Improving Rural Health and Telehealth Access
This executive order (EO) aims to improve health outcomes in rural America by expanding access to care, modernizing payment and care delivery, and investing in the infrastructure needed for telehealth and other technologies. It directs federal agencies to pursue three main tracks: (1) launch an innovative Medicare payment model for rural providers to support higher-quality, value-based care; (2) build and upgrade physical and communications infrastructure in rural areas to support health services and telehealth; and (3) develop policy actions to increase rural access, reduce disease and mortality (including maternal mortality and mental health needs). It also seeks to extend certain telehealth flexibilities introduced during the COVID-19 public health emergency (PHE) beyond the PHE timeframe, if feasible. The overall goal is to make rural health care more sustainable and capable of leveraging telehealth and other innovations. The EO emphasizes the challenges rural communities face, such as hospital closures and workforce shortages, and notes the rapid expansion of telehealth during the pandemic as a potential long-term improvement in access. It directs specific actions within tight timeframes to begin testing new payment models, infrastructure investments, and policy reporting, while preserving existing legal authorities and funding limitations.
Key Points
- 1Launch an innovative payment model under section 1115A of the Social Security Act within 30 days to test new ways to finance rural health care. The model should give rural providers flexibility from some Medicare rules, provide predictable payments, and encourage high-quality, value-based care.
- 2Invest in physical and communications infrastructure for rural health care within 30 days. The Secretary of HHS and the Secretary of Agriculture will develop and implement a strategy—working with the FCC and other agencies—to improve rural health by upgrading facilities and connectivity (e.g., broadband) needed for modern care delivery.
- 3Improve rural health through a 30-day report outlining policy initiatives. The report should address: (a) reducing regulatory barriers that limit clinical professionals in rural areas; (b) rural-specific efforts to prevent disease and mortality; (c) reducing maternal mortality and morbidity; and (d) improving rural mental health.
- 4Expand telehealth and related flexibilities beyond the PHE. Within 60 days, the Secretary should review temporary telehealth measures and staffing/supervision flexibilities introduced during the PHE and propose regulations to extend them where appropriate for rural Medicare providers and beneficiaries.
- 5General provisions. The order preserves existing authorities and budget processes, and it does not create new rights or entitlements. Implementation is subject to applicable law and available funding.