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Centers for Medicare and Medicaid Services unveils strategy to boost rural telehealth

CMS aims to improve access to care, increase quality and cuts costs by reducing readmissions and unnecessary ER visits.

Susan Morse, Managing Editor

The Centers for Medicare and Medicaid Services has unveiled a new strategy it said will make it easier for clinicians in rural areas to use telehealth technologies. 

The new CMS strategy comes as some hospitals are forging ahead with telemedicine and essentially betting that the regulatory landscape will become clearer in the short-term. 

"To promote the use of telehealth, CMS will seek to reduce some of the barriers to telehealth such as reimbursement, cross-state licensure issues, and the administrative and financial burden to implement telemedicine," the agency said in its Rural Health Strategy.

Getting paid for performing telehealth services has been a roadblock for many hospitals, not just those located in rural areas. But rural hospitals may more keenly feel workplace shortages as baby boomers age and need more services.

CMS did not give specifics about how reimbursement will be changed to promote the use of telehealth, but said supporting activities include exploring options for modernizing and expanding telehealth through CMMI models such as the Next Generation ACO, Frontier Community Health Integration Project Demonstration and bundled payments for care initiative advanced model.

The estimated 60 million people who live in rural areas are more likely to live in poverty, be unhealthy, older, uninsured or underinsured and medically underserved than their urban counterparts, CMS said.

They also face a fragmented healthcare delivery system, a stretched and diminished workforce, affordability of insurance and lack of access to specialty services and providers.

CMS's strategy was developed by the agency's Rural Health Council with stakeholder input. The CMS Rural Health Council, founded in 2016, helps shape regulations and policies.

Stakeholders said their concerns centered around improving reimbursement, adapting and improving quality measures and reporting, improving access to services and providers, improving service delivery and payment models, engaging consumers, recruiting, training and retaining the workforce and leveraging partnerships and resources.

CMS said it plans to apply a rural lense to its programs and policies, improve access to care through provider engagement and support, empower patients to make decisions about their healthcare and leverage partnerships to achieve these goals.

The strategy supports CMS's overall effort to reduce provider burden and aligns with other CMS priorities, such as improving quality of care and tackling the opioid epidemic. 

The American Hospital Association voiced approval for the initiatives.

"AHA is pleased CMS put forward thoughtful recommendations to address the unique challenges of providing care to patients in rural communities," said Joanna Hiatt Kim, AHA vice president of payment and policy. "We look forward to working with CMS and Congress to take meaningful action to stabilize access in rural communities, such as creating new alternative payment models, expanding coverage of telemedicine and access to broadband, and reducing regulatory burden."

Twitter: @SusanJMorse
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