Funding for Rural Health Care Broadband Program Underused

Resources aimed at expanding broadband connectivity among rural health care providers are underused, according to a blog postpublished in Health Affairs, Government Health IT reports.

Background

The Rural Health Care Program — established under the Telecommunications Act of 1996 — provides subsidies to public and not-for-profit health care providers for:

• Advanced telecommunications and information services for urban and rural providers;


• Internet access to rural providers; and


• Telecommunications services for rural providers.

Details of Blog Post

The Health Affairs blog post was written by:

• Mohit Kaushal, a partner at Aberdare Ventures, an investment group;


• Kavita Patel, a fellow and the managing director of delivery system reform and clinical transformation at the Engelberg Center for Health Care Reform;


• Margaret Darling, chief evaluation and advocacy officer at Nueva Vida;


• Kate Samuels, project manager at the Engelberg Center; and


• Mark McClellan, director of the Engelberg Center and chair of health policy studies at the Brookings Institution.

While the cap on RHCP spending is $400 million annually, the authors noted that spending commitments in 2013 and 2014 were “far less,” at $178 million and $65 million, respectively. In addition, the authors wrote, “Cumulative spending for the telecommunications and Internet access funds over the first 12 years of the RHCP did not exceed the single-year cap.”

Further, they found that the 2010 National Broadband Plan to boost RHCP’s effectiveness has not been implemented (Government Health IT, 4/3).

The authors identified specific factors that could be inhibiting use, including that:

• Eligibility requirements exclude certain entities involved in care delivery;


• The landscape of the need for broadband access in the health care field is changing quickly; and


• Less than one-quarter of the total 11,000 eligible providers participate in the program, many due to the burdensome application process.

Recommendations

Based on the findings, the authors made several recommendations for RHCP, including that FCC should:

• Simplify broadband support for rural providers by clarifying the application process, accepting outcome metrics as defined by other agencies and increasing infrastructure support through the Healthcare Connect Fund to at least 85% of eligible costs; and


• Expand eligibility requirements by adopting a definition of “health care provider” that includes all entities that participate in care delivery and remote patient management.

In addition, they argued that Congress should add not-for-profit providers that serve vulnerable populations to the list of eligible organizations.

Further, the authors suggested that RHCP should be adjusted to meet the needs of a rapidly changing broadband environment by:

• Publishing a Health Care Broadband Status Report every few years; and


• Regularly updating the program’s funding guidance based on the findings of such reports (Kaushal et al., Health Affairs Blog, 4/1).

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