Rural Healthcare’s Noble Fight to Survive (Part 2)

by webadmin on February 14, 2013

Yesterday, we examined the plight of rural healthcare in Georgia and how it is reflective of the nation as a whole. Today, we’re going to look at what the federal government plans to do to aid rural areas.

John Commins at HealthLeaders Media details the pledges that were made at a teleconference earlier this month by Health and Human Services Secretary Kathleen Sebelius, Agriculture Secretary Tom Vilsack, and Patrick Conway, MD, CMO and director of clinical standards and quality at the Centers for Medicare & Medicaid Services, all of whom expressed a firm and abiding commitment to rural healthcare.

Commins reports, “The three senior officials detailed Medicare reforms that they determined were obsolete or excessively burdensome on hospitals and healthcare providers.” According to CMS estimates, $3.4 billion over five years or $676 million per year would be saved by getting rid of these regulations. Doing so “would greatly ease regulatory and staffing burdens for rural providers in particular.”

Paraphrasing Commins, these reforms include the following:

  • The staff at critical-access hospitals would no longer have to directly provide radiology, diagnostic, laboratory, therapeutic, and emergency-room services and instead, can contract them out.
  • No longer must a physician be onsite on a biweekly basis at federally qualified health centers, critical-access hospitals, and rural health clinics. Conway explained, “Specifying a specific timeframe for a physician to visit a rural facility does not ensure better healthcare. With the development of telemedicine a physician should have the flexibility to utilize a variety of options to provide medical direction.”
  • Dieticians can control a patient’s diet. No longer will a clinician have to first approve it. “This will provide hospitals with the flexibility to allow dieticians to practice to the full extent of their scope of practice and enter orders directly,” Conway said.
  • Rural hospitals with swing beds will be surveyed “when the hospital is surveyed, rather than being surveyed separately.”
  • Having one director of outpatient services will be eliminated as a requirement, a change, Conway asserted, that “is critical for small, low-volume rural hospitals with more limited staff resources.”

In May 2012, the White House Rural Stakeholder meeting advocated a series of reforms to the Obama administration, and they have since been implemented, Conway said.

“Those include the final rule of the physician-fee schedule, which was amended to allow nurse practitioners and physicians’ assistants to order portable X-rays,” Commins writes.

Conway explained, “This recognizes the important role these providers play in rural clinics and hospitals and the need for flexibility. Lastly we made changes to the electronic health records incentive payments. We now allow cause to include capital-lease costs for the purpose of determining their electronic health records incentive payments.”

So, what do you think of these reforms? There is a 60-day public-comment period on these proposed reforms, and CMS wants to hear from rural providers.

As Commins urged, “Now is the chance for those providers to step up and help shape federal rural healthcare policy.”

-by Pete Fernbaugh

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