Health in Vulnerable Populations

The American Hospital Association’s (AHA) www.aha.org “Task Force for Ensuring Access to Vulnerable Communities”, recently released a report outlining a menu of options for communities, hospitals, and policymakers to ensure that vulnerable rural and urban communities have access to essential healthcare services.

The report discusses in detail the need for virtual care strategies to be used to help vulnerable communities. These communities are dealing with declining and aging populations, the need to provide additional access to primary care services, high rates for the uninsured or underinsured, cultural differences resulting in low education, plus dealing with environmental challenges that may hinder caring for vulnerable populations.

The report specifically identifies telehealth and virtual care strategies as very promising options to help maintain or supplement access to health care in vulnerable rural and urban communities with problems recruiting an adequate healthcare workforce.

Today, payment for telehealth and virtual care services can be an issue that must be addressed. Medicaid covers telehealth to some extent although the criteria for coverage can vary widely from state to state.

On the private payer side there has been significant expansion with many states passing laws requiring private payers to provide coverage for telehealth services. Also, Medicare coverage for telehealth can be restrictive as a result of the program’s narrow definition and scope regarding telehealth.

The report points out that access to broadband is a problem in rural communities which hinders the ability to utilize virtual care strategies in these areas. To address the need for broadband to provide for telehealth, the FCC is working to find ways to increase the adoption of health technology.

This would include telehealth but it would require identifying regulatory barriers, and finding incentives to build stronger partnerships with stakeholders. This would not only help in areas related to telehealth and telemedicine but also to mobile applications.

The report sums up with several suggestions such as hospitals will need to build upon their current infrastructure for health IT, patient and family education must be provided, care management increased, more detailed discharge planning, and the need to form new and different contractual relationships. In general, vulnerable communities will need to make significant investments of time, effort, and finances to achieve success in addressing rural and vulnerable populations.

Go to www.aha.org/advocacy-issues/accesscoverage/access-taskforce.shtml to view the report titled “Task force Ensuring Access to Care in Vulnerable Communities” (November 2016