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.