by
Brendon Nafziger, DOTmed News Associate Editor | February 05, 2011
From the January/February 2011 issue of HealthCare Business News magazine
Sometimes it worked -– a 2007 report found it helped increase telehealth services for some native Alaskans leading to a drop in wait times to see ear specialists from six to nine months to only two weeks. And about 86 percent of committed funds were spent, with some rural providers saying they’re now dependent on the support they receive from the fund, the GAO said.
But the GAO said overall the program was too complicated and poorly managed to really fulfill its mission. The agency never properly assessed the telecommunications needs of rural health providers, the GAO said, and they never really found out if the program was truly being underused, as they claimed. Still, the commission only disbursed $327 million over the 12 years of the program, far less than the $400 million funding cap it could spend in a single year.
One of the primary complaints was that the application process for the FCC help was too unwieldy for understaffed rural hospitals. “It was too complicated and too convoluted,” McBeath, with TORCH, says. “It equated right up there to a federal grant application.”
“The average person in Washington, D.C. who designed this stuff has sat at his desk his whole life,” he adds. “And they don’t know what it’s like for a person in a small rural community.”
Most rural hospitals can’t afford to hire a full-time grant writer, the NRHA said. And the staff they do have rarely is trained or has the time to handle the complex forms. As the American Hospital Association dryly noted in its letter commenting on the plan’s aftermath, “The structuring and management of communications services are not primary
disciplines for health care facilities.”
FCC tries again
But the FCC recognizes the problems. A spokesman told DOTmed News the rural health care program was “not as useful as it could have been.” The agency hopes its new proposals, announced last year, go some way to rectifying the earlier troubles. The agency said it wants to lift payment for monthly broadband costs from 25 percent of the costs to 50 percent for all rural providers (and not just those in Guam). It’s working with other agencies to improve and streamline communications. And it also wants to make the pilot program, sunsetting in June, permanent.
Of course, even if broadband troubles clear up for hospitals, telemedicine still has other obstacles – namely, reimbursement, which for telehealth services can still be a hassle. But some observers think with the rise of accountable care organizations and a shift toward bundled payments, these difficulties will go out the window, too.
“We feel lucky that this is not a partisan issue,” Linkous says. “This is one of the things both the conservatives and liberals agree on.”
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