Governor Nathan Deal’s new rural health committee has revealed an ambitious program aimed at saving rural healthcare in Georgia. The Rural Health Stabilization Committee, created in March 2014, released a report Monday introducing a pilot program centered on hard-hit rural emergency departments. 

The program would use “hubs and spokes” — i.e. hospital hubs and off-site monitoring/diagnostics — in an effort to “ensure that each patient is being transported to the appropriate setting,” and “monitor chronically ill patients to help them avoid repeat trips to the hospital.” 

According to the report, the “spokes” would include telemedicine-equipped ambulances, school clinics (also relying heavily on telemedicine), smaller hospitals, and local physicians. The Committee’s stated goal in employing these off-site resources is “to prevent the over-utilization of the ED as a primary care access point.”

The Committee requested $3 million for implementation of the program, which would be piloted at four hospitals serving different rural areas.

CON Support

The Committee’s report also contained a formal recommendation in support of Georgia’s Certificate of Need (“CON”) program. This program has often been the subject of legislative debate, but the Committee firmly endorsed the CON process for its role in maintaining and protecting rural hospitals. 

Freestanding EDs No More?

While Monday’s report served primarily to advance the Rural Health Stabilization Committee’s first major project, it also marked a setback for an earlier initiative brought before the Committee. Last year the Committee considered a proposal by the Department of Community Health to facilitate the establishment of freestanding emergency departments in rural areas. While the rules governing such freestanding EDs remain in effect, the Committee’s report all but recalled the program, stating that reimbursement issues made it financially unworkable. 

Medicaid Expansion a Non-Starter

One way of immediately benefiting rural healthcare in Georgia was conspicuously absent from the committee’s report: the Affordable Care Act’s Medicaid expansion. Georgia Health News reports that Gov. Deal has never considered the Medicaid expansion a realistic outcome of the Committee.