CMS Unveils Strategy to Improve Rural Healthcare

Dive Brief:

• CMS on Tuesday announced its first Rural Health Strategy, which looks to improve access to and quality of care in rural areas.
• CMS Administrator Seema Verma said the effort looks to “apply a rural lens to the vision and work of the agency” and was the culmination of input from rural providers and beneficiaries.
• Objectives for the plan include advancing telehealth and telemedicine, empowering patients in rural communities and leveraging partnerships to achieve rural health goals, the agency said.

The announcement was short on specifics, but CMS said it was aiming to improve access through provider engagement and support.

CMS estimates that 60 million Americans live in rural areas. Those areas have their own obstacles, including higher poverty rates, potential healthcare provider shortages, more chronic conditions and higher percentages of uninsured and underinsured. With that in mind, the strategy looks to “better serve individuals in rural areas and avoid unintended consequences of policy and program implementation,” CMS said.

Rural hospitals have been hard hit by industry trends of lowering patient volumes and reduced reimbursements. They also struggle to recruit qualified physicians and other healthcare professionals, and are often at the mercy of state Medicaid policies. More than a third of rural hospitals are currently vulnerable and could close, according to the National Rural Health Association.

One piece of the CMS plan — expanding telehealth access — will be accomplished by paying for additional services and making it easier for providers to bill Medicare for those services. Congress also recently passed legislation that extends telehealth access to Medicare beneficiaries with chronic conditions.

Telehealth and virtual care are often cited as a way to improve healthcare, especially in rural areas. Large healthcare organizations, including Kaiser Permanente and UnitedHealthcare, are using virtual care to supplement primary care visits.

And patients seem to like the flexibility. A recent Accenture report said about 70% of consumers are interested in virtual healthcare, though only 20% said they’ve actually received such care. “Virtual care offers what consumers really want: a variety of health and care service available to any location at any time, crossing the spectrum from health and wellness to episodic injury and illness to ongoing condition management,” the report said.

Telehealth interests providers and organizations, too. A recent Mordor Intelligence report said the North American telehealth market will reach $16.8 billion by 2020 due to more chronic diseases and rising healthcare costs. A REACH Health survey also reported about 70% of healthcare leaders considered telehealth a high priority in their organization.

Though health officials see potential in telehealth, a recent report by HHS Office of Inspector General found that CMS paid about $3.7 million on telehealth claims that did not meet Medicare requirements during a 2014-2015 audit. So, the agency will need to work out those issues if telehealth is going to become a cost-effective way to help bridge gaps and improve rural healthcare.