Official podcast from the Nebraska Alliance for Physician Advocacy. This is a 501(c)(3) organization dedicated to supporting Nebraska physicians in their advocacy efforts to improved the practice of medicine, the health of their communities and physician well-being.
HR1 Series: Medicare Impact on Physician Payment and A Deep Dive Into How Doctors Get Paid.
This podcast is FULL of the background on the physician fee payment structure and how HR1 is immediately impacting this year. Dr. Fox is a long time advocate with great insight into how to bring about meaningful change moving forward.
Revaluing Physician Services: CMS Has Some (but Not All) Answers | Annals of Internal Medicine (https://www.acpjournals.org/doi/abs/10.7326/ANNALS-25-03638)
William Fox. Revaluing Physician Services: CMS Has Some (but Not All) Answers (https://www.acpjournals.org/doi/abs/10.7326/ANNALS-25-03638). Ann Intern Med.2026;179:127-128. [Epub 4 November 2025]. doi:10.7326/ANNALS-25-03638 (https://doi.org/10.7326/ANNALS-25-03638)
Schafer J, Vogel M, Grell T, Paez M, Parker A. 2023 Status of the Nebraska Healthcare Workforce. University of Nebraska Medical Center; 2023:70. https://www.unmc.edu/rural-health/_documents/healthcare-workforce-2024.pdf#2023%20Report (https://www.unmc.edu/rural-health/_documents/healthcare-workforce-2024.pdf)
Key Findings on Primary Care Deserts (2023-2024 Data):
County-Level Shortages: In 2023, 21 of Nebraska's 93 counties lacked a primary care physician.
Maternity Care Deserts: Over 50% of Nebraska counties are considered maternity care deserts, lacking access to OB/GYN care or birth centers, which is significantly higher than the national average of 32.6%.
Geographic Concentration: Approximately 83% of all diagnosing and treating practitioners in Nebraska are concentrated in metropolitan areas (Omaha/Lincoln), leaving rural areas underserved.
Aging Workforce: A significant portion of the workforce is nearing retirement, with 19.4% of physicians in Nebraska being 61 or older, increasing the risk of further shortages in the next 5-10 years.
Shortage Trends: While the number of counties with at least one primary care physician slightly increased, the overall number of primary care physicians per 100,000 population has continued to decline.
Acronym key:
Relative Value Scale Update Committee (RUC)
Relative Value Units (RVU)
Medicare Payment Advisory Commission (MedPAC)
Medicare Access and CHIP Reauthorization Act 2015 (MACRA)
Merit-Based Incentive Payment System (MIPS)
Medicare Economic Index (MEI)
William E. Fox, MD MACP is the Immediate Past Chair of the American College of Physicians, the country's largest medical specialty organization, representing internal medicine physicians, related subspecialists, and medical students.
Previously, Dr. Fox served as Chair of ACP’s Board of Governors and prior to that, he served as Governor of ACP’s Virginia Chapter. Dr. Fox has received numerous honors and recognitions including the American College of Physicians Virginia Young Internist of the Year award in 2010, the Paul Florentino Volunteerism Award in 2013 and the Richard Neubauer Advocate for Internal Medicine Award in 2014.
We rely on your donations to keep producing this podcast content and to support physician advocacy in Nebraska. If you would like to support Nebraska Alliance for Physician Advocacy, a 501(c)(3) organization in Nebraska please click to DONATE NOW. (https://www.paypal.com/donate/?hosted_button_id=4KF6XCPLQU56Y)
If you have questions or answers, please email us at contact@nebraskaallianceforphysicianadvocacy.org
Please check out our website at: Nebraska Alliance for Physician Advocacy (https://nebraskaallianceforphysicianadvocacy.org/)
Follow on social media:
@NEAllianceforPhysicianAdvocacy (https://www.instagram.com/neallianceforphysicianadvocacy/) on Instagram
https://www.facebook.com/neallianceforphysicianadvocacy (https://www.facebook.com/neallianceforphysicianadvocacy) on Facebook
22 Feb 2026
HR1 and Title X: Reproductive Health Collaborative Nebraska
Join Dr. Libby Crockett as she talks with Joanna Murray and Cleo Zagurski from the Reproductive Health Collaborative, Nebraska to learn about Title X in the State of Nebraska and how HR1 affects the delivery of reproductive healthcare in our state.
Reproductive Health Collaborative Nebraska Advocacy Ask:
Contact your U.S. Senators and Representative and urge them to reach out to HHS and demand the immediate release of the Title X - Year 5 non-compete continuation application and guidance. Nebraska stands to lose over $2 million dollars for the coming year if Title X funding is not released, which will lead to possible clinic closures and Nebraskans not receiving life-saving preventative care.
