House committee supports telehealth flexibilities, rural health residencies

© Philip - stock.adobe.com

Good news could be coming for advocates of telehealth and rural health.

Both found support this month in the House Committee on Ways and Means, where representatives supported the full Congress consider legislation expanding telehealth flexibilities and rural medical training.

The Committee advanced the “Preserving Telehealth, Hospital, and Ambulance Access Act,” bipartisan legislation that would extend for another two years the flexibilities granted for Medicare patients for the COVID-19 pandemic. Those will expire at the end of 2024.

“Embracing telehealth is one of the most moral actions we can take to expand patient access to health care providers, which will in turn make our brothers and sisters healthier while reducing overall costs,” bill cosponsor Rep. David Schweikert (R-Arizona) said in a joint announcement with cosponsor Rep. Mike Thompson (D-California). “This bipartisan bill ensures that patients can continue to meet virtually with their providers and receive the quality care they deserve to make informed decisions about their health.”

Rep. Schweikert. “This bipartisan bill ensures that patients can continue to meet virtually with their providers and receive the quality care they deserve to make informed decisions about their health. I’m pleased to see the Ways and Means Committee pass this legislation, and I look forward to working with Rep. Thompson to pass this bill through the House.”

“Telehealth allows Medicare beneficiaries – especially those with low mobility or who otherwise can’t make it to the doctor’s office – to access the care they need when they need it,” Thompson said. “Protecting seniors’ access to telehealth’s vital services just makes sense.”

With technology to meet online, 25% of adults reported using telehealth in the last month. A full 91% of telehealth patients reported a favorable experience, and 78% would use telehealth to complete a medical appointment again, according to a committee summary posted online.

The bill also would extend the Medicare Hospital at Home initiative through 2029, while supporting Medicare programs to sustain rural and low-volume hospitals and emergency ambulance services. Hospital at Home, set to expire at the end of this year, now has 300 hospitals participating in 37 states.

The representatives’ joint announcement was loaded with statements of support from telemedicine and medical groups. Endorsements came from the American Telemedicine Association (ATA), the Alliance for Connected Care, the National Rural Health Association, the National Multiple Sclerosis Society, the Advanced Care at Home Coalition, and more.

ATA published a list of the telehealth provisions it supports:

Geographic and originating-site waivers

• Ability for federally qualified health centers (FQHCs) and rural health clinics (RHCs) to continue to furnish telehealth services
• Expanded list of eligible Medicare providers, allowing physical therapists, occupational therapists, speech language pathologists, and audiologists to render telehealth services
• Ability to offer audio-only services
• Repeal of telemental health in-person requirement

Rural medical training

The Committee also supported the “Rural Physician Workforce Preservation Act,” sponsored by Rep. Greg Murphy, MD.

Congress created 1,200 Medicare-funded residency slots in 2020 and 2022 with a formula intended to allocate 10% of the slots to rural hospitals. But non-rural hospitals can be reclassified as “treated as rural,” scooping up 81 of 93 educational slots attributed as “rural,” according to a committee bill summary.

The legislation will close that loophole so a full 10% of the 1,200 residency slots will go to truly rural hospitals.

“As a physician of over 35 years, serving 29 counties in Eastern North Carolina, I uniquely understand the challenges rural America faces in accessing care,” said Murphy, who remains a practicing surgeon. “We must address the critical physician workforce shortage our non-metro communities experience and preserve the opportunity for all patients to utilize telehealth services. It is well known that if a medical student comes from, or a resident rotates into, a rural area they will be much more inclined to come practice there after their studies.”

The committee summary included figures about the state of physicians and rural communities, and it’s clear help is wanted:

• 91% – rural communities with health care workforce shortages
• 65% – rural areas with primary care physician shortages
• 28% – the decline of medical school entrants from rural areas from 2002 to 2017
• 10% or less – the amount of residents who receive training in rural medicine
• 5% or less – the amount of physician residents from rural areas