- March 30, 2021
The U.S. Department of Health and Human Services (DHHS) in September 2020 released an 82-page Rural Action Plan aimed at evaluating and engaging challenges facing rural healthcare in the country. The plan lays out a four-point strategy intended to address hurdles to providing rural healthcare, including building a sustainable health model for rural communities; preventing disease and mortality; increasing rural access to care; and leveraging technology and innovation.
The latter initiative includes broader support for telehealth and funding for the development of technological solutions to chronic conditions. It also acknowledges broadband access as a continuing concern for making use of health IT.
The DHHS plan notes that President Donald Trump’s fiscal year 2021 budget would require the Centers for Medicare and Medicaid Services (CMMS) to value telehealth services separately from similar services provided face-to-face for purposes of setting reimbursement rates, framing this move as a way to broaden beneficiary access to Medicare telehealth services. Providers have raised the question of reimbursement rates as a cause for anxiety about future telehealth availability.
The plan also reiterates the budget’s proposal to allow rural health centers and federally qualified health providers to be distant site providers for Medicare telehealth services and to expand access to Medicare telehealth services for Indian Health Service and Tribal facilities – making permanent a temporary flexibility furnished in response to the pandemic. “The Rural Action Plan identifies key, tangible areas where DHHS agencies can soon make a real difference in the health outcomes of millions of Americans,” said DHHS Secretary Alex Azar in a statement.
WHY IT MATTERS
Advocates and stakeholders have pointed to telehealth as a key tool for bolstering access to healthcare around the country, including for rural communities.
The DHHS plan repeatedly invokes telehealth as a key stepping-stone for expanding rural care. Its strategy includes elevating the role of the Office for the Advancement of Telehealth, housed in the Health Resource and Service Administration (HRSA), to “create a focal point on telehealth that will serve as a resource across HHS and enhance coordination with other key federal and private sector partners.”
The plan notes that HRSA has leveraged about $30 million in fiscal year 2020 to support the expansion of telehealth and that its Federal Office of Rural Health Policy will be investing about $8.7 million over the next four (4) years to support organizations through a new Telehealth Network Grant Program.
Where other technological innovations are concerned, the plan notes a number of U.S. Food Drug Administration (FDA) marketing authorizations for medical devices that could prove particularly beneficial to patients who lack access to local specialists. It also supports a new DHHS Health Challenge aimed at using technology to improve screening and management of postpartum depression for rural patients.
Some experts have noted that the plan references projects that are already underway, while others say telehealth remains short on funding in the DHHS plan.
THE LARGER TREND
The plan follows an announcement earlier this week that the DHHS had signed a Memorandum of Understanding (MOU) with the Federal Communications Commission (FCC) and the U.S. Department of Agriculture (DoA) to work together on a Rural Telehealth Initiative.
“We look forward to working with our colleagues at the FCC and USDA to expand access through telehealth to quality, affordable care for the 57 million Americans living in rural areas,” said Azar about the MOU. The initiative does not appear to be mentioned in the Rural Action Plan.
The plan also comes after a list of recommendations in August 2020 from the American Hospital Association (AHA) about the steps that must be taken to safeguard access to telehealth after the COVID-19 pandemic. The AHA told Kaiser Health News in September that it was still reviewing the HHS plan; however, that it was “encouraged by the increased attention on rural health care.”
ON THE RECORD
“The Rural Action Plan continues DHHS and the Administration’s continued focus on rural communities,” said former Kansas Governor Jeff Colyer, Chair of the National Advisory Committee on Rural Health and Human Services, in a statement. “It provides an important reminder of the key steps DHHS has already taken to support rural communities as well as a number of new initiatives for this year and beyond,” he added.
REFERENCE: HealthCare IT News (Global Edition TeleHeath); 04 SEP 2020; Kat Jercich