Senator Fischer’s Office: 202-224-6551
Senator Ricketts' Office: 202-224-4224
Representative Flood’s Office: 202-225-4806
Representative Bacon’s Office: 402-938-0300
Representative Smith’s Office: 308-384-3900
Reproductive Health Collaborative Nebraska Links:
https://rhcnebraska.org/ ( https://rhcnebraska.org/)
https://incontrolnebraska.com/ (https://incontrolnebraska.com/)
Link to HR1 - One Big Beautiful Bill Act
https://www.congress.gov/bill/119th-congress/house-bill/1 (https://www.congress.gov/bill/119th-congress/house-bill/1)
If you have questions or answers, please email us at contact@nebraskaallianceforphysicianadvocacy.org (contact@nebraskaallianceforphysicianadvocacy.org )
Please check out our website at: https://nebraskaallianceforphysicianadvocacy.org/ (https://nebraskaallianceforphysicianadvocacy.org/)
Nebraska Alliance for Physician Advocacy
Follow on social media:
@NEAllianceforPhysicianAdvocacy (@NEAllianceforPhysicianAdvocacy) on Instagram
https://www.facebook.com/neallianceforphysicianadvocacy (https://www.facebook.com/neallianceforphysicianadvocacy) on Facebook
The views and opinions expressed on this podcast are solely those of the speakers and guests and do not necessarily reflect the official policy or position of their employers or any other organization or entity. This podcast is for informational and entertainment purposes only and does not constitute professional medical, legal, or financial advice. If you have a specific concern, please consult with a qualified professional.
17 Jan 2026
HR1 In Nebraska: Rural Health Transformation Fund
Join Thanks to our guest today, Jed Hansen, PhD, APRN, FNP-C, who is the Nebraska Rural Health Association’s Executive Director. He and Libby Crockett, MD are discussing the Rural Health Transformation Fund which was established by HR1 (or the One Big Beautiful Bill Act) July 4, 2025.
He serves as the Nebraska Hospital Associations’s rural consultant. He is a native Nebraskan, growing up in the community of Minden. His academic background is focused on healthcare utilization facilitators and barriers in ambulatory care settings.
Dr. Hansen leads projects focused on the rural emergency hospital model, improving veteran access to care, and innovative community-level health economic models. He also works diligently to improve interoperability and data flow in rural health care settings and increase workforce pipelining.
Dr. Hansen is a fellow of the National Rural Health Association, the 2023 Rural Advocate of the Year and he recently published in JAMA on the impact of OBBA/HR1 on rural healthcare (read it here): https://pubmed.ncbi.nlm.nih.gov/40900579/ (https://pubmed.ncbi.nlm.nih.gov/40900579/)
Additional Background on HR1 (OBBA)
Link to HR1 (https://www.congress.gov/bill/119th-congress/house-bill/1) - One Big Beautiful Bill Act
NE DHHS text of Application (https://dhhs.ne.gov/Pages/Rural-Health-Transformation.aspx)- click here and scroll down to find text of application
https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview (https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview)
https://shvs.org/wp-content/uploads/2025/08/SHVS-Manatt-Rural-Health-Transformation-Fund-Discussion-8.28.25.pdf (https://shvs.org/wp-content/uploads/2025/08/SHVS-Manatt-Rural-Health-Transformation-Fund-Discussion-8.28.25.pdf)
https://shvs.org/tracking-state-preparation-for-the-rural-health-transformation-program/ (https://shvs.org/tracking-state-preparation-for-the-rural-health-transformation-program/)
Rural Health Association Links:
https://nebraskaruralhealth.org/ (https://nebraskaruralhealth.org/)
I Love Rural Health Program Link:
https://iloveruralhealth.com/ (https://iloveruralhealth.com/)
We rely on your donations to keep producing this podcast content and to support physician advocacy in Nebraska. If you would like to support Nebraska Alliance for Physician Advocacy, a 501(c)(3) organization in Nebraska please click to DONATE NOW.
If you have questions or answers, please email us at contact@nebraskaallianceforphysicianadvocacy.org
Please check out our website at: Nebraska Alliance for Physician Advocacy
Follow on social media:
@NEAllianceforPhysicianAdvocacy on Instagram (@NEAllianceforPhysicianAdvocacy on Instagram )
https://www.facebook.com/neallianceforphysicianadvocacy on Facebook (https://www.facebook.com/neallianceforphysicianadvocacy on Facebook )
The views and opinions expressed on this podcast are solely those of the speakers and guests and do not necessarily reflect the official policy or position of their employers or any other organization or entity. This podcast is for informational and entertainment purposes only and does not constitute professional medical, legal, or financial advice. If you have a specific concern, please consult with a qualified professional.
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Apple Podcasts (US)
5.0 / 5
13 ratings
Spotify
5.0 / 5
7 ratings
Podcast Authority Score: 49 / 100
A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.
Quality
51
Social presence
91
YouTube
0
Engagement
71
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