With rural hospitals facing financial pressures and many forced to close, telehealth can help solve some of the challenges confronting rural communities in maintaining access to care.
That’s the contention of Sen. Chuck Grassley (R-Iowa), chairman of the Senate Finance Committee, who spoke on Tuesday at a Bipartisan Policy Center event in Des Moines on the topic of rural health.
“Rural communities are struggling to keep healthcare services available for their residents,” said Grassley, who noted that 18 percent of Iowa’s rural hospitals are at high risk for closure. “Some rural communities are facing the stark possibility of having no healthcare services available in their county whatsoever.”
A February 2019 analysis by consultancy Navigant shows that 21 percent of rural hospitals—430 facilities across 43 states—are at high risk of closing—of those, 64 percent, or 277, are considered essential to their communities.
“The good news is there are viable solutions with new models of care on the horizon—the delivery of healthcare is changing, and policy needs to keep pace with that technology,” emphasized Grassley. “Cutting ridiculous red tape and prioritizing telehealth services will grow patient volume, expand access, improve care and increase flexibility.”
Towards that end, Grassley said he—along with other senators—has reintroduced a bipartisan bill that would allow rural diabetic patients to receive regular vision screening using telemedicine.
More broadly, the Rural Emergency Acute Care Hospital (REACH) Act would create a new “rural emergency hospital” classification under Medicare. Many rural hospitals are currently designated as critical access hospitals under Medicare and as a result have to maintain a certain amount of inpatient beds and provide emergency care services.
However, the REACH Act calls for the creation of a rural emergency hospital designation under the Medicare program that would enable facilities in rural areas to provide emergency medical services without having to maintain inpatient beds. In addition to providing emergency care, rural emergency hospitals could convert the space previously used for inpatient services to provide other medical services, including telemedicine.
According to a provision of the REACH Act, costs associated with “having a backup physician available via a telecommunications system shall be considered reasonable costs” of providing rural emergency hospital outpatient services.
“We hope to get that moving forward, but we had a tremendous problem the way that it was introduced last year,” acknowledged Grassley.