In comments submitted to the Federal Communications Commission (FCC) on a proposed telehealth rule, the College of Healthcare Information Management Executives (CHIME) urged the agency to consider doubling funding for rural health care and to use funding to focus on areas impacted by the opioid crisis.
In its recent proposed rule, Promoting Telehealth in Rural America, the FCC notes that as technology and telemedicine assume an increasingly critical role in healthcare delivery, a well-designed Rural Health Care (RHC) Program is more vital than ever. Trends suggest that rural communities across the country are falling behind when it comes to the availability of high-quality healthcare. When the FCC established the RHC program in 1992, it was aimed at improving care for Americans living in less populated areas of the country.
The FCC noted that by improving rural healthcare provider access to modern communications services, the RHC Program can help in overcoming some of the obstacles to healthcare delivery faced in isolated communities.
In the proposed rule, the FCC outlined that for the second funding year (FY) in a row, demand for RHC Program support is anticipated to exceed available program funding, leaving healthcare providers to potentially pay more for service than expected. According to FCC officials, part of that growth is due to an increase in waste, fraud, and abuse in the RHC Program. Further, the Telecommunications (Telecom) Program, a component of the RHC Program, has not been significantly reviewed or revised since its inception in 1997.
The current cap on the RHC Program has remained at $400 million since its inception in 1997. RHC Program demand, however, exceeded the cap in FY 2016 and is expected to exceed the cap in FY 2017 and in future years. The proration that comes with capped funding may be especially hard on small, rural healthcare providers with limited budgets, and so the FCC examines whether a cap of $400 million is an appropriate level of funding for the RHC Program going forward.
With the proposed rule, the FCC seeks comment on increasing the cap for the RHC Program and whether to retroactively increase the cap for FY 2017.
In response, CHIME supports increasing the RHC program funding and to increase it retroactively. CHIME recommends that the cap be doubled to $800 million annually, noting that the demand to connect to skilled nursing facilities will drive the demand even higher.
What’s more, CHIME urges the FCC to consider the role RHC program funding can play in addressing the opioid epidemic. CHIME notes that Americans living in rural areas can be particularly vulnerable to opioid addiction. According to data from the Centers for Disease Control and Prevention, opioid misuse and related deaths are higher among poor and rural populations. CHIME recommends that FCC leverage broadband and telehealth access in underserved areas to help address the opioid abuse problem.
CHIME also made a number of other recommendations, including that FCC work collaboratively with other agencies, including the Substance Abuse and Mental Health Services Administration, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) on telemedicine solutions to help curb the opioid crisis. What’s more, CHIME recommends that FCC establish a national broadband strategy and that it take a vendor neutral approach.
