By skyforbes 
Following an announcement in early 2018 that the Centers for Medicare and Medicaid Services (CMS) would focus on rural health, in May the federal agency formally released an eight-page statement outlining strategies for improving health care for rural residents across the United States. While the document does not detail any specific new policies, its objectives include improving healthcare providers’ engagement with and support of patients, advancing telemedicine and telehealth, and empowering patients who live in rural areas to make their own decisions about healthcare.
“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,” Seema Verma, CMS administrator, said in a press statement.
Background
According to the CMS, about 60 million people live in rural areas in the United States. Millions of these residents receive Medicare and Medicaid benefits, and they are more likely than urban residents to be poor, older, unhealthy, and without insurance or enough insurance. They also face ongoing challenges with access to health care, as health care systems in rural areas are shrinking, and many rural residents live far away from specialty medical services and providers.
The CMS Rural Health Council (RH Council) was formed in 2016 to make long-term recommendations that will shape CMS policies and regulations. The council’s members include CMS experts who focus on ways the CMS could positively impact health care in rural America. They prioritize three strategic areas: making sure that all Americans who live in rural communities have access to high quality healthcare, looking at the “unique economics” of health care provision in rural areas, and ensuring that CMS makes rural healthcare a focus in its payment reform and health care delivery initiatives.
Objectives
The CMS report outlines five objectives for improving rural health care:
1. Apply a rural lens to CMS programs and policies:
When creating health care policies, programs, and strategies, CMS will consider how they affect people who live in rural areas. CMS will look for ways it can better serve rural communities and make sure that it does not make recommendations that would unintentionally undermine people and communities who are vulnerable.
2. Improve access to care through provider engagement and support:
There are many reasons that rural healthcare professionals and patients have trouble providing and accessing care, including a limited number of medical providers, lack of success in recruiting new medical professionals to work in rural areas, and limited administrative staff. This CMS objective calls for looking at new ways to overcome these barriers, such as improving transportation to medical facilities in rural areas, increasing the number of health providers working in rural communities, and streamlining programs to focus more on outcomes rather than volume.
3. Advance telehealth and telemedicine:
Telehealth has proven to be an effective method for reaching people who live in rural communities and providing them with better and more frequent access to health care. To increase the use of telehealth, CMS proposes easing some of the barriers to telehealth, including reducing the administrative and financial costs of implementation, and easing reimbursement and cross-state licensing issues.
4. Empower patients in rural communities to make decisions about their health care:
Many patients, including those who live in rural areas, have a hard time understanding health care insurance and figuring out how to get the care they need. In rural communities especially, it is important that patients have access to accurate information so that they can be informed and make their own health care decisions. CMS proposes developing easy-to-understand materials about health care that can be disseminated through patient and family networks in rural areas and through outreach in rural communities.
5. Leverage partnerships to achieve the goals of the CMS rural health strategy:
CMS acknowledges that it cannot solve the health care problems in rural America alone, so one of its primary objectives is to build collaborative partnerships with stakeholders. These partners should be on the local, state, regional, and federal levels, and the groups should work together to gather and share information and implement joint action plans. These partnerships can also help CMS implement its Rural Health Strategy. CMS proposes working with federal officials to increase the use of electronic health records in rural areas along with collaborating with federal and state officials to assess the impact CMS policies have on -rural areas and make appropriate recommendations. In addition, the Centers for Disease Control and other federal agencies could be valuable partners in addressing pressing health issues such as maternal health, substance abuse, and the integration of primary care and behavioral health care.
Some hospital officials already have expressed support for the CMS plan. Alan Morgan, CEO of the National Rural Health Association, told the online news site Modern Healthcare that he was optimistic that the plan could provide a “better regulatory environment” for rural health care providers. Erin O’Malley, America’s Essential Hospitals senior director of policy, said that her group was pleased the CMS plan focused on telehealth and using technology to overcome health care access barriers.