The federal Centers for Medicare and Medicaid Services unveiled its rural health strategy earlier this month in an attempt to “better serve individuals in rural areas and avoid unintended consequences of policy and program implementation,” the agency said in a press release.
The project has been in the works for some time, said spokesman Dennis Delpizzo, and is the result of collaboration between CMS and rural providers and health care officials. According to the press release, the strategy will focus on a handful of objectives:
- applying a rural lens to Medicare and Medicaid policies and programs;
- improving access to care via provider engagement and support;
- advancing telemedicine and telehealth;
- and “empowering patients in rural communities to make decisions about their health care.”
“I think the challenges we see in the delivery of rural health care are access to primary care providers, access to specialty care, even access to health care in general in (some) communities, the driving distances,” Delpizzo said.
None of this would be news to Wyoming health care providers and officials. The state is home to just over two dozen hospitals, and at least one county here has no hospital at all. It has some of the most expensive health care costs in the nation. For instance, silver plans bought on the federal exchanges are among the costliest in the U.S.
Delpizzo said the Trump administration is especially focused on helping rural areas, where an estimated 60 million people — nearly one in five Americans — live. Those people are “more likely than urban populations to be living in poverty, unhealthy, older, uninsured or underinsured, and medically underserved,” according to CMS.
“Understanding this, CMS sought to develop a strategy to help make health care in rural America accessible, affordable and accountable,” the agency added in a fact sheet accompanying the announcement.
He said CMS is looking at the scope of practice for nurses, meaning what nurse practitioners can do under their state license and how to possibly expand those duties. He added telehealth — meaning, for example, specialists off-site using video feeds to help patients and other physicians in rural areas — as another example.
“Are we always going to put a specialist” in every Wyoming and rural community, he asked. “Possibly not, but possibly we could improve the usage and payment of telehealth services to alleviate and address that need.”
Telehealth is a frequent topic of conversation among health officials who seek to improve options for rural patients. The CEO of Wyoming Medical Center, for instance, has mentioned exploring telemedicine as a way to bring the hospital’s services to the far reaches of the state.
The agency may look at how it does outreach in education in rural areas, as well, Delpizzo said.
Generally, the rural health strategy seeks to communicate with rural providers and patients to see what they need and how the federal government can help them, Delpizzo said. CMS wants to establish “face-to-face” relationships in rural areas, connections that can persist through administrations.
“We’re trying to lessen the burden, that’s what this whole (strategy is about),” he said. “It kind of rolls into putting patients first. That is listening to providers, what barriers are we creating that are impacting your ability to deliver quality, affordable care.”
And if there’s ways that CMS can ease the burden that its rules and regulations may impose without having to go through Congress, “we’re doing it,” Delpizzo said.