- Rural Telehealth Sees More Policy Wins, but Only Short-Term
- Healing a Dark Past: The Long Road To Reopening Hospitals in the Rural South
- Study: Obstetrics Units in Rural Communities Declining
- Q&A: Angela Gonzales (Hopi), on New Indigenous Health Research Dashboard
- Not All Expectant Moms Can Reach a Doctor's Office. This Kentucky Clinic Travels to Them.
- Hawaiʻi's Physician Shortage Hits Maui Hardest
- Choctaw Nation Found a Better Way to Deliver Harm Reduction. It's Working.
- In Rural America, Heart Disease Is Increasingly Claiming Younger Lives
- HHS Launches Healthy Border 2030 Framework Highlighting Health Priorities and Actions to Support Border Communities and Populations
- Gaps in Mental Health Training, Rural Access to Care Compound Az's Maternal Mortality Crisis
- Enticing Rural Residents to Practice Where They Train
- New Round of Federal Funding Open for Rural Health Initiatives
- UAA Training for Health Care Providers Keeps Victims of Violent Crimes from Falling Through the Cracks
- Helene Exacerbated Rise in Homelessness Across Western North Carolina
- 'It's a Crisis': How the Shortage of Mental Health Counselors Is Affecting the Rural Northwest
Research: Rural Residents Pay Higher Insurance Rates
By Liz Carey
Lack of competition for insurance and healthcare services are two of the likely culprits.
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Strained Rural Water Utilities Buckle Under Pandemic Pressure
By April Simpson
Covid-19 forced many water utilities to maintain service with far less revenue. Two bills making their way through Congress could provide support.
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Rural ‘Red-Zone’ List Shortens Significantly for First Time in Two Months
By Tim Murphy and Tim Marema
The number of rural counties where the spread of Covid-19 is extremely high fell from 806 two weeks ago to 701 last week. The number of new cases and deaths also declined.
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HHS Invests Nearly $115 Million to Combat the Opioid Crisis in Rural Communities
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) awarded approximately $25 million to 80 award recipients across 36 states and two territories as part of the Rural Communities Opioid Response Program (RCORP). RCORP is a multi-year HRSA initiative to reduce morbidity and mortality of substance use disorder (SUD) and opioid use disorder (OUD) in high-risk rural communities. Today’s announcement builds upon HRSA’s RCORP awards made this August, reflecting a total fiscal year 2020 investment of nearly $115 million.
“The Trump Administration continues to provide historic levels of support for Americans with substance use disorders, especially those in rural areas, because the COVID-19 pandemic hasn’t put a pause on our country’s opioid crisis,” said HHS Secretary Alex Azar. “These grants are part of the Rural Action Plan that HHS launched in response to President Trump’s Executive Order on rural health, which lays out a path forward to transform and improve rural healthcare in tangible ways.”
HRSA’s Federal Office of Rural Health Policy (FORHP) awarded nearly $15 million to 30 award recipients through the Rural Communities Opioid Response Program-Neonatal Abstinence Syndrome (RCORP-NAS). Each recipient will receive up to $500,000 over three-years to reduce the incidence and impact of neonatal abstinence syndrome in rural communities by improving systems of care, family supports, and social determinants of health.
In addition, through the Rural Communities Opioid Response Program-Planning (RCORP-Planning), $10 million is being awarded to 50 award recipients to strengthen and expand the capacity of rural communities to provide SUD/OUD prevention, treatment, and recovery services to high-risk populations. Award recipients will use the funds to build partnerships and develop comprehensive plans to address SUD/OUD workforce and service delivery challenges in their communities.
“We are excited to celebrate these awards during National Recovery Month,” said HRSA Administrator Tom Engels. “RCORP-Planning will continue to help rural communities build the coalitions needed to fight opioid use disorder, and RCORP-NAS will provide needed funding to rural residents grappling with the opioid epidemic to help many people reach recovery.”
Through the RCORP initiative, the funding will help rural communities address barriers to care and additional strains that COVID-19 has placed on both rural individuals with SUD and on rural organizations providing prevention, treatment, and recovery services.
For a list of today’s award recipients, visit HRSA’s RCORP-Planning and RCORP-NAS pages.
To learn about HRSA-supported resources, visit HRSA’s Opioid Crisis page.
For more information about the national opioid crisis, visit: https://www.hhs.gov/opioids/.
Coronavirus (COVID-19) Relief for Medicare Direct Bill Beneficiaries
Medicare provided extra time for people to pay their Medicare premiums because of the Coronavirus Disease 2019 (COVID-19) public health emergency. This extra time ends on September 30, 2020. Letters were sent to impacted people with Medicare last month. Please see the attached sample letter. This message is a reminder that the deadline to pay any owed Medicare premiums is approaching at the end of this month.
People with Medicare who owe past due Medicare premiums must pay the full amount owed before September 30, 2020, to keep their Medicare coverage. If there are people with Medicare who are unable to pay their past-due premiums in full by the end of September, they should contact their local Social Security Office as soon as possible to see if they are eligible for a payment plan with the Social Security Administration.
