Hospitals Help: Schoolcraft Memorial Expands Access to Financial Assistance for Rural Residents

The teams at Schoolcraft Memorial Hospital (SMH) are working to expand access to financial assistance to ensure residents across Michigan’s Upper Peninsula don’t delay or forego essential care.

As rising healthcare costs continue to impact communities and hospitals across the state, SMH remains committed to caring for all patients regardless of their ability to pay. The hospital’s sliding fee scale program offers financial assistance to those who have limited or no means of covering medical costs.

In understanding the financial realities that many rural households currently face, SMH recently revised their program eligibility to take into account a broader range of essential living expenses.

Housing, utilities, food, medical debt and transportation costs are all factored in when determining a patient’s eligibility for assistance. Those who qualify are also given access to financial counseling and support from a patient financial services representative.

During a routine OB/GYN appointment, one provider caring for a patient named Kathy discovered a lump that required a mammogram and ultrasound for further investigation. Kathy chose to drive 90 minutes to seek follow-up care at Schoolcraft Memorial Hospital in Manistique, MI.

Rather than wait months for insurance-covered care or scrambling to pay out of pocket, Kathy turned to Schoolcraft Memorial Hospital’s financial services team and received assistance that made it possible for her to get the care she needed, when she needed it.

“Knowing I was going to get help with this, especially while waiting to find out if something could be seriously wrong, made all the difference,” she said.

Federal initiatives like the 340B Drug Pricing Program also play a critical role in helping rural residents access lifesaving medications and essential services close to home, from preventive screenings to advanced treatments.

As an independent critical access hospital serving the central upper peninsula, SMH teams are focused on reducing barriers that prevent residents from getting the care they need. Under Internal Revenue Code Section 501(r), non-profit hospitals are required to have a written Financial Assistance Policy (FAP). Those who previously did not qualify for financial assistance are encouraged to reapply under the hospital’s updated guidelines.

Questions or content ideas for the Hospitals Help series may be directed to Lucy Ciaramitaro at the MHA.

State House Minority Leader Addresses Legislative Policy Panel

Rep. Ranjeev Puri (D-Canton) during the MHA Legislative Policy Panel at the MHA Capitol Advocacy Center.

State House Minority Leader Ranjeev Puri (D-Canton) addressed the MHA Legislative Policy Panel May 13 at the MHA Capitol Advocacy Center, providing the panel with a legislative and political update and sharing his commitment to protecting access to care for Michiganders. During the meeting, the panel developed recommendations for the MHA Board of Trustees on legislative initiatives affecting Michigan hospitals.

MHA Capitol Advocacy Center staff provided updates on healthcare activity at the federal and state levels. Adam Carlson, senior vice president, advocacy, MHA, shared additional details on the state budget, including timelines and current proposals.

Taylor Alpert, director, government relations, MHA, presented Senate Bill (SB) 910, which would establish a commission to review the cost of legislatively mandated healthcare coverage.

Elizabeth Kutter, vice president and deputy general counsel, MHA, provided presentations on federal legislation related to 340B rebate program exemptions and SB 914, which could require insurers to recognize patient prescription drug payments toward deductibles and annual out-of-pocket maximums.

The panel also received an update on Certificate of Need legislation.

The panel recommended that the MHA support legislation establishing a process to review government mandates on health insurers and providers.

For more information on the MHA Legislative Policy Panel, contact Adam Carlson at the MHA.

Media Recap: Behavioral Health and Drug Manufacturer Pressures

Common Ground published a story April 28 detailing Michigan’s behavioral health landscape. Lauren LaPine-Ray, DrPH, MPH, vice president, policy & rural health, was cited throughout the article highlighting growing concern about emergency department (ED) boarding. LaPine-Ray notes that hospitals are increasingly serving as the default entry point for patients experiencing mental health crises due to gaps in the behavioral health system. She shared the staggering number of patients – more than 155 – in Michigan emergency departments each day waiting for behavioral health services.

MHA CEO Brian Peters pushed back on a Michigan Health Purchasers Coalition report that falsely represents the federal 340B drug discount program in an article published by MIRS April 29.

Peters highlights the report’s flawed methodology and urges the coalition’s members to engage with Michigan hospitals on solutions that address the real drivers behind rising healthcare costs like the prices set by drug manufacturers.

Members with questions regarding media requests should contact Elise Gonzales at the MHA.

Fact Check: Drug Pricing Savings Are the Lifeline to Community Healthcare Services

Gary L. Roth, DO, Chief Medical Officer, MHA

Recent headlines have taken aim at the 340B Program – a federal drug savings initiative that serves as a lifeline to important community healthcare services. As a long-time cardiothoracic surgeon, it’s time to set the record straight on 340B.

