telehealth access

Executive Order on Improving Rural Health and Telehealth Access


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President Issues Executive Order on Improving Rural Health and Telehealth Access

In an announcement by the United States President today, the Executive Order on Improving Rural Health and Telehealth Access was published in the White House list of presidential actions. The stated purpose of the Executive Order is to:

…increase access to, improve the quality of, and improve the financial economics of rural healthcare, including by increasing access to high-quality care through telehealth.​​​​​​​

While the focus of this order is on rural health only, it will establish precedents that undoubtedly will open the door to many more telehealth changes for other US citizens.  Meanwhile, understanding the movement toward wide-scale telehealth adoption can be useful to any forward-thinking professional planning to work over the next several years.

Telehealth Access Historical Perspective

Coming after a number of sudden telehealth breakthroughs due to the forced adoption of telehealth with the COVID Public Health Emergency (PHE), today’s announcement is nothing new to members of the telehealth research community. Since the 1950’s many researchers and clinicians alike have shown that telehealth has been underutilized to reach the millions of people who could benefit. Telehealth has been proven safe and effective by thousands of studies which culminated in several large-scale meta-analyses in 2012 and 2013. These studies showed that telehealth outcomes can be comparable to in-person care, particularly when adequate preparation and training are implemented using evidence-based protocols.

The literature has since developed in more specialized ways, including the publication of telebehavioral health competencies in 2017. A competency framework can be useful for addressing specific goals and assessments for clinicians and their employers. The field has since evolved even more rapidly. News readers will recall the February 2020 lead article, prior to the start of COVID in the United States, which featured this notable headline: AMA Says Nearly 75% of Medical Visits Could Be Handled Through Telehealth.

Today’s Executive Order

Following on the heels of last week’s formal extension of the COVID PHE and ensuing policy waivers to October 2020 by  Secretary Alex M. Azar II of the Department of Health and Human Services, today’s Presidential Executive Order on Improving Rural Health and Telehealth Access requires the following actions within the next 30 days:

  • The Secretary of HHS (Secretary) will announce a new model to test innovative payment mechanisms. The goal is to ensure that providers serving rural clients and patients are able to provide both the necessary level and quality of care. The evolving model being tested will provide flexibility for Medicare providers to establish predictable financial payments, and encourage the movement into high-quality, value-based care.
  • The Secretary will also work with the Secretary of Agriculture to develop and implement a strategy to improve the physical and communications healthcare infrastructure available to rural Americans.

Executive Order Requires Report to Suggest Needed Policy Initiatives

The Secretary will submit a report to the President, regarding existing and upcoming policy initiatives to cover a range of healthcare issues, including:

  • Increase rural access to healthcare by eliminating regulatory burdens that limit the availability of clinical professionals;
  • Prevent disease and mortality by developing rural-specific efforts to drive improved health outcomes;
  • Reduce maternal mortality and morbidity; and
  • Improve mental health in rural communities.

Extending Telehealth Access and Other Services Beyond COVID

Within 60 days, the Secretary shall review the following temporary COVID-19 measures to extend, as appropriate, beyond the duration of the Public Health Emergency:

  • The additional telehealth services offered to Medicare beneficiaries; and
  • The services, reporting, staffing, and supervision flexibilities offered to Medicare providers in rural areas
Introduction to Telehealth Theory & Practice

Enjoy a fast-moving overview of telebehavioral and telemental health. Understand the key points related to telehealth clinical, legal, ethical, technology, reimbursement, social media and other pivotal issues.

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What are your thoughts about this article? Please comment below.

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Sally S.
Sally S.
2 years ago

Thank you so much for keeping us all informed about Secretary Azar’s efforts and President Trump’s executive order on improving rural health and telehealth access. It is heartening in the middle of all of the bad news and misinformation in the media that those in the administration are moving forward to help us all to continue to provide services to those who are most in need.

Marlene Maheu, Ph. D.
Marlene Maheu, Ph. D.
Reply to  Sally S.
2 years ago

Sally, thank you for commenting.

2 years ago

I think Telehealth is a good tool for getting quality care to those who can’t get in-person treatment. I do, however, worry about credentialed professionals being eliminated in the process with platforms such as BetterHelp. Let’s hope this incentive will strengthen quality care rather than decrease it with unregulated individuals providing that care.

Marlene Maheu, Ph. D.
Marlene Maheu, Ph. D.
Reply to  cm
2 years ago

CM, Your point is well taken. The services delivered by many online employers are far from being the same as therapy, and I agree that something needs to be done about it. Unfortunately, you will find some national associations actually allowing such groups to advertise on their websites and in their publications.
On the other hand, the American Psychological Association banned all such advertising by a group a few years ago because of member complaints. While such an action is good for members and probably all an individual association can do, it leaves us wondering who will regulate companies encroaching on the serious business of behavioral healthcare with clearly visible efforts to make a fast buck at the expense of the consumer.
Poorly trained clinicians who voluntarily enlist to deliver services for such employers are also a big part of the problem, which is why educating our colleagues is the mission of TBHI. We recognized this problem in 1996 when we started a listserv called “PsyBus” and were privy to the inner thoughts of many of our colleagues working online. Our dismay fueled our efforts to start publishing about best practices and ultimately, to open TBHI in 2009.
We encourage you to keep up the good fight against many dishonorable online employers.