Historically, many rural hospitals were early adopters of telehealth due to the challenges rural residents faced in accessing care. Barriers included things like geographic distance, lack of a public transportation infrastructure, along with issues with provider shortages and their distribution/concentration in urban centers. Rural hospitals were frequently the recipients of rural health grants and formed the foundation for historical "hub and spoke" model of telehealth. The availability of telehealth services frequently allowed patients to remain in their community for care.
While telehealth best practices and policies are typically not different for rural hospitals than for other facilities, rural hospitals face some unique challenges. These include financial viability due to low patient volumes, older populations who require more services and who frequently rely on government payers, aging infrastructures and more. Therefore, several resources related to telehealth specific to rural hospitals have been developed. These are featured here:
Telehealth Resources for Rural Hospitals
- CMS Medicare Learning Network:
- Information for Critical Access Hospital (December 2023): Provides guidance around Telehealth Services Payment.
- Critical Access Hospital Telehealth Guide (February 2024): This Guide provides practical guidelines on implementing and sustaining telehealth to optimize health care delivery, expand access, enhance care coordination, and address health inequity. The guide primarily focuses on Medicare outpatient telehealth services but includes Medicaid coverage and remote services that may not strictly be considered telehealth.
- Telehealth Implementation: A Guide & Case Study for Critical Access Hospitals: This webinar provides practical guidance on implementing and sustaining telehealth to optimize health care service delivery, expand access, and enhance care coordination for Critical Access Hospitals (CAH). Just as health care organizations strive to take a person-centered approach to health care, this guide seeks to take a CAH-centered approach to telehealth that keeps the patient and community at the forefront.
- Cybersecurity Toolkit for Rural Hospitals and Clinics: This toolkit includes a survey of available resources from various government and non-profit organizations that are appropriate for rural settings.
- Telemedicine Applications for Small & Rural Hospitals: Guide developed by the American Society of Hospital Pharmacists (ASHP) to share ideas on ways telemedicine and telehealth have been used in small and/or rural hospitals to serve the needs of patients and communities.
Medicare has made several policy changes related to telehealth.
- See Final Rule for Medicare and Medicaid Programs and the Children’s Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Program Requirements; and Other Policy Changes
- See Final Rule for Hospital IPPS for Acute Care Hospitals and the Long-Term Care PPS; Quality Programs and Medicare Promoting Interoperability Requirements for Eligible Hospitals and CAHs; Rural Emergency Hospital and Physician Owned Hospital Requirements - FY2024