Here’s the reality: doctors, nurses and healthcare leaders share patient’s frustration over rising healthcare costs. Michigan hospitals and health systems employ 222,000 residents, while healthcare is the largest employer in the state. We experience rising healthcare costs and premiums in lockstep with other businesses; while seeing those costs in the faces of every patient who walks through our doors and how cost can influence a person’s decision to seek care.

But attacking the 340B program is the wrong answer to a real problem.

What 340B Actually Does

The 340B program allows eligible hospitals and safety-net healthcare providers – those serving disproportionately high numbers of low-income and uninsured patients – to purchase certain outpatient drugs at reduced prices. The savings are directly reinvested into patient care: keeping rural emergency departments open, funding behavioral health services, expanding pharmacy access in underserved communities and subsidizing care for patients who cannot pay.

Hospitals located in 340B-eligible communities are reimbursed at levels below the full cost to deliver care. This federal program was created to financially support community-based healthcare services without spending any taxpayer dollars.

In Michigan, where rural hospital closures remain a persistent threat and safety-net institutions serve our most vulnerable neighbors, 340B is a lifeline to keeping healthcare close to home. For myself, who spent my career caring for critical care patients in the Greater Lansing area, 340B is a key part of supporting the healthcare we can receive in our community. I know 340B works because of my lived experience providing care because of it. Without 340B savings, some Michigan hospitals would face an impossible choice: cut lifesaving services or close their doors.

Let’s examine what these recent headlines are doing – distracting attention from the reality that drug companies are significantly driving healthcare costs. Their solution is to blame the caregivers and their hospitals that care for everyone who walks through their doors, year-round.

Drug prices in the United States have risen at rates that far outpace inflation. The cost of drugs for hospitals grew 13.6% last year, while hospital prices only increased 3.3%.

Unlike hospitals, drug companies set their own prices with virtually no regulatory check. Unlike hospitals, drug companies boast nearly 23% annual increases in revenue while still raising drug costs. Unlike hospitals, they don’t have to be open at 3 a.m. when someone’s child is struggling to breathe. Hospitals are the ones staying through the night to treat emergency aneurysms, heart attacks and strokes. I know this because I’ve treated far more than I can count.

Hospitals are always there. Always caring. Always working to advance care, regardless of ability to pay, regardless of the hour, regardless of the complexity.

This tension between drug pricing and healthcare affordability was exactly the kind of issue raised at a recent Crain’s Detroit Business Healthcare Affordability Roundtable, where Michigan hospitals and business leaders gathered to confront the systemic forces driving costs higher. The consensus was clear: meaningful reform requires looking at the full picture, including the drug supply chain, and not taking a scalpel to programs that help hospitals keep their doors open around the clock to serve the patients who need them most.

Let’s Solve the Right Problem Together

Accountability and transparency matter and the MHA support both. What I know from meeting and caring for patients is that meaningful solutions are those that impact their pocketbook without touching their healthcare services. Dismantling 340B as drug companies and their partners wish to do fails to achieve either of those outcomes. It instead pads drug company profits while risks community healthcare services.

The MHA is ready to be at the table. We invite lawmakers, business leaders, insurers and drug companies to join us in pursuing real, collaborative solutions to the cost challenges facing Michigan families.

WJR Spotlight Highlights the Importance of the 340B Drug Pricing Program

Elizabeth Kutter, vice president and deputy general counsel, MHA, joined Paul W. Smith for a WJR Spotlight interview April 9 about the value the federal 340B Drug Pricing Program brings to Michigan communities.

The conversation explored how hospitals use 340B savings to reinvest directly into patient care by maintaining or expanding services, lowering out-of-pocket costs and supporting community health initiatives.

The segment also addressed ongoing pressure from drug manufacturers to enact policy changes that would weaken the program through restrictions that would impact healthcare access, especially in rural communities. Kutter emphasized how the program operates at no cost to taxpayers and allows hospitals to stretch limited resources as drug, labor and supply costs continue to rise.

Members with questions regarding media requests should contact Elise Gonzales at the MHA.

Hospitals Help: Mackinac Straits Retail Pharmacy Serves as a Lifeline in Northern Michigan

Mackinac Straits Health System opened its retail pharmacy in St. Ignace.

Mackinac Straits Health System opened its retail pharmacy in St. Ignace following valuable feedback from the community.

Previously, the community lacked access to pharmacy services on weekends and holidays. This created additional barriers to care, requiring patients to travel in excess of 60 to 100 miles round trip to the next closest pharmacy.

Now, the retail pharmacy continues to prosper and provides a lifeline for rural communities in the Straits area, filling over 56,000 prescriptions annually.

The 340B program has allowed the health system to promote discounted medications, enhanced vaccination offerings and specialty care services. Created by Congress more than 30 years ago, the 340B program helps hospitals and community health centers stretch their limited resources further without using any state taxpayer dollars.

