Today, numerous challenges are hindering providers in rural areas from delivering the best care possible. Rural populations are generally older, poorer, and sicker than their urban counterparts, and providers are more dependent on Medicare reimbursement, and susceptible to shifts and changes to the program.
In addition, rural hospitals which are often the primary providers of care are facing declining reimbursement rates and disproportionate funding levels making it a challenge to serve rural residents.
To help alleviate some of the problems, Representative Arron Schock (R-IL) recently introduced the bipartisan “Rural Health Clinic Fairness Act” (H.R. 986). This bill would help rural healthcare affordable and allow seniors to continue to receive high quality care from Rural Health Clinics (RHC)
The Act would close a loophole that prevents RHCs from being eligible for EHR incentive payments through the Medicare programs. The legislation would make it possible for professionals practicing in RHCs to now be eligible for EHRs and quality improvement incentives under Medicare. This eligibility is already given to larger hospitals and physicians throughout the country. The bill has been referred to the Committee on Energy and Commerce and to the Committee on Ways and Means.
Another piece of legislation introduced March 13th by Representative Pete Gallego from Texas is the “Rural Veterans Healthcare Accessibility Improvement Act”. The bill would assist veterans in rural areas with transportation to medical centers and improve healthcare for other veterans by incentivizing the transition of veterans’ medical records to electronic health records.
Each year more than 150,000 service members separate from the military and transition to veteran status. Electronic health records assist in that transition so the bill would create a pilot program to help veterans provide adequate medical information to physicians and veteran clinics via EHRs. The bill has been referred to the House Committee on Veterans Affairs.
To put more emphasis on rural healthcare in the House, Representative Ron Kind (D-WI) a member of the House Ways and Means Committee’s Health Subcommittee recently has been selected as Chair of the Rural Health Care Coalition. The Coalition is a bipartisan group of over 100 members who focus on improving access to care in rural communities.
Within the federal agencies, HHS has taken several actions to assist rural hospitals, clinics, and clinicians. The actions include a number of new proposals announced February 2013 seeking comments. These include allowing CAH’s to use existing staff to develop patient care polices, providing flexibility for on-site physicians, allowing dietitians to order patient diets, allowing flexibility in outpatient service orders, aligning and surveying requirements for swing beds and hospitals, plus new proposals for telehealth covered services.
In addition, HHS is increasing the level of technology assistance provided to CAHs so that a greater percentage of facilities will be able to voluntarily report quality data for public reporting. HHS wants to see quality improvement focus on transferring information from CAH emergency departments to acute care receiving facilities. For more details on the proposals, go to www.hrsa.gov/ruralhealth/policy/policyupdate0314313.pdf.