Rural health IT feels FCC change

Changes made by Federal Communications Commission officials in how they define rural could affect the provision of information technology services used by rural health providers to treat their patients starting July 1.

FCC officials said the new definition will improve the effectiveness of the rural health care universal service support mechanism. The mechanism is used to determine discounts that health providers get to ensure the providers have access to modern IT services for medical and health maintenance purposes.

Those areas outside Core Based Statistical Areas are always considered rural, but whether areas inside a CBSA are rural or not depends on the makeup of the CBSA.

The new definition considers small CBSAs that only have urban areas with populations of 25,000 as rural, for example. A large CBSA does have urban areas of 25,000 or more, but if a census tract in that CBSA contains urban areas of 25,000 or less then that tract is considered rural.

Under the current rule only counties of a certain size would undergo analysis to determine which of their areas were urban and rural. The new rule expands the review to include counties of all sizes. FCC officials believe that will make the determination of a rural area more accurate.

Although the ruling presumably will enable health providers to get IT discounts that were previously unavailable, it could also cut some providers out of the scheme. But FCC officials said those providers who have received funding commitments from the Universal Service Administrative Company will continue to qualify for funding for the next three years under the old definition.

FCC officials also changed the way mobile rural health care providers receive discounts for their satellite telecom services.

Under the commission's previous ruling, rural health care providers received a discount for satellite service even where wireline service was available. The discounts were capped at the amount the health care provider would have received if they purchased functionally similar wireline alternatives.

However, in many cases, no wireline services are available in the locations the mobile health providers operate. Therefore, there's no way to decide what the discounts should be, which means they pay more than they should for satellite service. Now, the discount will be determined by comparing the rate for a satellite service to the rate for an urban wireline service of similar bandwidth.

Robinson is a freelance journalist based in Portland, Ore. He can be reached at hullite@mindspring.com.

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