Caucus, and U.S. Representative
David Kustoff
(R-Tenn.) introduced their bicameral and bipartisan Rural Health Agenda, which includes the
Save Struggling Hospitals Act
,
Rural Health Innovation Act
, and
Rural America Health Corps Act
.
Read more about each of these bills below.
“Rural Tennesseans and Americans face countless barriers to accessing quality health care in their communities,”
said Senator Blackburn.
“78 of Tennessee’s 95 counties are considered rural, and addressing health care delivery challenges in rural America could mean the difference between life and death for some patients. The Rural Health Agenda targets key areas of reform, including the recruitment of health professionals, the delivery of urgent care and emergency triage services, and the flawed Medicare Area Wage Index that results in rural hospitals receiving lower payment rates.”
“Access to healthcare should not depend on a person’s ZIP code,”
said Representative Kustoff.
“I am proud to help advance the rural health agenda to expand access to quality care in Tennessee and across the nation. It is vital that rural hospitals, clinics, and providers remain a reliable resource for the people who depend on them every day.”
SAVE STRUGGLING HOSPITALS ACT
Rural hospitals are closing at an alarming rate with more than
200
rural hospitals around the nation having closed or converted to models that exclude inpatient care since 2010. Low patient volumes and significant financial strain are often the primary factors in these rural hospital closures. Financial strain for rural hospitals is compounded by the flawed Medicare Area Wage Index that results in rural hospitals receiving lower payment rates.
The Medicare Area Wage Index formula is based on outdated assumptions for labor costs, resulting in hospitals in historically high-wage urban markets continuing to receive higher payments, while lower-wage regions start from a lower-wage base and cannot easily catch up because Medicare payments themselves influence wage capacity.
The
Save Struggling Hospitals Act
, sponsored by
Senator Mark Warner
(D-Va.), would strengthen rural health care by ensuring that hospitals in rural and low-wage areas receive
fair Medicare reimbursement
for the essential services they provide.
The bill would codify the Medicare low-wage index hospital policy, which increases Medicare wage index values for hospitals in the bottom 25
th
percentile.
This legislation is endorsed by the Alabama Hospital Association, Ballad Health, Community Health Systems, Lifepoint Health, National Association of Rural Health Clinics, National Rural Health Association, Tennessee Hospital Association, Virginia Hospital and Healthcare Association, Virginia Hospital and Healthcare Association, and University of Tennessee Medical Center. It is co-sponsored by Senators
Cindy Hyde-Smith
(R-Miss.) and
Tommy Tuberville
(R-Ala.).
Click
here
for bill text.
RURAL HEALTH INNOVATION ACT
Rural Americans increasingly face barriers to accessing quality health care in their communities, including workforce shortages, geographic distance, limited transportation options, gaps in broadband access, and lower health literacy. Together, these challenges make it harder for rural patients to receive timely care close to home and contribute to significant health disparities between rural and urban populations. Rural residents are
more likely
to die prematurely from the five leading causes of death—including heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.
Low patient volumes and financial pressures have made it increasingly difficult for rural hospitals to remain open, further limiting access to care and creating additional challenges for local economies that rely on health care providers as major employers.
The
Rural Health Innovation Act
, co-sponsored by Senator
John Hickenlooper
(D-Colo.), would address these challenges by helping rural communities expand urgent care and emergency triage services through existing local health infrastructure by establishing two competitive grant programs administered by the Health Resources and Services Administration (HRSA).
The Rural Health Center Innovation Awards Program would support Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) by expanding their ability to provide walk-in urgent care, triage, and emergency stabilization services.
The Rural Health Department Enhancement Program would provide grants to rural local health departments to help meet urgent care and triage needs in their communities
This legislation is endorsed by the National Rural Health Association.  It is co-sponsored by Senator
Hyde-Smith
.
Click
here
for bill text.
RURAL AMERICA HEALTH CORPS ACT
Rural communities face persistent challenges recruiting and retaining health professionals, which can compound the economic and workforce challenges these areas already face. As a result, millions of rural Americans live in federally designated shortage areas for physicians, dentists, and mental health providers.
The National Health Service Corps (NHSC) typically provides $50,000 in loan repayment awards for a 2-year service commitment to attract clinicians to serve in communities with shortages of health professionals. However, only about one-third of NHSC placements are in rural areas. After completing their two-year commitment, many clinicians leave for higher-paying opportunities elsewhere.
The
Rural America Health Corps Act,
co-led by Senator
Dick Durbin
(D-Ill.), would incentivize more health professionals to serve and plant roots in rural communities by creating a pilot program within the NHSC.
Under the program, the U.S. Department of Health and Human Services would help repay student loans for clinicians who agree to work full-time in a rural health professional shortage area for five years. Participants could receive up to $200,000 in loan repayment.
This legislation is endorsed by the American Hospital Association (AHA), National Rural Health Association (NRHA), and American Psychiatric Association. It is co-sponsored by Senators
Shelley Moore Capito
(R-W. Va.),
Lisa Murkowski
(R-Alaska), and
Gary Peters
(D-Mich.).
Click
here
for bill text.
RURAL HEALTH AGENDA ENDORSED BY TENNESSEE HOSPITAL ASSOCIATION
The Rural Health Agenda is endorsed by the
Tennessee Hospital Association
:
“Hospitals across Tennessee are grateful for Senator Blackburn’s continued leadership to strengthen rural healthcare through efforts to enhance the rural workforce and patient access. I applaud Senator Blackburn for her leadership on the Save Struggling Hospitals Act to address the flawed area wage index which has strained Tennessee hospitals for decades. By mitigating the downward spiral hospitals face, this legislation will help to level the playing field and ensure patients across Tennessee have access to the care they need,”
said Dr. Wendy Long, President and CEO of the Tennessee Hospital Association.
https://www.blackburn.senate.gov/2026/3/health care/blackburn-kustoff-introduce-rural-health-agenda-to-ease-financial-strain-for-rural-hospitals-expand-access-to-urgent-care-and-strengthen-recruiting