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Policy Development

The Office of Rural Health Policy helps shape rural health policy in a variety of ways. The Office advises the Secretary on major issues such as the effects of Medicare and Medicaid on rural citizens' access to health care -- specifically on the viability of rural hospitals and the availability of rural physicians. The Office staff regularly works with other representatives of the Department on development of Medicare and Medicaid regulations. In this capacity, ORHP staff is able to provide the rural perspective as these regulations are being developed. The Office also has established working relationships with other federal agencies in the development of policy and regulatory decisions.

The passage of the Balanced Budget Act of 1997 (BBA) brought some of the most dramatic changes to the Medicare and Medicaid programs since their inception. During the past few years, the Office has worked extensively both within the Department and with outside groups to analyze the impact of this sweeping legislation. The ORHP Rural Health Research Centers have produced several reports that have analyzed the impact of changes to the Medicare system mandated by this legislation. In addition, the Office, in cooperation with the Capital Area Rural Health Roundtable, has held several forums examining the rural impact of particular provisions from the BBA and BBRA. The Office also works within the Administration and the Department, as well as Congressional staff to mitigate some of the adverse effects of enacted legislation.

The National Advisory Committee on Rural Health, which the Office staffs, is another major arena for policy development. The Committee, chartered in 1987, is a sixteen-member citizens' panel of nationally recognized rural health experts that provides recommendations on rural health issues to the Secretary of the Department of Health and Human Services. The Committee meets three times annually, once in Washington and twice in the field. At each meeting, the Committee hears testimony from experts in the field on any number of issues affecting rural health. The Committee then debates the issue and drafts recommendations which are forwarded to the Secretary for review.

Department secretaries, senators, congressmen, governors, state legislators, and many national, state and local health care leaders have worked with the National Advisory Committee in recent years to help shape its recommendations. The Committee has focused on addressing the Medicare payment differentials between rural and urban providers, health care workforce issues such as Medicare payment for graduate medical education, and managed care. For the past two years, the Committee has reviewed and made recommendations on many of the rural provisions in the Balanced Budget Act of 1997. In 1999, the Committee worked on a report on the rural public health infrastructure in conjunction with a Departmental initiative focusing on public health issues. In 2000, the Committee examined the rural impact of any potential Medicare reform proposals.

For more information, Contact: HRSA, Federal Office of Rural Health Policy, Room 9-A-55, 5600 Fishers Lane, Rockville, MD 20857. Phone 301-443-0835. Fax:301-443-2803.


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