President Issues Executive Order on Improving Rural Health and Telehealth Access
In an announcement by the United States President today, the Executive Order on Improving Rural Health and Telehealth Access was published in the White House list of presidential actions. The stated purpose of the Executive Order is to:
…increase access to, improve the quality of, and improve the financial economics of rural healthcare, including by increasing access to high-quality care through telehealth.
While the focus of this order is on rural health only, it will establish precedents that undoubtedly will open the door to many more telehealth changes for other US citizens. Meanwhile, understanding the movement toward wide-scale telehealth adoption can be useful to any forward-thinking professional planning to work over the next several years.
Telehealth Access Historical Perspective
Coming after a number of sudden telehealth breakthroughs due to the forced adoption of telehealth with the COVID Public Health Emergency (PHE), today’s announcement is nothing new to members of the telehealth research community. Since the 1950’s many researchers and clinicians alike have shown that telehealth has been underutilized to reach the millions of people who could benefit. Telehealth has been proven safe and effective by thousands of studies which culminated in several large-scale meta-analyses in 2012 and 2013. These studies showed that telehealth outcomes can be comparable to in-person care, particularly when adequate preparation and training are implemented using evidence-based protocols.
The literature has since developed in more specialized ways, including the publication of telebehavioral health competencies in 2017. A competency framework can be useful for addressing specific goals and assessments for clinicians and their employers. The field has since evolved even more rapidly. TBHI News readers will recall the February 2020 lead article, prior to the start of COVID in the United States, which featured this notable headline: AMA Says Nearly 75% of Medical Visits Could Be Handled Through Telehealth.
Today’s Executive Order
Following on the heels of last week’s formal extension of the COVID PHE and ensuing policy waivers to October 2020 by Secretary Alex M. Azar II of the Department of Health and Human Services, today’s Presidential Executive Order on Improving Rural Health and Telehealth Access requires the following actions within the next 30 days:
- The Secretary of HHS (Secretary) will announce a new model to test innovative payment mechanisms. The goal is to ensure that providers serving rural clients and patients are able to provide both the necessary level and quality of care. The evolving model being tested will provide flexibility for Medicare providers to establish predictable financial payments, and encourage the movement into high-quality, value-based care.
- The Secretary will also work with the Secretary of Agriculture to develop and implement a strategy to improve the physical and communications healthcare infrastructure available to rural Americans.
Executive Order Requires Report to Suggest Needed Policy Initiatives
The Secretary will submit a report to the President, regarding existing and upcoming policy initiatives to cover a range of healthcare issues, including:
- Increase rural access to healthcare by eliminating regulatory burdens that limit the availability of clinical professionals;
- Prevent disease and mortality by developing rural-specific efforts to drive improved health outcomes;
- Reduce maternal mortality and morbidity; and
- Improve mental health in rural communities.
Extending Telehealth Access and Other Services Beyond COVID
Within 60 days, the Secretary shall review the following temporary COVID-19 measures to extend, as appropriate, beyond the duration of the Public Health Emergency:
- The additional telehealth services offered to Medicare beneficiaries; and
- The services, reporting, staffing, and supervision flexibilities offered to Medicare providers in rural areas
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