The National Rural Health Association’s Rural Health Policy Institute met in Washington D.C for their rural advocacy event on February 6-8, 2018. Over 400 rural health advocates came from all over the U.S to take part in the event. Today, rural communities are eroding since 83 rural hospitals have closed since 2010.
NRHA actively seeks support for the “Save Rural Hospitals Act” (H.R. 2957) to help stop the flood of rural hospital closures, provide needed access to care for rural communities, provide for rural hospital stabilization, equalize patient copayments for outpatient services at CAHs with copays at other hospitals, and provide regulatory relief.
The Act would also establish a new Medicare payment designation, referred to as the Community Outpatient Hospital (COH). This model would ensure access to emergency care and enable hospitals to offer outpatient care to meet the health needs of the population in rural communities. Rural EMS Hospital-based grants would be included to assist rural hospitals changing to value based payment models and for rural hospitals working on population health.
The speakers and attendees discussed topics such as the future of the ACA in rural America, the effects on rural communities now greatly affected by the opioid crisis, improving and providing more telehealth services, addressed the plight of veterans seeking healthcare in rural communities, and how to provide more broadband to rural areas.
Telemedicine is used only in 0.2 percent of Medicare Part B visits. In almost every state over 90 percent of the rural population has access to high speed internet access. However, urban areas are twice as likely as rural areas to have access to copper and cable modem wireline technologies.
Senator Joe Manchin, (D-WV) and Shelley Moore Capito (R-WV) on January 19, 2018, announced funding to expand telemedicine in five West Virginia counties. Specifically, the funding will go to the CAMC Health Education and Research Institute to help provide obstetrical care remotely to West Virginians
According to published data from the Rural Health Research Gateway, rural communities report a smaller proportion of behavioral healthcare providers than urban areas. Rural communities have fewer psychiatrists, clinical psychologists, psychiatric nurse practitioners, social workers, and counselors.
Providing telemental health could be used to address the shortages of mental health clinicians. Quality telemental health access in rural areas has grown while the cost has decreased. However, the fee-for-service reimbursement model does not provide sufficient financial reimbursement or incentive to sustain growth.
Growth in telemental health also affects the workforce supply, challenges to issues related to recruitment and retention, and how to deal with the high rates of un-insurance and under-insurance in rural areas.
NRHA would like to see grants and funding to help rural areas adopt and use new technologies. In addition, funding is needed to train rural IT professionals in healthcare as well as train doctors, nurses, and medical staff on how to use the new technologies, and ways to better utilize data and analytic tools.
According to NRHA, the opioid crisis is tearing through rural America and as many as 2.5 million people in the U.S are suffering from opioid addiction. In the last decade, the opioid crisis has escalated in rural America, resulting in opioid death rates in rural areas quadrupling among those 18-25 years old.
Legislation was introduced to help rural communities. Representative Cheri Bustos (D-IL) https://burtis.house.gov on January 11, 2018 with other members of the Bipartisan Heroin Task Force introduced “The Addiction Recovery for Rural Communities Act” to address the lack of resources to combat addiction.
Community Health Centers (CHC),which are community-based and patient-directed organizations serve populations with limited access to healthcare. The Bipartisan Agreement passed last Friday does include a two year extension for CHCs.
NRHA reports that the USDA’s Rural Development (RD) program plus other agencies are underutilizing or not awarding grants to those that have the greatest need in rural areas. NHRA will be meeting with USDA RD in the coming weeks to discuss how rural communities can be better served.