CMS seeks to advance rural, tribal, and geographically isolated community health
Nearly 61 million Americans live in rural, tribal, geographically isolated areas, as well as U.S. territories that face similar but locally unique challenges regarding time and distance to health care facilities, health professional shortages, and other barriers. That’s why CMS is working to advance health equity across the nation’s health system to enable people living and working in rural, tribal, and geographically isolated communities to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes.
To ensure CMS’ approach is responsive to the unique needs of these communities across Medicare, Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP), CMS engaged with individuals, organizations, and government entities across the nation with experience receiving health care or supporting health care service delivery in these communities. These individuals and organizations helped shape the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities (referred to as the Rural, Tribal, and Geographic Framework), which focuses on six priorities over the next five years and updates existing efforts to include people living in rural areas, Tribal nations, and those in geographically isolated communities. Throughout this blog and the framework, “rural” refers to the community-informed geographic lens that encompasses Tribal nations and geographically isolated communities.
Click here to review the framework.
CMS sought input through listening sessions
In 2022, CMS held a series of listening sessions and engagement opportunities around the previous CMS Rural Health Strategy that included experts, people with lived experiences, community organizations, and rural health providers. These stakeholders provided feedback concerning areas that are working well, gaps the framework should address, and actions needed to improve the health and well-being of people living in rural areas, Tribal nations, and geographically isolated communities. The recently released Rural, Tribal, and Geographic Framework reflects the input CMS heard from an audience of more than 1,000 individuals across several public listening sessions.
One of the key advancements of the Rural, Tribal, and Geographic Framework is to be inclusive of rural communities as well as Tribal nations and geographically isolated areas. This supports CMS in focusing its health equity work on the unique needs of people living in rural, tribal, and geographically isolated areas, as well as the U.S. territories and frontier communities.
CMS builds on health equity framework
The Rural, Tribal, and Geographic Framework also builds on the CMS Framework for Health Equity 2022 – 2032 to continue CMS’ cross-cutting efforts to expand access to quality, affordable health coverage, advance health equity, and improve health outcomes for all Americans. The Rural, Tribal, and Geographic Framework consists of six priority areas designed to help guide CMS’ work in rural, tribal, and geographically isolated communities and ensure health care needs and disparities are considered as policies, programs, and initiatives are developed.
- Priority 1: Apply a community-informed geographic lens to CMS programs and policies
- Priority 2: Increase collection and use of standardized data to improve health care for rural, tribal, and geographically isolated communities
CMS also recently released a blog that discusses the current state of health equity data collection and consolidation across CMS programs, including issues and challenges. As the largest payer of health care in the US, CMS can set the bar for meaningful health data across the health care industry. The blog details progress that has been made to date in improving CMS data completeness, quality, and alignment to standard and defines CMS’ future actions to continue the improvement of health equity data and achieve a vision of health equity.
- Priority 3: Strengthen and support health care professionals in rural, tribal, and geographically isolated communities
In addition, effective Jan. 1, critical access hospitals and small rural hospitals will be able to convert their provider type to a rural emergency hospital (REH), which may be a more sustainable option for rural hospitals facing closure and supports access to care in rural and underserved communities. Conversion to an REH allows also for the provision of emergency department services, observation care, and additional specified outpatient medical and health services in rural areas.
- Priority 4: Optimize medical and communication technology for rural, tribal, and geographically isolated communities
- Priority 5: Expand access to comprehensive health care coverage, benefits, and services and supports for individuals in rural, tribal, and geographically isolated communities
- Priority 6: Drive innovation and value-based care in rural, tribal, and geographically isolated communities
Through the priority areas outlined in the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities, CMS continues to demonstrate its commitment to enhancing access to high-quality, equitable care.
Learn more by visiting CMS’ rural health portal and sign up for CMS’ rural health listserv to receive the latest updates.