March 2015 Letter on Policy Briefs

March 10, 2015

The Honorable Sylvia Burwell, Secretary
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201

Dear Secretary Burwell,

On behalf of the National Advisory Committee on Rural Health and Human Services, I am sending you two policy briefs and their accompanying recommendations. The first brief examines telehealth in rural America and the implications of using this technology to help HHS meet the broader goals of value, quality and costs savings inherent in the Affordable Care Act (ACA). The second examines rural intimate partner violence (IPV), an issue that presents unique challenges in rural areas. These briefs were developed during the Committee meeting in Sioux Falls, South Dakota, September 24-26, 2014 which included additional site visits and stakeholder engagement in rural communities in both South Dakota and Minnesota.

The Committee believes telehealth can play a key role in supporting many of the ACA goals related to enhancing quality, access and value. Toward that end, the Committee’s brief makes several recommendations, including:

  • Allowing Rural Health Clinics and Federally Qualified Health Centers (FQHCs) to serve as distant sites eligible for Medicare payments;
  • Allowing use of telehealth visits in nursing homes based on clinical need rather than limiting such visits to one in a 30 day period;
  • Expanding evidence based research on the effectiveness, quality, and outcomes of telehealth use in rural areas.

The Committee believes there are several steps HHS can take to better understand and address IPV in rural communities. Specifically, the Committee’s brief includes a number of recommendations, including:

  • Ensuring that data from the National Intimate Partner and Sexual Violence Survey be analyzed from a rural/urban perspective so that a clearer picture of the problem can emerge;
  • Increasing training for providers on integrating IPV screening and counseling to help rural providers better serve their clients.

Our next meeting will be held in rural Kentucky and will cover a significant topic that hasn’t received the attention it deserves; an increasing differential between life expectancy in rural and urban areas. We have engaged with the Administration for Children and Families and Administration for Community Living and, given the topic, reached out to the Centers for Disease Control and Prevention as well.

As always, please let us know if we can assist you in any way.


The Honorable Ronnie Musgrove

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