THE VALUED VOICE

Leaders from the Centers for Medicare & Medicaid Services (CMS) held a rural health care listening session January 24 in Springfield, IL. The Wisconsin Hospital Association participated in the session and raised key issues with CMS, including telehealth, behavioral health and regulatory flexibility among others. In addition, WHA provided a memo to CMS highlighting these issues. Also participating in the listening session were Hospital Sisters Health System (HSHS) and the Rural Wisconsin Health Cooperative.

One of the policies raised by WHA and reiterated by others at the session was the importance of telehealth services, particularly in rural communities. CMS heard multiple times that it should do more to support the use of telehealth by removing the regulatory and reimbursement barriers currently in place. 

“There are great opportunities to provide essential services, such as behavioral health care, in rural communities via the use of telehealth,” Jenny Boese, WHA vice president, federal affairs & advocacy, told CMS. “Unfortunately, current regulatory policies create unnecessary barriers and obstacles for its use in many rural communities where needs are greatest.” 

CMS asked attendees to discuss other priorities the Agency should consider with respect to rural health care. In addition to behavioral health and telehealth, participants discussed the importance of the Critical Access Hospital program, the 340B program and swing beds, among others. 

HSHS stressed, and WHA concurred, that CMS must provide more flexibility with respect to graduate medical education (GME). HSHS elaborated that CMS should allow hospitals to be able to accept additional residents under Medicare’s GME caps even if the hospitals had previously taken rural rotators for some short periods of time in the past. 

During the session, CMS asked attendees what services are the most difficult to provide in rural communities. Participants indicated behavioral health, pediatric care, specialty services, oral health and pregnancy/maternity care. 

CMS also provided attendees with a draft vision statement for rural health care. That statement focused on providing accessible, accountable and affordable care in rural communities. Through a facilitated discussion, attendees were asked to provide feedback on this vision statement and other questions, which CMS will now work to incorporate into the strategic plan it is developing for rural health care.