How technological developments can address gaps in quality care

Roughly 59 million people—almost 20 percent of the U.S. population—live in rural areas. The CDC found that rural Americans are at greater risk for developing chronic health conditions and their mortality rates from those conditions are also higher, when compared to people living in urban and suburban communities. These disparities in health outcomes can be attributed to limited access to quality care. Providers and patients face unique challenges to offering quality care in rural areas—geographic isolation, access to transportation, a shortage of clinicians, lack of insurance, weaker infrastructure—leading to poor health outcomes.

An Initiative to Improve Rural Health Care

In order to more comprehensively address the challenges faced by both rural communities and providers, the National Quality Forum launched the Measure Applications Partnership (MAP) Rural Health Workgroup. The Workgroup was convened to make recommendations to the Centers for Medicare and Medicaid Services (CMS) on meaningful quality measures to assess health service access for rural Americans. The Workgroup, comprised of leading rural health organizations including the National Rural Health Association, recently released a report—A Core Set of Rural-Relevant Measures and Improving Access to Care—which details the challenges of care quality measurement and outlines potential solutions to improve access.

Future Potential of Virtual Communications for Rural Settings

The Workgroup consistently focused on access to care among its core measures as a key issue for rural residents. While the report acknowledged that access does not necessarily equal quality, it can be a strong indicator. The Workgroup specifically recognized telehealth’s ‘tremendous potential’ for improving access for patients in rural settings, along with the key challenges of implementing telehealth programs. Many technology services are not covered under Medicare and Medicaid programs, and other regulatory barriers may block their use.

As of January 1, 2019, policies included in this year’s Medicare Physician Fee Schedule offer reimbursement codes to support patients through technology. The Workgroup noted the need for more education to help patients become comfortable with virtual healthcare, and encouraged health systems and their partners (health plans, community health centers, etc.) to guide and disseminate these messages. Through ongoing expansion of remote access technologies, a simple virtual check-in with a clinician or coach could serve as a bridge to better care.

Innovative strategies are needed to address the health disparities between the millions of Americans in rural communities and their urban and suburban counterparts by increasing access to quality care. This report and the ongoing work across the country represent an important effort to make room for technologically-driven solutions like emocha as essential tools to connect patients with providers, and enhance healthcare delivery.