Government Agencies Showing New Focus on Rural Health

From DOTmed News:

A review of U.S. government agency activity, funding and legislation indicates that there is a new focus on the rural health sector of the U.S, giving support and attention to this usually unheard and underfunded sector.

Just recently on June 1, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced $30 million of dollars in funds to be released in grants and a National Resource Center, in order to assist persons in obtaining Medicare. The initiative, Secretary Sebelius’ website says, “…also includes special targeting efforts to rural areas of the country and to Native American elders.”

The HHS had already been given a stronger focus this year on rural health care through the February appointment of Dr. Mary Wakefield as Administrator of the Health Resources and Services Administration (HRSA). Dr. Wakefield had previously been director of the Center for Rural Health at the University of North Dakota. The HRSA assists in delivery of health care to those who are uninsured and underserved. Later in March, HHS directed $338 million of American Recovery and Reinvestment Act funds to community health centers, including those in rural states.

UPDATE:United Health, Cisco Unveil New Telehealth Network

Update on the UnitedHealth/Cisco telemedicine network, from the Wall Street Journal:

United Health Group (UNH) and Cisco Systems, Inc. (CSCO) announced Wednesday a new health initiative that will use technology to bring remote medical care to rural and underserved populations.

The first national telehealth network, called “Connected Care,” will employ Cisco videoconferencing and other technologies to simulate in-person doctor visits between United Health’s 590,000 medical professionals and patients in rural areas, the workplace and underserved populations. United Health is providing “tens of millions of dollars” in funding the program, the company said in a statement. The program also aims to connect hospitals and clinics with patients at home or in the workplace.

“This is another major advance in the way consumers receive health care,” said United Health Group CEO Stephen Hemsley.

Designed to operate in real time, the network will rely on video and audio technology from Cisco and several other companies, as well as electronic health records, to help doctors assess and talk with patients in hard-to-reach areas through an open, but secure network. Patients with chronic diseases or rural residents in need of a specialized doctor stand to benefit the most from the technology, said Jim Woodburn, United Health’s medical director of clinical initiatives.

One snag in the distribution of telehealth medicine nationwide has been confusion over how doctors consulting in multiple regions have to be credentialed. Different agencies have imposed different standards on whether doctors need new testing and background checks at every hospital that they work with.

But a section of telehealth legislation introduced by Rep. Mike Thompson, D-Calif., would change Medicare rules to allow for credentials to carry with a doctor. The provision is slated to be discussed at Thursday’s House Ways and Means Committee markup.

Mass. Panel: End Fee-for-Service Payments for Doctors

From the WSJ Health Blog:

One of the much-discussed drivers of the high cost of health care in the U.S. is that doctors are paid for every procedure and test, which gives a financial incentive to provide more and more treatments, even if they aren’t strictly necessary. That system could change drastically in Massachusetts, as the state struggles to pay for its universal health insurance plan.

A Massachusetts commission yesterday recommended that the state shift its payment method from the ubiquitous “fee for service” formula to one where health-care providers would be grouped into networks and paid a flat monthly or annual fee. Here’s the WSJ story.

The goal is to improve care while reducing costs by forcing health-care providers to work within a budget and coordinate care between providers, according to the Boston Globe.

Patients would choose a primary care provider to coordinate care, a model that resembles the “medical home.” But, they may not get all the tests and procedures they want with providers working within a budget and trying to keep costs down. In addition, the plan could fail if the provider payments are too low or not appropriately adjusted for very sick patients, the reason for the failure of a similar attempt to pay doctors that way in the 1990s, notes the Globe.

Many of the important details haven’t yet been determined and enacting the plan — the goal is to do so within five years — is expected to be tough, according to the New York Times. One of the committee’s leaders, state Rep. Harriett Stanley, told the NYT, “It’s going to be a very long haul, but it’s a trip worth taking.”

American Medical Association backs House health bill

From Reuters:

The influential American Medical Association on Thursday said it supported the healthcare overhaul legislation moving through committees in the Democratic-led House of Representatives and urged its approval.

“This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform,” AMA executive vice president Michael Maves wrote to the House committee leaders.

In particular, he said, the doctors’ group backs the insurance market reforms that seek to expand healthcare coverage and the proposed health insurance exchange. In this exchange consumers would choose between private insurers and a public plan.

He also cited the ban on exclusion from coverage for pre-existing conditions and an increased reliance on primary care doctors.

On federal healthcare programs, the AMA said it welcomed the changes in Medicare health care for the elderly which would include a repeal of the sustainable growth rate formula and the expansion of Medicaid for the poor.

“This year, the AMA wants the debate in Washington to conclude with real, long overdue results that will improve the health of America’s patients,” he wrote.