The Centers for Medicare & Medicaid Services (CMS) recently announced a new rural health strategy, targeting Medicare and Medicaid beneficiaries located in rural America.

One of the strategy’s aims is to boost telehealth and telemedicine, a growing area of in-home based care.

“For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency,” CMS Administrator Seema Verma said. “The Rural Health Strategy supports CMS’ goal of putting patients first. Through its implementation and our continued stakeholder engagement, this strategy will enhance the positive impacts CMS policies have on beneficiaries who live in rural areas.”

Regarding telehealth, CMS plans to reduce barriers to stakeholders, such as reimbursement, cross-state licensure issues, and the administrative and financial burden to implement telemedicine.

Telehealth has been gaining traction in the in-home care space. One New York-based provider, Visiting Nurse Service of New York (VNSNY), implemented a digital avatar program, VERA, to provide at-home therapy for patients recovering from surgery. VERA—Virtual Exercise Rehabilitation Assistant—is an FDA-cleared program that engages patients in virtual rehab and physical therapy to boost health outcomes.

Another organization, North Carolina-based health system FirstHealth of the Carolinas, saved $1.9 million and reduced hospital readmissions 53% through telehealth and patient engagement software for 220 high-risk patients. And money is also pouring into the space; last year, a Texas-based telehealth start-up raised $5.1 million.

VNSNY is one of the nation’s oldest home health care providers and is the largest not-for-profit home- and community-based health care organization in the nation. But for many rural providers without the same resources, adding a virtual rehab program may be out of reach.

Easing some financial burdens, as CMS has stated, could lead to an increase in telehealth use in home health care and across the care continuum.

“This Administration clearly understands that one of the keys to ensuring that those who call rural America home are able to achieve their highest level of health is to advance policies and programs that address their unique healthcare needs,” Verma said.

The Department of Veterans Affairs (VA) is already on the forefront of pushing more telehealth and telemedicine, providing monitoring to veterans in their homes and awarding contracts of more than $1 billion to companies to provide these services.

CMS will explore telehealth expansion and modernization through the Center for Medicare and Medicaid Innovation (CMMI) models and demonstrations, such as the Next Generation Accountable Care Organization (ACO) model, the Frontier Community Health Integration Project Demonstration, and the Bundled Payments for Care Initiative advanced model, CMS stated.

About one in five people, or 60 million, live in rural communities across the country, according to CMS. These communities, while not as diverse as their urban counterparts, face challenges that can somewhat limit access to health care. For example, rural Americans are more likely to be unhealthy, older, uninsured or underinsured, and medically underserved, CMS stated in its strategic outline — with an increased incidence of poverty. A limited health care workforce, fragmented delivery system and affordability of insurance are also challenges in rural communities.

The strategic plan, developed by the CMS Rural Health Council, aims to complete five objectives:

  1. Apply a rural lens to CMS programs and policies
  2. Improve access to care through provider engagement and support
  3. Advance telehealth and telemedicine
  4. Empower patients in rural communities to make decisions about health care
  5. Leverage partnerships to achieve the Rural Health Strategy goals

Written by Amy Baxter