In Pennsylvania, KinConnector Website Connects Kinship Families to Resources
The Pennsylvania Department of Human Services has launched www.kinconnector.org, a resource designed to help kinship care families connect to services and supports that can help children and their caregivers.
Grandparents raising grandchildren are among the most common type of kinship caregiver, but kinship care families also can include an aunt or uncle, adult sibling, or a non-relative caregiver such as a close family friend raising a child when their parents cannot care for them. Kinship care arrangements help maintain family bonds and reduce trauma experienced when children cannot be cared for by their own parents.
Kinship caregivers make a selfless choice to care for young loved ones so they receive care and support from a family member they know and trust. As children navigate their own emotions around their family situation, this connection and familiarity can be a grounding force necessary to help children process and heal. While this can be an easy choice for kinship caregivers, navigating this new family situation can have its challenges for both the caregiver and children. KinConnector is here to be a resource and support to ease this process for the entire kinship family.
KinConnector was established through Act 89 of 2018 and is part of a kinship navigator program for Pennsylvania. After a competitive procurement process, The Bair Foundation was selected to administer the kinship navigator program coordinator and will work with kinship care families around Pennsylvania to help them access resources and supports and connect with families in similar situations around the commonwealth.
Kinship caregivers can visit the KinConnector website to find resources in their communities, learn about trainings and services available for kinship families, and find support groups and networks of other kinship care families and family care professionals.
KinConnector also runs a helpline that can be reached by calling 1-866-KIN-2111 (1-866-546-2111) The KinConnector helpline is staffed by knowledgeable, compassionate social service professionals prepared to help kinship care families understand and access resources that may be able to help them. The helpline is available from 9 a.m. to 10 p.m. Monday through Thursday and 9 a.m. to 5 p.m. Friday. The KinConnector helpline can support callers needing assisting in English and Spanish.
More information and resources are available on kinconnector.org. To speak with a trained KinConnector professional, call 1-866-KIN-2111.
Pennsylvania Governor’s Administration Warns of Heightened Fall Wildfire Dangers
With hunting and other outdoors activities increasing at a time when woodlands and brush can become tinder dry in just a few days, the Wolf Administration is urging all residents to guard against increased wildfire dangers in Pennsylvania’s 17 million acres of forestlands.
State officials noted a sustained dry period over much of the state comes at a time when wildfire dangers normally are high, and critical conditions can develop almost overnight in many forested areas of Pennsylvania.
“With rainfall varying greatly across the commonwealth, a dry windy span of just a few days quickly can make wildfires a very real threat,” said Department of Conservation and Natural Resources (DCNR) Secretary Cindy Adams Dunn. “Amid the pandemic we know so many are seeking outdoors pursuits. Hunting soon will be popular and fall foliage is a joy to behold, but when the leaves begin dropping and drying, they become added fuel for woodland fires.”
“Amid these conditions, it takes only a careless moment to ignite a devastating wildfires. We know debris burning is leading cause of wildfires throughout the state and more than 95 percent of Pennsylvania wildfires are caused by people,” Dunn said.
“While most Pennsylvanians are used to wildfires being confined to relatively far off places, these catastrophic events pose an escalating risk to communities throughout the commonwealth,” said State Fire Commissioner Bruce Trego. “Increasingly, our state is being affected by weather patterns that turn fields and forests into accidents waiting to happen.”
The wildfire warning comes amid sparse rainfall and drying conditions, and as drought advisories are widening in Pennsylvania.
DCNR is responsible for administering a grant program paid through federal grants from the U.S. Department of Agriculture Forest Service. This program has awarded more than $14.5 million since it began in 1982. In 2019, more than $617,800 was awarded to 133 volunteer fire companies. Both Dunn and Trego encourage eligible departments to learn more about this important program for future grant opportunities.
With several deer and small-game hunting seasons opening in the coming weeks, both Dunn and Trego urged hunters and other woodlands visitors to be especially careful with smoking and fires amid dry vegetation.
Dunn noted the need to guard against wildfires increases each year as more development encroaches on heavily wooded tracts. Homeowners always should be diligent when burning trash and debris, she said.
Property owners should always consider the weather and conditions when burning outdoors. If it’s windy or dry, burning should be postponed until conditions change. A hose, rake, and shovel should be handy when burning outdoors, and any burnable materials cleared within 10 feet of a fire.
The Bureau of Forestry is working through state agencies and local fire companies to educate Pennsylvania citizens on procedures to make their homes in forest environments safer from wildfires. Information can be obtained from the Bureau of Forestry, county Emergency Management Office, or the Office of the State Fire Commissioner.
Details on wildfire prevention can be obtained at local forest districts and the Bureau of Forestry also maintains information on county burn bans in effect.
Child Oral Health Resource Center Releases New Resources
The National Maternal and Child Oral Health Resource Center (OHRC) released three new resources focusing on the Title V national performance measure on oral health. The first resource, “Title V National Performance Measure 13 (Oral Health): Strategies for Success (2nd ed.),” provides information to help state maternal and child health programs in their implementation of the Title V NPM 13 and oral-health-related state performance measures. The other two resources are infographics that provide information for oral health professionals about benefits of and barriers to preventive dental visits for pregnant women and children.
