Can CMS' New CHART Model Add Telehealth to the Rural Health Agenda?

Federal officials are promoting telehealth expansion in rural communities through a new funding model that gives healthcare providers the financial resources to adopt connected health platforms.

The CHART (Community Health Access and Rural Transformation) Model, unveiled this week by the Centers for Medicare & Medicaid Services in response to President Donald Trump’s Executive Order, “will empower rural communities to develop a system of care to deliver high quality care to their patients by providing support through new seed funding and payment structures, operational and regulatory flexibilities and technical and learning support,” CMS announced.

The program create two separate tracks: the Community Transformation Track and the Accountable Care Organizations (ACO) Transformation Track.

According to a fact sheet supplied by CMS, a key facet of both tracks is the continuation of expanded telehealth coverage put in place over the past few months to address the coronavirus pandemic. Trump’s Executive Order called on CMS to extend many of those emergency rules beyond the national emergency, and CMS has included some enhancements in its proposed 2021 Physician Fee Schedule, which came out at the same time as the Executive Order.

The model also offers opportunities to use telehealth for home health visits, remote patient monitoring programs and in skilled nursing facilities.

Telehealth advocates have long lobbied for expanded connected health resources in rural areas, where access issues are often caused by physical barriers (geography, travel time and weather), broadband capacity and a shortage of care providers.

One of the critical pieces of telehealth adoption is financial support. Particularly during the current COVID-19 crisis but long before the pandemic hit, rural providers have been struggling to stay afloat, and have found little time or inclination to try out telemedicine and mHealth tools. Giving them the financial footing up front and the encouragement to look at new delivery models may prompt more rural providers to embrace teleehalth.

“Through the CHART Model, CMS aims to continue addressing these disparities by providing a way for rural communities to transform their health care delivery systems by leveraging innovative financial arrangements as well as operational and regulatory flexibilities,” CMS officials said in the fact sheet.

CMS officials plan to release a Notice of Funding Opportunity (NOFO) for Community Transformation Track, which will involve as many as 15 lead organizations, in September. A Request for Application (RFA) for up to 20 rurally focused ACOs expected to take part in the ACO Transformation Track will be posted in early 2021.