The RUPRI Health Panel offers comments in response to the Committee on Ways and Means Request for Information regarding Improving Access to Health Care in Rural and Underserved Areas. The comments focus on all five topics included in the RFI. The five topics include comments on:
Geographic Payment Difference: The Panel recommends that changes to existing payment methodologies include elements addressing historical payment inequities affecting rural providers and reducing opportunities for abuse.
Sustainable Provider and Facility Financing: Financing healthcare organizations through patient-generated revenue is currently dependent on volume, which puts rural systems at a disadvantage. There must be different payments based on value in rural systems. A new payment design must reward the value rural providers provide patients and community populations, while still providing sufficient revenue to cover fixed costs.
Aligning Sites of Service: Efforts to implement site neutrality in payment systems may place rural hospitals in financial jeopardy. In rural settings, the fair approach to preserve a safety net is to establish fixed costs and then assess the price per service after the first condition is met.
Health Care Workforce: The Panel realizes workforce shortages affect all aspects of health care delivery. Our comments in this section will focus principally on workforce issues concerning the delivery of long-term supports and services (LTSS) in rural locations.
Innovative Models and Technology: We encourage the use of telehealth to supplement (not supplant) existing rural health services in creative ways, including primary care.