CMS on Tuesday released its first-ever rural health strategy, which focuses on improving access to high-quality and affordable care for the approximately 60 million people who live in rural regions of the United States.
Rural health strategy details
CMS said the strategy—which does not contain any specific policy changes—provides a proactive and strategic focus for the agency to address health care issues across the United States' rural regions. According to CMS, the strategy aims to ensure people who live in rural areas can access high-quality and affordable health care in their communities.
The strategy, which CMS said is based on input from rural patients and providers on the challenges and solutions related to providing high-quality health care in rural communities, centers on five objectives:
- Advancing telemedicine and telehealth in rural regions;
- Applying a rural perspective to CMS policies and programs;
- Empowering patients in rural communities to make health care decisions;
- Improving access to health care in rural communities through provider support and engagement; and
- Leveraging partnerships to accomplish the goals of the CMS Rural Health Strategy.
Strategies focused on patients
Under the strategy, CMS said it will seek to address the barriers patients face to accessing health care services, such as a lack of transportation, and look to empower patients to play a bigger role in their care. For instance, CMS said it will collaborate with rural communication networks to develop comprehensive material designed to encourage people who live in rural areas to actively engage in their care and make sure such individuals understand how their health insurance works and how to navigate the health care system.
In addition, CMS said it will partner with CDC to increase the agencies' attention on maternal health, behavioral health, and substance use disorders.
Strategies focused on providers
CMS said it also will look to reduce the administrative burdens faced by providers in rural areas by implementing a new approach to quality measurement under the agency's Meaningful Measures initiative. As part of that initiative, CMS plans to review and revise the agency's current quality measures to ensure that the measures are aligned, outcomes-based, and valuable to patients and providers in rural communities. CMS under the strategy also will align quality measurement activities with the National Quality Form's initiatives focused on promoting health in rural regions.
In addition, CMS said it will offer providers technical assistance to ensure they participate in CMS programs and seek to boost state and local stakeholder engagement to ensure the agency's policies are effective in rural communities, as well as to ensure the agency reduced any unintended consequences tied to its programs and policies.
Strategies focused on health IT
CMS under the strategy also will support the adoption of health IT and the development of infrastructure to bolster patient access to health information. CMS said it will seek to reduce barriers—such as administrative, cross-state licensure, financial, and reimbursement issues—that prevent the implementation of telehealth and telemedicine services.
CMS under the strategy also will collaborate with the Office of the National Coordinator for Health IT (ONC) to promote interoperability among rural health care facilities. As part of the collaboration, CMS and ONC will work to increase health data exchange and the use of electronic health records among rural providers to improve health care quality.
CMS Administrator Seema Verma said, "For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency." She said, "The Rural Health Strategy supports CMS' goal of putting patients first. Through its implementation and our continued stakeholder engagement, this strategy will enhance the positive impacts CMS policies have on beneficiaries who live in rural areas."
George Sigounas, who heads the Health Resources and Services Administration (HRSA), said, "HRSA is excited to see CMS spell out a strategy to better serve rural populations that was informed by rural stakeholders who have a unique lens on the issues in their communities." He continued, "This builds on our long-standing collaboration with CMS and will highlight key issues for rural safety net providers like rural hospitals and community health centers for CMS and HHS."
Alan Morgan, CEO of the National Rural Health Association, called new strategy "substantial," noting that the strategy's primary focus involves formally analyzing the effects of future rulemaking on rural communities and providers—a practice that currently happens inconsistently. Morgan said the association is "optimistic that this effort at 'rural proofing' will provide a better regulatory environment for rural providers."
Erin O'Malley, senior director of policy at America's Essential Hospitals, said the group is "pleased the [Trump] administration has made [health IT] central to its strategy and signaled the need to reduce barriers to their use" (Dickson, Modern Healthcare, 5/8; Monica, EHRIntelligence, 5/8; O'Brien, HealthLeaders Media, 5/8; Goedert, Health Data Management, 5/8; CMS release, 5/8; CMS fact sheet, 5/8).
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