HJAR May/Jun 2022

8 MAY / JUN 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   EDITOR’S DESK Forgive me, my time in Texas just poked through. But, from this editor’s perspective, what is happening to citizens in Arkansas and other poor states, vis à vis the Medicare Area Wage Index (AWI), using federal funds is unconscionable. In this AWI death spiraI, hospitals in rural areas and poorer states are paid nearly 30% less for the same procedure than is paid to the average U.S. hospital when treating a Medicare patient, which includes nearly all 65+ Americans. Oh, and 180% less than what is paid to richer, urban hospitals. Know why? Because you are poor. It is a dirty little secret that hospitals in poorer states have had to accept because the richer, more powerful ones have more congressional representatives to keep it that way and to ensure their hospitals get paid more. This is set up as a David and Goliath fight. It shouldn’t be. Our leadership time is now; may we continue to find a way to provide the best care for all. If rules set up by past leaders, for different circumstances, need to be adjusted, then let’s have the courage to rewrite the rulebook. Current rules and laws are making this way too complicated and simply unfair to people in poorer states and rural areas. Should Medicare payments across the U.S. be equal — you know, that “... one nation under God, indivisible, with liberty and justice for all,” thing? Should the index be flipped temporarily to give these hospitals a chance to catch up? Should the federal government be blind to cost-of-living indexes when it comes to healthcare, because the pandemic exposed the need for all hospitals to be able to compete nationally for workforce? We asked Bo Ryall from the Arkansas Hospital Association to explain, in more eloquent terms than my expletive above, the background and status of the Medicare Wage Index. Bo, you are right; this is a “meaty topic.” Readers, be prepared to hold your noses, and when you are finished, let’s figure out how to change this. Poor means poor; it doesn’t mean less. We, as a country, can do better. Let’s. Dianne Marie Normand Hartley Chief Editor editor@healthcarejournalar.com bull·shit /ˈbo͝ olˌSHit/ VULGAR SLANG noun 1. stupid or untrue talk or writing; nonsense. verb 1. talk nonsense to (someone), typically to be misleading or deceptive.