The Centers for Medicare & Medicaid Services (CMS) has launched the agency’s first Rural Health Strategy to help improve access to high quality, affordable healthcare in rural communities. The strategy is intended to provide a proactive and strategic focus on healthcare issues across rural America to ensure the nearly one in five individuals who live in these areas have access to care that meets their needs.
CMS is organizing and focusing its efforts to apply a rural lens to the vision and work of the agency. The CMS Rural Health Strategy supports CMS’ goal of putting patients first. Through its implementation and continued stakeholder engagement, this initiative will enhance the positive impacts CMS policies have on beneficiaries who live in rural, underserved areas. This Administration understands that one of the keys to ensuring that those who call rural America home are able to achieve their highest level of health is to advance policies and programs that address their unique healthcare needs.
Background
Approximately 60 million people live in rural areas across the United States – including millions of Medicare and Medicaid beneficiaries. CMS recognizes the many obstacles that rural Americans face when accessing healthcare services, including a fragmented healthcare delivery system, stretched and diminishing rural health workforce, unaffordability of insurance, and lack of access to specialty services and providers. CMS developed this strategy to focus on areas where the agency can better serve individuals in rural areas and work to avoid unintended consequences of policy and program implementation for these communities.
Summary
The new strategy announced today builds on several overarching CMS priorities launched by the Trump Administration, including reducing regulatory burdens and empowering patients and providers to make more informed decisions about their healthcare. In addition, the CMS Rural Health Strategy underscores CMS’ commitment to combat our nation’s opioid epidemic given its disproportionate impact on rural communities.
The CMS Rural Health Council -- an agency-wide panel of experts formed in 2016 -- developed the CMS Rural Health Strategy with input from 14 listening sessions with rural health care providers, consumers, and other stakeholders. The Council gathered real world evidence on the challenges and local solutions associated with providing high quality healthcare in rural communities to inform the development of a strategic plan to improve healthcare in rural America.
Representing an agency-wide mindset, the strategy aligns with goals of is the approaches the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP), which was created in 1987 to advise the Secretary of the U.S. Department of Health and Human Services on healthcare issues impacting rural communities, including:
- Access to quality healthcare and health professionals;
- Viability of rural hospitals; and
- Effect of the Department’s proposed rules and regulations, including policies under Medicare and Medicaid, on access to and financing of healthcare in rural areas.
The CMS Rural Health Strategy identifies five specific objectives intended to achieve the agency’s vision for equitable rural health:
1. Apply a Rural Lens to CMS Programs and Policies
CMS recognizes the need to look at policymaking, program design, and strategic planning through a specific lens to promote health equity among all populations that it serves. The first objective focuses on areas where the agency can better meet the needs of rural populations and avoid unintended consequences of policy and program implementation for these communities. To accomplish this, CMS will:
- Apply a newly-developed checklist to relevant policies, procedures, and initiatives that impact rural communities; and
- Identify and accelerate evidence-based practices to improve access to services and providers in rural communities.
2. Improve Access to Care Through Provider Engagement and Support
The second strategic objective is to improve access to care through provider engagement and support. This objective focuses on:
- Maximizing scope of practice;
- Providing technical assistance to health care providers to ensure that they can fully participate in CMS programs; and
- Identifying new ways to overcome patient barriers to access, such as a lack of transportation.
3. Advance Telehealth and Telemedicine
The third objective focuses on the advancement of telehealth and telemedicine. Telehealth has been proven to be a successful tool to improve access to care and help meet the needs of rural areas that lack sufficient health care services. To help promote the use of telehealth, CMS will seek to reduce barriers stakeholders identified such as reimbursement, cross-state licensure issues, and the administrative and financial burden to implement telemedicine.
4. Empower Patients in Rural Communities to Make Decisions About Their Health Care
CMS will leverage existing rural communication networks to empower patients with the information and tools to engage in their health care and will explore ways to support enhanced access through the use of health information technology (health IT). CMS will work to ensure information is reaching rural beneficiaries by:
- Collaborating with rural communication networks to develop and disseminate easy-to-understand materials;
- Supporting the adoption of health IT and the development of infrastructure to enhance patient access to health information; and
- Fostering engagement of rural beneficiaries in their health care.
5. Leverage Partnerships to Achieve the Goals of the CMS Rural Health Strategy
A key objective of the strategy is to leverage partnerships with stakeholders nationally, as well as at the regional, state, and local levels. To accomplish this, CMS will:
- Explore opportunities with the Office of the National Coordinator for Health Information Technology and other federal partners to promote interoperability of health information and increase the use of electronic health records among individuals and their healthcare providers and care teams.
- Work with federal and state partners to understand and evaluate the impacts of CMS programs on rural communities, and develop recommendations.
- Meet with health plan representatives to discuss challenges and strategies to increase participation in rural areas.
- Work with the Centers for Disease Control and Prevention to increase the focus on maternal health, behavioral health, substance abuse, and the integration of behavioral health and primary care.
- 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.
CMS will continue to collaborate with agency partners across the U.S. Department of Health and Human Services (HHS), including Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy, to implement this strategy.
For more information on the CMS Rural Health Strategy, please visit: http://go.cms.gov/ruralhealth.