HHS issues plan to improve rural health, leaning on telehealth

• HHS released a plan Thursday to improve rural health services as the pandemic continues to highlight the significant health barriers facing these areas. However, the plan has not been completely revised. Some experts say that the problem requires it and there are already numerous drafts and guidelines in it.

• The 84-page plan includes steps to expand the availability of telemedicine services to connect residents with non-local healthcare professionals. It directs the federal government to provide more than $ 8.7 million in grants to up to 29 providers to virtually see rural providers without emergency specialists over the next four years.

• In line with its emphasis on emergency care, the plan calls for the administration to invest $ 5 million this year in hiring and training first responders in rural areas. The government also wants to allow network adequacy adjustments to facilitate the management of care in rural areas by private Medicare Advantage plans.

COVID-19 reiterated that rural issues must be a top priority for the agency, HHS Secretary Alex Azar said in the report’s opening letter. In some rural states, including South Dakota, North Dakota, and Iowa, the number of COVID-19 cases has increased over the past week.

Although Azar said the government “cannot just play with the margins of a rural health system that has struggled for too long,” the plan appears to be mostly discussing relatively moderate seven- and eight-figure initiatives that have already been underway since then to a billion-dollar plan to reshape the way, Americans receive health care services in rural areas.

Rural areas are plagued not only by a shortage of providers but also by lower incomes and a higher incidence of chronic diseases than urban areas. The 57 million rural residents are far more likely to die from heart disease, cancer, or stroke than urban residents. At the same time, rural establishments are closed and it is more difficult to hire doctors.

President Donald Trump signed an executive order in early August asking HHS to report on current and future efforts to improve rural health care. The project is also linked to a recently announced memorandum between HHS, the Federal Communications Commission, and the US Department of Agriculture to improve broadband access in rural areas.

Perhaps the boldest proposal is contained in the 2021 budget proposal. This would allow rural health clinics and state-rated health centers to provide Medicare telemedicine services and virtual care reimbursements at discounted rates. . CMS launched the 2021 physician pricing plan in early August and added nine new permanent telemedicine codes.

The rural health plan would also allow Indian health services and Native American managed facilities to receive compensation even when telemedicine services are provided across state lines. Most providers can temporarily provide such services across state lines due to emergency regulations enacted by HHS after the COVID-19 pandemic.

The Trump administration also promised $ 12.4 million to expand a pilot project to improve rural care for rural maternity and midwifery patients with better telemedicine services.

Telemedicine has the potential to help reduce geographic disparities in access to care, but the administration’s somewhat shortsighted emphasis on telemedicine as a comprehensive solution for rural health may not prevail. Telemedicine relies on digital infrastructure, which is largely non-existent in non-underground regions. A third of rural households say they do not have a broadband connection at home.