Last week the Centers for Medicare & Medicaid Services (“CMS”) released its first Rural Health Strategy. The strategy is intended to improve the agency’s service to individuals living in rural areas. CMS’ Rural Health Council, created during the Obama Administration, developed the strategy by examining current rural-focused programs at CMS, reviewing the methods used by CMS Centers and Offices to integrate rural issues in agency policies, and hosting several listening sessions with stakeholders, including healthcare providers and consumers. CMS notes in the strategy that approximately one in five Americans live in rural areas, and that rural communities are plagued with many issues: higher poverty, more chronic conditions, greater levels of uninsured and underinsured, a shrinking healthcare workforce, lack of specialty services, and fragmented care.
The information gathered was grouped into eight themes, including: improving reimbursement; adapting and improving quality measures and reporting; improving access to services and providers; improving service delivery and payment models; and improving affordability and accessibility of insurance options.
From the themes, the Rural Health Council drafted five key objectives that constitute the goals of the Rural Health Strategy: apply a rural lens to CMS programs and policies; improve access to care through provider engagement and support; advance telehealth and telemedicine; empower patients in rural communities to make decisions about their health care; and leverage partnerships to achieve the goals of the CMS Rural Health Strategy.
According to CMS, applying a rural lens to the agency’s actions aims will ensure rural communities’ unique needs are considered in CMS policymaking and program creation. Improving access to care will focus on transportation, the move away from volume and toward value, technical assistance to providers, and scope of practice. Advancing telehealth and telemedicine will build on CMS’ recent support of such measures, including improved reimbursement, easing cross-state licensure, and reducing related administrative and financial burdens. The strategy concludes that the latter two objectives, empowering rural patients and leveraging partnership, will require better engagement and communication with patients and collaborations with stakeholders, respectively.
CMS noted it was already working on several of these initiatives, even before the Rural Health Strategy was announced. The extent to which, and how quickly, these initiatives are adopted and implemented, however, is unclear. We will continue to monitor any future developments and progress of CMS’ Rural Health Council and Rural Health Strategy and provide additional analysis of related legal changes.