- Improving patient health literacy and reducing out-of-pocket healthcare costs can support improved rural population health, according to a recent report from the National Quality Forum (NQF).
More than 59 million people currently live in rural areas, NQF noted, and residents in these communities are more likely to experience poor health, chronic disease, and insufficient access to care.
To help overcome these issues, and to improve rural health outcomes, NQF developed the Measure Applications Partnership (MAP) Rural Health Workgroup, which recommends potential quality reporting measures to CMS.
Between November 2017 and July 2018, the MAP Rural Health Workgroup identified core measures for both inpatient and outpatient settings, focusing on developing recommendations to increase rural access to healthcare.
The workgroup suggested that healthcare leaders enhance rural patients’ understanding of their health information to improve access.
“Members recommended a two-fold approach to increase health literacy of rural residents: education for both patients and clinicians on the importance of patient engagement in healthcare, along with improvements in clinician-patient communication overall,” the report stated.
In addition, because many rural residents lack adequate health insurance, out-of-pocket healthcare costs pose a substantial barrier for patients.
“Members recommended that providers and payers monitor the balances that patients owe after insurance. They also suggested working to increase literacy about insurance (e.g., to help patients understand the implications of selecting a high-deductible insurance plan),” the report said.
Stakeholders also said that to improve the timeliness of care in rural communities, health plans should devote more attention to network adequacy in these areas and ensure enough clinicians are available in-network.
Health plans can also work to accelerate administrative processes to allow rural providers to see patients in a timely manner.
NQF identified transportation as a critical barrier impacting rural care access, and suggested telehealth as a viable solution to this issue. Additionally, healthcare organizations can partner with existing transportation services to overcome transportation challenges.
In addition to improving rural care access, the workgroup created cross-cutting measures that can apply to all rural providers and patients.
The panel also developed measures that would adequately address transitions in care, a common practice for rural clinicians who may not provide specialized care for high-acuity patients.
Moreover, the workgroup supported the inclusion of measures that address specific conditions that are relevant for rural populations, including measures related to mental health, substance abuse, and chronic diseases like diabetes and hypertension.
“I am pleased with the work of the MAP Rural Health Workgroup to design the first set of rural-relevant quality measures,” said US Senator Pat Roberts (R-KS).
“These measures are an important step in bringing quality programs to rural providers in a way that is appropriate, while accounting for the unique challenges they face. It is my hope that the work of the Rural MAP will help us find meaningful ways to integrate rural providers into quality improvement efforts in the future.”
NQF expects that this report will serve as a resource to enhance CMS’ focus on rural health, including its recently announced Rural Health Strategy, which aims to ensure that every one in five rural residents has access to quality healthcare.
With these recommendations, stakeholders can improve rural care access and quality.
“To keep our rural communities vibrant, we also need to thoroughly address the challenges they face, and that includes making sure those living in rural areas have access to affordable, quality health care,” said US Senator Heidi Heitkamp, co-chair of the US Senate Rural Health Caucus.
“Yet far too often, rural America gets left behind as recommendations are made for how to improve health care nationwide. This important report from NQF will help make sure the federal government really considers the health care needs of rural communities as it does its job.”