Allison Inserro | May 8, 2018
On Tuesday, CMS released its first strategy to address rural healthcare, saying that it wants people who live in rural America to “have access to high quality, affordable healthcare.”
The 8-page strategy document notes that rural Americans are more likely to be poor, unhealthy, older, uninsured, underinsured, and medically underserved.
In a statement, the agency said that the strategy focuses on 5 objectives:
Apply what it calls a “rural lens” to CMS programs and policies
CMS said it wants to avoid unintended consequences of policy and program implementation in these communities. It plans to apply a checklist to relevant policies, procedures, and initiatives that impact rural communities and to identify and accelerate evidence-based practices to improve access to services and providers in rural communities.
CMS wants to keep promoting the interoperability of health information and increase the use of electronic health records among patients and healthcare providers. It said it will work with the CDC to increase the focus on maternal health, behavioral health, substance use, and the integration of behavioral health and primary care.
CMS also said it will work with state Medicaid agencies and other state partners to advance rural health strategies for Medicaid-eligible individuals, including people with disabilities, dual-eligible beneficiaries, and people with substance use disorders.
People with disabilities may be eligible for exemptions from the Medicaid work requirements that CMS started approving this year. On Monday, it approved New Hampshire as the fourth state for Medicaid work requirements but rejected an attempt by Kansas to impose lifetime limits on benefits.
There are some fears that Medicaid work requirements will fall the hardest on those in rural areas precisely because of some of the challenges that CMS is trying to address with this health strategy.
Improve access to care through provider engagement and support
CMS wants to be able to allow healthcare providers to practice up to the limits of their license, provide technical assistance to providers so they can fully participate in CMS programs, and identify new ways to overcome patient barriers to access, such as a lack of transportation.
This could involve exploring opportunities within existing Center for Medicare and Medicaid Innovation fraud and abuse waivers that could cover certain transportation services, it said.
Advance telehealth and telemedicine
CMS will seek to reduce barriers, such as reimbursement, cross-state licensure issues, and the administrative and financial burden to implement telemedicine. It said it will explore options for modernizing and expanding telehealth through the Next Generation Accountable Care Organization Model, Frontier Community Health Integration Project Demonstration, and the Bundled Payments for Care Initiative advanced model.
Empower patients in decision making
CMS will collaborate with rural communication networks to develop and disseminate easy-to-understand materials, support the adoption of health information technology and the development of infrastructure to enhance patient access to health information, and foster engagement of rural beneficiaries in their healthcare.