“The 340B program directly benefits patients by allowing us to stretch scarce federal resources to offer critical services including additional pharmacy access and personalized prescription delivery to those who have limited means of transportation on Mackinac Island and beyond,” said Karen Cheeseman, president and chief executive officer, Mackinac Straits Health System.

Those interested in learning more about the program can visit the 340B webpage. To read more positive hospital stories, check out more Hospitals Help webpage and the 2025 Community Impact Report.

Members with questions may contact Lucy Ciaramitaro at the MHA.

Media Recap: Rural Health Transformation Project Fund Distribution

The Detroit News published a story Jan. 29 on two recent House Appropriations Committee hearings on the distribution of Rural Health Transformation Program (RHTP) funds.

The article details concern from House lawmakers and rural providers surrounding the program, particularly the designation of Wayne and Oakland counties as partially rural in the Michigan Department of Health and Human Services (MDHHS) RHTP application.

Lauren LaPineLauren LaPine-Ray, DrPH, MPH, vice president, policy and rural health, MHA, is quoted in the story clarifying the department’s commitment expressed to the MHA to ensure rural communities benefit from the funding.

“The state is juggling varying state and federal definitions of rural as it applies for and administers the program,” LaPine-Ray said.

“I can say, very transparently, in our conversations with MDHHS, they did not intend to define a rural community as being one within Wayne or Oakland County,” she said. “They were very specific and intentional in making sure the definition that they used really focused on rural community and rural populations.”

The MHA also received coverage from MIRS and Bridge on 340B and medical debt collection legislation.

Members with questions regarding media requests should contact Elise Gonzales at the MHA.

 

Healthcare Bills Advance During Final State Legislative Session Week of 2025

Enforcement of hospital price transparency measures, removal of mental health questions on health professionals’ license applications, and the creation of a palliative care advisory task force were among the healthcare-related bills that advanced in the House and Senate in the final legislative session week of 2025.

The House of Representatives unanimously approved Senate Bill (SB) 95 by a vote of 106-0. Sponsored by Sen. Jonathan Lindsey (R-Coldwater), the bill enforces hospital price transparency measures largely based on existing federal requirements and prohibits medical debt collection when a hospital is out of compliance with those requirements. The legislation now awaits concurrence action in the Senate. SB 95 was previously tied to legislation protecting the 340B program in Michigan, and the MHA supports maintaining 340B as an integral component of the bill package.

The House also passed House Bill 4277, sponsored by Rep. Matthew Bierlein (R-Vassar), which removes mental health questions from licensure applications for healthcare professionals. The MHA-supported bill has been referred to the Senate for further consideration.

Additionally, the Senate passed SB 483 on Dec. 16. Sponsored by Sen. Rosemary Bayer (D-West Bloomfield), the bill establishes a palliative care advisory task force within the Michigan Department of Health and Human Services. The task force would develop an annual report identifying palliative care services offered throughout the state. The MHA-supported bill has been referred to the House Government Operations Committee.

Members with questions may contact the MHA advocacy team.

MHA Monday Report Oct. 6, 2025

Michigan Legislature Passes State Budget, Preserves Healthcare Funding

The Michigan House of Representatives and Michigan Senate passed a state budget protecting all existing healthcare funding on Oct. 3. House Bill 4706, sponsored by Rep. Ann Bollin (R-Brighton), passed by both chambers, includes …


CMS Shares Updates for Medicare Operations During Federal Shutdown

The Centers for Medicare and Medicaid Services (CMS) recently directed Medicare Administrative Contractors to hold Medicare fee-for-service claims for ten business days due to the expiration of several Medicare payment provisions and the Oct. …


Hospital Communicators Gather at MHA Communications Retreat

The 2025 MHA Communications Retreat brought together about 100 communications, marketing and public relations professionals from MHA-member facilities Oct. 1 to network and learn from peers across the state. The agenda featured sessions on reputation management …


CE Credits Available for Maternal Health Quality Improvement Modules

Continuing education (CE) credits are now available for obstetric teams that complete the Michigan Alliance for Innovation on Maternal Health (MI AIM) virtual modules. The approximately three-hour series consists of the following modules: MI AIM …


MDHHS Introduces New Provider Updates Under Michigan’s Mental Health Framework

The Michigan Department of Health and Human Services (MDHHS) recently introduced new requirements under the state’s Mental Health Framework to strengthen assessments, referrals and care coordination for Medicaid enrollees. These changes take effect beginning October …


MHA Rounds image of Brian PetersMHA CEO Report — Launching Collaboratives to Improve Community Health

In the healthcare community, we know that a person’s health is shaped outside the four walls of a hospital and our support must expand beyond acute care. The MHA recently launched community benefit collaboratives with …


Keckley Report

Who Owns the Public’s Health?

