Many attendees from all over America sharing common interests in rural health gathered at the National Rural Health Association’s 25th Annual Rural Health Policy Institute meeting held February 3-6, 2014 in Washington D.C. The NRHA and its 21,000 members are fighting to support strong funding for rural health.
Leaders of NRHA are very concerned with providing healthcare to rural areas, because the sequestration cuts eventually will result in long term effects that will push rural hospitals and many rural healthcare facilities to close their doors. Several rural hospitals closed in 2013, in part because of the sequestration cuts.
In general, NHRA leaders want to see more funding for rural health programs like the Rural Hospital Flexibility Program, funding for the State Offices of Rural Health, and funding for telehealth to provide efficient and effective healthcare delivery in rural America.
The goal for the meeting attendees was to visit their legislators on Capitol Hill to let them know that the NRHA is fighting for the 62 million who call rural America home and entitled to good healthcare in their communities.
To help rural residents, a number of legislators already realize that telehealth and health IT can play a huge part in delivering the best care possible in rural areas. The NRHA 2014 Legislative and Regulatory Agenda discussed at the NHRA Policy Institute points out the changes needed so that telehealth and telemedicine services can grow to meet the healthcare needs of the residents in not only rural but also in underserved urban areas.
NRHA wants to see a number of the key recommendations listed in the Agenda that apply to the use of telehealth presented to lawmakers. For example, NRHA wants to see the Medicare law expanded to allow anything currently covered by Medicare to be reimbursed when provided through telehealth by licensed or credentialed providers.
Also, NHRA wants a telemedicine payment methodology to enable a professional fee to be paid to all providers, and reimbursements made for originating telehealth sites. This should be implemented along with reimbursements for store-and-forward applications. Also, physical therapists, respiratory therapists, occupational therapists, speech therapists, and social workers should be reimbursed when providing care
The association sees a need to allow healthcare facilities receiving telehealth services to perform credentialing by proxy. If a provider is already credentialed at a Medicare-participating facility that credential should be sufficient for providing telemedicine services at another facility.
NHRA wants geographical patient requirements lifted when receiving care in a HPSA. The geographical eligibility should be expanded to patients living in or receiving care in an MSA county with less than 30,000 residents.
The NHRA agenda for health IT recommends that vendors of IT systems have the responsibility to incorporate national standards for health IT into their systems. This includes systems used in all care settings to assure interoperability in both large and small networks and within all rural facilities.
To help increase the seamless exchange of information among rural healthcare providers, incentive payments for implementing EHRs should include payments to home health agencies, hospices, skilled nursing facilities, emergency medical services, and any other providers eligible for Medicare and/or Medicaid payments.
Federal anti-kickback statues and the Stark Laws often limit adoption of health IT by limiting opportunities for rural hospitals, which many times are in the strongest position to invest in health IT. Stark and other applicable laws should be liberalized to allow rural hospitals to serve as the hub for rural networks.
Lastly, to help install health IT, funding should be provided via a combination of grants, loan guarantees, and/or principal and interest forgivable loans, to support expansion, upgrade, and/or to renovate rural health facilities to enable the use of health IT.
For more information go to www.ruralhealthweb.org.