Bill Overview
Title: To amend title XVIII of the Social Security Act to extend telehealth services for federally qualified health centers and rural health clinics.
Description: This bill permanently allows federally qualified health centers and rural health clinics to serve as the distant site (i.e., the location of the health care practitioner) for purposes of Medicare telehealth services.
Sponsors: Rep. Murphy, Gregory [R-NC-3]
Target Audience
Population: Elderly and disabled individuals in rural and underserved areas
Estimated Size: 50000000
- Federally qualified health centers (FQHCs) and rural health clinics (RHCs) are healthcare providers specifically designated to serve medically underserved areas and populations.
- Medicare caters to individuals who are 65 years and older, younger people with disabilities, and people with end-stage renal disease.
- Telehealth services expansion will benefit individuals who have limited access to healthcare services due to geographical and physical constraints.
- Globally, rural population constitutes approximately 44% of the total population.
- The introduction of permanent telehealth services may significantly impact the elderly and disabled populations in rural and underserved areas.
Reasoning
- Given the focus on Medicare beneficiaries who are predominantly older and possibly disabled, the inclusion of population samples should lean towards those over the age of 65 and those with disabilities.
- There should be a variance in geographical locations represented, primarily focusing on rural areas for a genuine representation of the policy's target group.
- While the budget is substantial, it is important to consider that not every urban resident will have access or be impacted, so the primary focus remains on a balance of rural beneficiaries.
- The policy impacts should primarily result in improved healthcare accessibility, especially for populations with low mobility or residing in geographically isolated areas.
- The policy's effect on wellbeing should generally favor positive outcomes in the context of accessibility to healthcare services.
Simulated Interviews
retired (rural Appalachia, Kentucky)
Age: 72 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- This policy could be a game-changer for me. I can't drive long distances, so being able to connect with my doctor remotely means better management of my diabetes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 3 |
part-time farmer (rural Texas)
Age: 68 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- I'm looking forward to the possibility of seeing specialists without having to make long trips.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
software engineer (urban New York)
Age: 45 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 13/20
Statement of Opinion:
- I don't think this policy affects me, but I'm glad it supports those with limited access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
unemployed (rural Idaho)
Age: 33 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- It might not be enough on its own, but being able to see a doctor over the internet could help me catch health issues before they become serious.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 4 | 2 |
| Year 10 | 3 | 2 |
| Year 20 | 2 | 1 |
teacher (rural Minnesota)
Age: 58 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 11/20
Statement of Opinion:
- I'm really optimistic that telehealth means less traveling for routine prescriptions and check-ups.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
retired rancher (rural Montana)
Age: 79 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Easier access to doctors could mean I manage my condition better, but I'll still need help with day-to-day activities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 2 |
retired teacher (suburban Florida)
Age: 85 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- I depend on video calls to speak to my doctor. It's reassuring to know this can continue.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 4 |
bank manager (urban California)
Age: 50 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- While telehealth is great, I'm already seeing the best doctors just around the corner.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
retired nurse (rural Maine)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- Having fought for better healthcare access all my life, this sounds like a step in the right direction.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
retired factory worker (rural Ohio)
Age: 65 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 2.0 years
Commonness: 7/20
Statement of Opinion:
- It would be nice to use telehealth, but we need more infrastructure in my area for this to be feasible.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 4 | 2 |
Cost Estimates
Year 1: $4000000000 (Low: $3500000000, High: $4500000000)
Year 2: $4200000000 (Low: $3675000000, High: $4725000000)
Year 3: $4410000000 (Low: $3858750000, High: $4961250000)
Year 5: $4851000000 (Low: $4244625000, High: $5457375000)
Year 10: $5941420154 (Low: $5206287131, High: $6676553178)
Year 100: $191719920722 (Low: $168254934631, High: $215184906813)
Key Considerations
- While the upfront costs are significant, long-term savings and public health improvements are expected.
- Implementation depends heavily on the existing technology infrastructure in FQHCs and RHCs, requiring initial capital investments.
- The policy could transform rural healthcare accessibility, significantly impacting the quality of care for underserved populations.