- Recent funding cuts for the Rural Health Care (RHC) program could restrict broadband access for rural patients, which is needed for telehealth programs, the American Hospital Association (AHA) explained in an open letter to FCC Secretary Marlene Dortch.
The letter was written on behalf of the AHA’s nearly 5,000-member hospitals and health systems as well as 270,000 physicians and 2 million nurses.
The RHC uses connectivity to bring healthcare to rural patients. This program depends on broadband access and provides participating patients with reduced rates for broadband services.
Rural communities can benefit greatly from telehealth, especially patients living with chronic illnesses. Telehealth allows patients to benefit from health services without needing to travel to their primary care provider or a specialist.
Broadband services are critical to rural telehealth programs but internet services can be more expensive in isolated communities. Rural internet customers may only have the option to pay for internet by the gigabyte, which makes video conferencing extremely expensive. The RHC subsidizes some of the broadband costs so rural patients don’t have to pay for excessive broadband use for their healthcare.
The letter addressed the fact that the RCH program exceeded its $400 million cap for the first time in 2016. The cap was exceeded because telemedicine is growing as the technology used to treat patients remotely has improved.
The AHA suggested that the FCC adjust the RCH budget accordingly and account for inflation. If the FCC had adjusted the budget for inflation every year, 2017 should have had a cap of $571 million.
“The AHA supports this approach,” AHA Senior Vice President Ashley Thompson stated in the letter. “We also recommended that the Commission undertake a detailed assessment of the future demand for broadband-enabled health care services to more accurately set a program cap to meet the needs of rural health care providers and their patients, as the Commission has done for similar programs, such as the E-rate program.”
The USAC announced reductions of 15 percent for individual participants and 25 percent for consortia participants. These reductions further underfund an already underfunded program.
The USAC stated that it received $521 million in eligible requests, which is far beyond the cap of $400 million, but comes in below the projected inflation budget of $571 million.
“Unfortunately, these deep reductions were announced eight months into the funding year, and were far greater than anticipated,” said Thompson. “These cuts not only affect the ability of these rural health care providers to maintain strong broadband connections but also could force tough decisions affecting funding for essential health care services.”
While the FCC is making unused funds from previous years available, it’s not enough to sustain support of the innovations in telehealth that require better broadband.
Last spring, AMIA released a letter urging the FCC to categorize broadband access among the social determinants of health as they continue to develop policies and programs in the future.
AMIA agreed with what the FCC has said in the past, that healthcare is being “transformed by the availability and accessibility of broadband-enabled services and technologies and the development of life-saving wireless medical devices.”
The significance of broadband to telehealth has prompted it to be considered a social determinant of health.
Social determinants of health are the conditions in which people live, grow, work, and age. They include socioeconomic status, education, employment, physical environment, and social support.
AMIA believes that social determinants include access to health information and care via broadband-enabled technologies.
Video streaming and communicating information digitally are critical to telehealth and depend on internet access. Broadband being a social determinant of health makes it even more important that rural patients have access to it so they can receive the same caliber of care as patients who are able to physical go into their doctor’s office.