AHA: Reduce administrative burden from rural broadband program

The American Hospital Association is urging the Federal Communications Commission to simplify the application and reporting requirements for its Rural Health Care Pilot Program to make it more accessible to small hospitals.

Earlier this month, the FCC declared the $415 million broadband pilot, launched in 2006, a success. It said it improved the quality and reduced the cost of delivering healthcare in rural areas through telehealth, increased revenue for rural clinics and hospitals, and allowed exchange of electronic health records and training of rural medical personnel. It since has put out a call for comments about proposed revisions to the program.

In a letter, Linda Fishman, senior vice president for public policy analysis and development at AHA, however, said the program's limited scope and burdensome requirements have restricted its usefulness. While cloud-based services offer great appeal to small, rural hospitals, she said, that requires fast, reliable broadband service.

She pointed to a Government Accountability Office report showing that smaller, rural hospitals are less likely to receive EHR payments as evidence that the smallest hospitals still need more help.

"Hospitals report that the application requirements for individual members of a consortium are onerous and have resulted in significant delays," Fishman wrote. "Individual participants are often small hospitals or rural health clinics with limited administrative capacity and technical resources."

In urging that the program operate on procedures that impose the minimum burden on applicants, she notes that rural healthcare facilities generally don't have staff with expertise in structuring and managing communications services.

Among the AHA recommendations:

  • Allow both urban and for-profit providers to be part of consortia that apply for funding under the program as long as controls are in place to ensure that rural providers receive the most benefit. Fishman says 12 percent of rural hospitals are for-profit and should be allowed to be part of consortia that obtain lower prices by purchasing services together.

  • Make the commission apply a clear and consistent test for rural benefit. "Policies ensuring that funding predominantly benefits rural providers are more important than policies that address the make-up of the participants in the program," she said.

  • Provide limited funding to further help rural facilities with demonstrated need, as the AHA's rural members find the ability to ensure access to "last mile" broadband connections a fundamental constraint to broadband access.

The Department of Veterans Affairs has been one of the biggest proponents of telemedicine to provide services in rural areas. It has expanded its mental health services in that area and in one pilot is using specialists to train rural primary care physicians.

To learn more:
- here's the call for comments
- read the AHA letter

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