Roe applauds Medicare wage rule, explains Syria vote

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Phil Roe in Johnson City

A new change to Medicare’s “Area Wage Index” should prove a boon to the region’s hospitals and health care providers, Tennessee Rep. Phil Roe (R-1st) said Friday. A Ballad Health spokesperson later confirmed the system expects the change to boost Medicare reimbursements systemwide by $25-30 million annually.

During a conference call, Roe also explained his vote on the resolution condemning President Donald Trump’s pullout of troops from northern Syria near the Turkish border, saying he feared a resurgence by ISIS.

“(Turkish President) Erdogan was adamant about his opposition to the Kurds, so the president decided to pull out,” Roe said. “I disagreed with the president on that.”

Roe acknowledged the complexity of the region’s geopolitics, but said even a limited U.S. military presence has had a stabilizing effect, including in the area where the Kurds have now allied with the Syrian government in a bid to protect themselves from Turkish forces. Roe joined 128 other Republicans and the entire Democratic caucus in the largely symbolic 354-60 vote condemning the troop withdrawal.

“I heard him say on the news that he had promised people he was coming out of there (Syria), so I think he’s going to stick with that,” Roe said. “My concern is that we’ll have the same issue that President Obama had. You’ll leave a void (and) it’s going to get filled with some really bad people.”

A bump for area medical providers

While the Middle East was cause for concern, Roe was much happier about a rule change from the Centers for Medicare and Medicaid Services (CMS) that took effect Oct. 1. Medicare’s “Area Wage Index” was adjusted in a way that has increased reimbursements in many rural areas, including Northeast Tennessee.

“I have been harping on this for awhile and I got much shriller once we had control of the White House,” Roe said. He said as a co-chair of the physicians’ caucus he met with Health Secretary Alex Azar several times, as well as CMS director Seema Verma.

Southwest Virginia’s Lee County Hospital closed in 2013. Ballad Health plans to reopen it next year.

“I said, ‘I know you didn’t set this system up, but if your goal is to put rural hospitals out of business, it’s working,” Roe said of those conversations. He said Tennessee has shared the lowest rural area wage indexes in the nation with Texas and Alabama, “and we have the most hospital closures.”

“If you lose your rural hospital it’s disastrous for a community,” Roe said. “Rural America’s struggling enough as it is.”

Representatives from urban areas lobbied hard against the change, which was discussed for years. Roe acknowledged that some indexing makes sense due to different cost of living. “But CT scanners cost us the same, and IV fluids, and we can’t keep our nurses,” he said. “The nurses we educate are traveling or moving elsewhere … it’s a huge problem.”

Teresa Hicks of Ballad Health said the inpatient change in the index already took effect and that outpatient increases would kick in Jan. 1, 2020. With the change still pending last spring, Ballad elected to put $10 million into raising nursing and other clinical pay rates in an effort to boost recruitment and retention.

“When I look back at my career, for where we live that may be one of the most important things we did,” Roe said. “It will be a huge help for our area and for the people who live in Northeast Tennessee and Southwest Virginia.”



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