Cancer Prevention Through HPV Vaccination
Check out PCOH’s informative flyer, “Cancer Prevention Through HPV Vaccination: A Dental Provider’s Role.”
This document is intended for all dental staff and includes information about the importance of the HPV vaccine, facts about oropharyngeal cancer, and tips for dental providers to educate families through teledentistry and in-person visits.
CMS Issues New Roadmap for States to Accelerate Adoption of Value-Based Care to Improve Quality of Care for Medicaid Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) issued guidance to state Medicaid directors designed to advance the adoption of value-based care strategies across their healthcare systems and align provider incentives across payers. Under value-based care, providers are reimbursed based on their ability to improve quality of care in a cost-effective manner or lower costs while maintaining standards of care, rather than the volume of care they provide. Value-based care arrangements may also permit providers to address social determinants of health, as well as disparities across the healthcare system. Moving toward a more value-driven healthcare system allows states to provide Medicaid beneficiaries with efficient, high quality care, while improving health outcomes. Value-based care may also help ensure that the nation’s healthcare system is better prepared and equipped to handle unexpected challenges, including the ongoing COVID-19 pandemic.
This guidance includes an assessment of key lessons learned from early state and federal experiences in implementing value-based care reforms, as well as a comprehensive toolkit of available federal authorities for states to adopt innovative payment reform efforts within their individual programs. It stresses the importance of multi-payer alignment in value-based care to drive care transformation, and supports state efforts to align new payment models in Medicaid with Medicare and other private payers.
CMS has made a strong commitment to advancing value-based care in Medicare for its 61.7 million enrollees. This guidance is designed, with the understanding that many of the providers overlap, to ensure that this same commitment can be made at the state level through Medicaid with its nearly 74 million beneficiaries by aligning strategies and common understanding of effective approaches. While these programs serve different populations, they share common goals of lower costs and improved health outcomes, and reduce burden if payers are aligned with value-based care.
“The Trump Administration has long worked to accelerate the overdue move to value-based care, but for too long these efforts have been piecemeal,” said CMS Administrator Seema Verma. “Our health care providers need Medicare, Medicaid and private insurance payers to work in tandem with one another, and I am calling on our state partners to use this guidance to develop a plan to improve quality for their Medicaid beneficiaries by advancing value-based care in their own programs.”
With Medicaid costs rising and continuing to consume a greater share of state budgets, and with federal costs forecasted to continue to grow according to the CMS Office of the Actuary[1], CMS has a duty to ensure the program remains sustainable. Moving toward more value-driven reimbursement models is a critical part of this effort, as fee-for-service payment incentivizes higher volume and greater spending, rather than accountability for costs and outcomes. This guidance is designed to support states as they develop plans to increase Medicaid provider participation in and adoption of value-based care models.
In taking this new direction, CMS is building on its experiences and lessons learned from states and other payers. Since 2010, CMS has engaged in cooperative partnerships with states and providers to test payment and service delivery models that aim to achieve better care for patients, smarter spending, and healthier communities. The CMS Innovation Center is testing a growing portfolio of various payment and service delivery models. All of these models have enabled CMS to better understand the opportunities and challenges that states should consider as they move toward a more value-driven system. Building on the lessons learned from these models, this guidance discusses those considerations, including multi-payer participation, delivery system readiness, stakeholder engagement, and the scope of financial risk to providers. In addition, this letter describes pathways, including flexibility available under the state plan, towards the adoption of value-based care models in Medicaid. States are invited to choose the pathway that best meets their reform goals, and do not need to rely only on time-consuming, complex demonstrations or waivers to achieve better value in their programs, where their proposals can be implemented under a state plan or managed authority. The guidance discusses how states can build payment models that promote value-based care under both fee-for-service and managed care.
The guidance encourages states to consider the adoption of models in the context of their individual circumstances and the lessons learned from implementing previous payment and service delivery models. Examples of payment models include advanced payment methodologies under fee-for-service, bundled payments, and total cost of care models. Each of these models, and others described in today’s letter to state Medicaid Directors, reflect the Administration’s priorities for a value-driven health care system, such as by:
- Improving quality of care for beneficiaries;
- Rewarding providers for reducing the effects and incidence of chronic disease and for helping patients improve their health;
- Improving value in the larger healthcare system by aligning provider incentives across multiple payers; and
- Helping the United States and its healthcare system handle unexpected challenges and disruption, including those experienced from the ongoing COVID-19 pandemic.
Many states have made progress in moving toward value-based payments in healthcare, yet there are still growth opportunities for more states to improve health outcomes and efficiency across payers including Medicare, Medicaid, and private insurance, by ensuring healthcare systems are financially incentivized to deliver the best quality, best value care. Aligning value-based care programs across payers could reduce the burden on providers who participate with multiple payers and improve the healthcare experience for patients.
To view the Value-Based Care Opportunities in Medicaid SMDL, please visit: https://protect2.fireeye.com/url?k=9c9690c2-c0c399d1-9c96a1fd-0cc47adb5650-e4057606ced02c16&u=https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/smd20004.pdf