NRHA Tackles Rural Health Challenges

Rural healthcare has to deal with enormous challenges such as not enough funding for Critical Access Hospitals (CAH), workforce shortages, providing care to older and poorer patient populations, geographic barriers, low patient volumes, plus high uninsured and under-insured populations.

The National Rural Health Association’s (NRHA) 2015 Annual Rural Health Policy Institute was held the beginning of February to help their members and other attendees promote legislative and regulatory issues that need action by Congress, federal regulatory agencies, the White House, States, and the healthcare industry.

Some of the highlights in the 2015 Legislative and Regulatory Agenda include:

  • The need for reimbursement for services provided through telehealth based upon medical effectiveness and utilization and not based upon or limited to particular delivery platforms or locations
  • Support for policy development and actions to remove barriers for necessary broadband services, federal and state licensing, credentialing, and reimbursement restrictions that impede the use of telemedicine, telehealth, and distance learning
  • Federal funding for innovative demonstrations, improved training, research, telehealth, preventive health, and personnel recruitment for rural and frontier areas
  • Improving the rural health infrastructure to increase the workforce, emergency medical services, laboratory, information systems, and components of the public health system
  • Assisting rural health facilities to plan for, purchase, and support health IT
  • More funding through a combination of grants, loan guarantees, and/or principal and interest forgivable loans, to support expansion upgrades and/or the renovation of rural health facilities including health IT and ambulance services
  • Enabling HRSA , SAMHSA, and NIMH  to be authorized to form a joint task force to address issues of access to mental health in rural areas
  • Evaluating and expanding the VA’s network of fee-based specialty providers within the non-VA care program and streamline policies to expedite access for veterans to locally obtain healthcare services


Legislation has been introduced in Congress called the “Community Access and Rural Health Equity Act” or referred to as the CARE Act to help provide innovative, sustainable delivery models for the future of rural healthcare.

Meeting attendees were very concerned with important issue concerning the rural Medicare Extenders that are due to expire on March 31st unless Congress intervenes. If Congress doesn’t act, rural health providers across the U.S will be hit with hundreds of millions of dollars in reimbursements cuts and many rural facilities will have to close.

The rural community wants to see funding in FY 2016 and beyond for Rural Hospital Flexibility Grants, State Offices of Rural Health, AHECs, the Small Hospital Improvement Program, Title VII nurse training programs, and for telehealth.

The association will continue to work with HRSA’s Office of Rural Health Policy (ORHP), Office of Personnel Management (OPM), and others on the 340B pharmaceutical program, the need for specific grants to improve healthcare delivery in rural areas, and how to best implement more opportunities to use telehealth.

Also, the rural community is going to work with the Centers for Medicare and Medicaid Innovation to ensure the ongoing inclusion of rural in new and innovative care models and will continue to stress the need for these models to be designed to meet the needs of rural populations.

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