Top senator: Rural health systems must be allowed to evolve, survive through telehealth
Thursday, August 22, 2019
Telehealth is getting some additional mainstream backing again in a significant way as one of Washington, D.C.'s leading healthcare voices continues to place his support behind it — Sen. Chuck Grassley, R-Iowa.
The reason for his doing so is because of the weakening of the rural healthcare community. These rural health systems face continual financial pressure, and many of them are facing closure. Thus, telehealth can help solve some of the many challenges confronting rural communities in maintaining access to care, Grassley says.
Sen. Grassley, chairman of the Senate Finance Committee, recently spoke out at a Bipartisan Policy Center event in Des Moines, Iowa, about rural health. "Rural communities are struggling to keep healthcare services available for their residents," said Grassley.
The senator said during his talk that almost 20% of the state's rural hospitals are at risk. "Some rural communities are facing the stark possibility of having no healthcare services available in their county whatsoever," he added.
There have been 98 closures of rural hospitals since 2010, but hundreds more are likely to follow, the National Rural Health Association (NRHA) claims. As of February 2019, 46% of rural hospitals operate at a loss, up from 44% in 2018 and 40% in 2017. Financial strains mean that about 700 rural hospitals are financially vulnerable and at high risk of closure.
The American Hospital Association reports that there were 1,875 rural community hospitals as of 2019.
These hardships to rural areas because of a hospital closure can have a staggering effect on the communities where they are located. These health centers are the nucleus of their rural economies, creating jobs for residents, and serve as incentives people to move to a county and open businesses, the NRHA says. "Without a rural hospital, a community will crumble. The most recent hospital closures will leave communities across the country without local care and will devastate rural economies nationwide."
Grassley believes that new models of care on the horizon, including the delivery of care through mediums like telehealth. Policies must keep pace with that technology, Grassley said at the forum. "Cutting red tape and prioritizing telehealth services will grow patient volume, expand access, improve care and increase flexibility,” he said.
Grassley has reintroduced a bipartisan bill that would allow rural diabetic patients to receive regular vision screening using telemedicine. His bill, the Rural Emergency Acute Care Hospital (REACH) Act, is designed to create a new rural emergency hospital classification under Medicare. Many of these hospitals are currently designated as critical access hospitals under Medicare. Thus, these care systems must maintain a required number of in-patient beds and provide emergency care services, which can be draining on their finances.
The space previously used for the in-patient beds could be used for providing other patient services, including telemedicine. The REACH Act also details the costs associated with having a backup physician available via a telecommunications system.
"We hope to get that moving forward, but we had a tremendous problem the way that it was introduced last year," Grassley said.
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