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Legislation Introduced To Improve Health IT Infrastructure in Rural Communities

July 18, 2016
by Heather Landi
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Senator Al Franken (D-Minn.) introduced three bills last week that aim to strengthen rural health information technology (health IT) infrastructure in rural communities and also calls for the establishment of quality measures tailored to rural healthcare delivery.

The bill, called Connecting Rural Americans to Care Act of 2016, calls for the establishment of an interagency task force on rural health IT to coordinate delivery of financial and technical assistance to rural providers and provide leadership and recommendations on best practices to increase internet access in rural areas.

According to a one-pager announcement about the bill, the legislation aims to improve access to high-quality health care services in rural America by addressing two central challenges—the lack of transportation options and the need for more health information technology infrastructure.

The legislation would also require the Federal Communications Commission (FCC) to simplify and strengthen its Healthcare Connect Fund, which expands access to broadband services for health care providers in rural areas. The legislation increases the discount the program provides on broadband services, equipment, and connections from 65 percent to 85 percent; local health care providers will now only be required to pay up to 15 percent of these expenses. The legislation also calls on the FCC to streamline the application process, and permits the FCC to further reduce cost sharing for health care providers in tribal areas.

The bill was one of three bills included in Sen. Franken’s legislative package. Another bill, the Rural Health Care Quality Improvement Act of 2016, calls on the Secretary of Health and Human Services to establish a core set of measures tailored to rural healthcare delivery, promoting payment reforms in rural areas and improving rural representation in delivery system reform organizations.

According to a one-pager announcement from Sen. Franken’s office, while Medicare and other private payers have  implemented new payment models to reward value over volume, small rural hospitals and other rural providers have been largely left out of these national quality reporting and improvement efforts. “This is because rural providers face a number of challenges when trying to measure performance and improve quality, including geographic isolation, small practice size, or low case volume. This legislation takes steps to overcome these challenges so that rural providers can fully engage and evolve with the health care system as it shifts toward value,” the announcement stated.

The legislation would establish quality measures designed to reflect the experience of rural communities and provide resources to support the implementation of new quality improvement initiatives. He provisions of the bill include establishing a core set of quality measures that focus on improving patient outcomes, increasing care coordination, improving patient safety and reducing costs in rural communities, and requires the Secretary to review and update the core set of quality measures on an annual  basis. The bill also reauthorizes The Medicare Rural Hospital Flexibility Grant Program, which funds innovative initiatives that improve access to health care in rural areas and supports quality improvement efforts.

And, another provision of the bill would establish a new grant program to support Critical Access hospitals in establishing or expanding quality improvement reporting programs and to provide technical assistance to hospitals that report relevant quality data.

In addition, the legislation promotes rural innovation in payment and delivery system reform by directing the HHS Secretary to integrate a core set of rural measures into new alternative payment models and to permit rural providers to participate in new delivery reforms, including the Comprehensive Primary Care Plus model.

According to the announcement about the legislation, the bill also directs the Centers for Medicare & Medicaid (CMS) Innovation to test new financial incentives to increase quality reporting, new value-based payment models for rural providers, and hospital readmission reduction programs for rural hospitals.

Finally, the bill also would increase rural representation by calling for the CMS Rural Health Council to include external stakeholders who have objective rural health expertise and increases rural representation on the Medicare Payment Advisory Commission (MEDPAC) and Medicaid and CHIP Payment and Access Commission (MacPAC).



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