On May 8, 2018, CMS released its first “Rural Health Strategy.”  The Rural Health Strategy focuses on the following five objectives to achieve CMS’s vision for rural health:  (i) applying a “rural lens” to CMS policies; (ii) improving access to care through provider engagement and support; (iii) advancing telehealth and telemedicine; (iv) empowering rural patients to make healthcare decisions; and (v) leveraging partnerships. For each of the objectives, the Rural Health Strategy lists certain “key supporting activities,” consisting primarily of policy options to promote each objective. One example of an activity proposed in the Rural Health Strategy for accomplishing the objective of advancing telehealth and telemedicine is exploring options for modernizing and expanding telehealth through Center for Medicare and Medicaid Innovation (CMMI) models and demonstrations, such as the Next Generation Accountable Care Organization Model, Frontier Community Health Integration Project Demonstration, and Bundled Payments for Care Initiative advanced model.

The Rural Health Strategy activities address a variety of policy areas, including health information technology, maternal health, clinicians’ scope of practice, and transportation. Although the Rural Health Strategy lists some current activities (e.g., collaboration between CMS and the Federal Office of Rural Health Policy and the Health Resources and Services Administration), most of the activities are options for future policy (e.g., an option to expand the scope of practice for certain health professionals).

While the initial reported response to the Rural Health Strategy from trade organizations representing rural providers has been optimistic, the document has come under some criticism as well. Specifically, U.S. Senators Lamar Alexander and Jerry Moran criticized the Rural Health Strategy for failing to address the Medicare wage index, whereby providers with high average wages get larger reimbursement per service than hospitals with lower average wages.

The Rural Health Strategy document is available here. A related fact sheet from CMS is available here. CMS also posted additional information regarding the Rural Health Strategy on its rural health webpage.