Rural hospitals and clinics are on the verge of receiving hundreds of millions of dollars in new government benefits. But the source of that subsidy will be a new one for healthcare providers.
Marking its first big foray into healthcare policymaking, the Federal Communications Commission next month will vote on a plan to subsidize rural telemedicine services through revenues derived from the telecommunications industry.
The funding is authorized by landmark telecommunications legislation passed in 1996. It comes from the federal government's "universal service fund," which is bankrolled by telephone companies and their customers.
The aim is to eliminate cost and technology as a barrier to greater use of telemedicine by rural not-for-profit and public providers for such services as consultations with specialists, office visits, continuing medical education and emergency-room support.
By encouraging telemedicine, the legislation could increase access to physicians, specialists and advanced technology otherwise unavailable in sparsely populated rural regions.
Up to $400 million annually could be available to help subsidize improvements to rural providers' telecommunications networks and charges for telecommunications services.
Along with the network upgrades, an FCC-appointed advisory committee last year recommended that the universal services fund be paid to telephone companies to help equalize payment rates between urban and rural providers for:
Transmission services up to "T1" speed-the transmission speed provided by some fiber-optic systems-or offer greater discounts for slower services until universal service revenues can be used to upgrade the telecommunications network to T1 speed.
Charges that increase with the distance of the transmission.
But FCC Chairman Reed Hundt last week warned healthcare providers that some of those benefits could be in jeopardy, particularly the subsidy for distance charges, when the commission votes on the universal services plan May 6.
"Healthcare providers historically have been a nonexistent lobby at the FCC," while the telephone companies "play man-to-man defense," Hundt said, after speaking to healthcare provider representatives at the Partnerships for Networked Consumer Health Information Conference in Washington.
"My main message is, you need to be present if you want to be heard," Hundt said.
Lisa Potetz, senior associate director for policy development at the American Hospital Association, said the AHA has urged the FCC to support the telemedicine advisory committee's recommendations on how to make telecommunications rates distance neutral.
Potetz added: "I think it's fair to say that lobbying the FCC is not something most healthcare organizations have been involved with."
The advisory commission said the law does not provide for use of universal service revenues for purchase of providers' telemedicine equipment, although it did say "additional mechanisms should be considered" to make sure the cost of such equipment does not interfere with expansion of telemedicine services.