“September 2025 marks a significant shift in U.S. health policy, especially its approach to the public’s health. …

Public health is a vital part of the U.S. health system but a stepchild to its major players. In reality, the U.S. operates a dual system: one that serves those with insurance (public and private) and another for those without. Public health programs like SNAP, HeadStart, Federally Qualified Health Centers et. al., serve lower income and under-insured populations and integrate with local delivery systems emergency services and during mass-events like pandemics, mass-casualties and disease outbreaks. Funding for public health programs is 2-5% of total health spending shared between local, state and federal governments.

Studies show food, housing and income insecurity—areas targeted by public health– correlate to chronic disease prevalence and health costs. Unlike most developed systems of the world which operate at a lower cost and produce better population-health outcomes, our system perpetuates a structural divide between healthcare and public health. Integrating the two is a necessary strategy for system transformation, but a difficult task given entrenched animosity toward “the system” held by public health leaders and funding pressures.  The bridge between public health and the healthcare delivery systems is a two-lane road with lots of potholes at the federal level, and sometimes better in local communities. But funding seems to be an afterthought unless local communities deem it vital.”

Paul Keckley, Sept. 28, 2025


New to Know

News to Know

  • MHA Endorsed Business Partner (EBP) SunRx is hosting a 340B Regulatory Brief webinar Nov. 4 at 2 p.m. EDT with Bharath Krishnamurthy, health policy & analytics, American Hospital Association.
  • The American Hospital Association (AHA) is accepting applications for the AHA’s 2026 Dick Davidson NOVA Award.

 

MHA Monday Report Sept. 29, 2025

House Health Policy Hears Testimony on 340B Legislation

The House Health Policy Committee took up recently introduced legislation addressing 340B contract pharmacy arrangements during the week of Sept. 22. House Bill 4878, sponsored by Rep. Curt VanderWall (R-Ludington), was recently introduced and …


U.S. Senate Approves SUPPORT Act Reauthorization to Address Opioid and Mental Health Crisis

The U.S. Senate passed the SUPPORT for Patients and Communities Reauthorization Act of 2025 on Sept. 18. The bill would provide more resources for preventing and treating addiction and mental illness. It passed the U.S. …


Vault Verify’s Role in HR Automation Featured in Podcast

MHA Endorsed Business Partner Vault Verify was recently featured on the RPI Tech Connect podcast episode “From Manual to Measurable: How UMMS Streamlined HR with RPI and Vault Verify.” Rebecca Hielke from the University of …


MHA Keystone Center PSO Hosts Human Errors and Design Thinking Safe Table

Registration is open for the MHA Keystone Center Patient Safety Organization (PSO) Human Errors and Design Thinking Safe Table. The event will be held from 10 a.m. to 3 p.m. on Oct. 1 at the …


Catching Up on All Things Healthcare with Tina Freese Decker

The MHA released a new episode of the MiCare Champion Cast exploring state and federal healthcare priorities with Tina Freese Decker, MHA, MSIE, FACHE, president & CEO, Corewell Health and 2025 chair of the American …


Keckley Report

Responding to Trump Healthcare 2.0: Key Takeaways after 8 Months

“The Trump 2.0 administration is 8-months into its MAGA agenda. Summer has passed. Schools are open. Congress is in session. Campaign 2026 is underway. The economy is slowing and public sentiment is dropping.

For U.S. healthcare, it’s more bad news than good. The challenges are unprecedented. Most organizations—hospitals, medical groups, drug and device makers, infomediaries and solution providers, insurers, et al—are defaulting to lower risk bets since the long-term for the health system is unclear.

The good news is that the health system in the U.S. is big, fragmented, complex, expensive (5% CAGR spending increases thru 2034) and slow to change. It is highly regulated at local, state and federal levels, labor intense (20 million) and capital-dependent (government funding, private investment)—a trifecta nightmare for operators and goldmine for private investors who time the system for shareholders effectively. And it operates opaquely: business practices are hidden from everyday users and bona-fide measures of its effectiveness not widely applied or accepted. …

Trump Healthcare 2.0 is not transformational: it is transactional. It aims to simplify the system and facilitate changes certain to disrupt the status quo. Its locus of control, is Main Street USA. not Pennsylvania Ave, in DC.”

Paul Keckley, Sept. 21, 2025


New to Know

News to Know

  • More than 50 Michigan hospitals are coming together to improve outcomes in maternal health, behavioral health and chronic disease through new community benefit collaboratives.
  • The MHA Human Resources (HR) & Workforce Council met Sept. 25 to discuss current HR priorities and review its role in advancing the mission of the MHA and the role of human resource leaders.
  • MHA Endorsed Business Partner (EBP) SunRx is hosting a 340B Regulatory Brief webinar Nov. 4 at 2 p.m. EDT with Bharath Krishnamurthy, health policy & analytics, American Hospital Association.
  • The American Hospital Association (AHA) is accepting applications for the AHA’s 2026 Dick Davidson NOVA Award.