- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Rural RPM Program Is a Lifeline for Pregnant Women
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
- Limited Continuing-Care Options in Rural Virginia Create Challenges for an Aging Population
How A Fire Department Funding Model Could Preserve Rural Emergency Departments And Quality Emergency Care
Health Affairs, Commentary, June 14, 2021
Nearly 60 million rural Americans depend on local hospitals and their emergency departments (EDs) when serious (for example, trauma, stroke, heart attack) and potential (for example, chest or abdominal pain) emergencies occur. Yet, since 2010, 136 small and rural hospitals have closed. The COVID-19 pandemic accelerated this trend, with a record 20 new hospital closures in 2020 and many more at risk. Mortality worsens when hospitals close because of reduced access to the life-saving skills of emergency physicians and the hospitals where they work.
Recent policy initiatives have attempted to address rural hospital closures. Some Pennsylvania rural hospitals and all Maryland hospitals are funded through global budgets. Starting in January 2023, a new rural emergency hospital (REH) designation will allow rural critical access hospitals to convert to an REH and receive fixed payments to support infrastructure and a 5 percent increase in fee-for-service payments in return for maintaining an ED and specified outpatient services. A weakness of these models is that they focus on supporting the hospital facility alone. None ensure sufficient resources to pay for the 24/7/365 on-site emergency physician, plus some level of surge capacity, needed to provide ED patient care.
To understand why rural and small hospitals struggle to maintain high-quality emergency physicians in their EDs, it is important to describe the economics of ED staffing and how the COVID-19 pandemic changed those economics for the worse. Pre-pandemic, a delicate balance of volume, complexity, and payer-mix supported ED staffing with fee-for-service payments. Some visits reimbursed well and required few resources (for example, privately insured, low acuity). For other visits (for example, Medicare, Medicaid, high acuity, and uninsured), reimbursement did not cover costs. Medicaid expansion under the Affordable Care Act reduced uninsured visits but has been no panacea. Medicaid expansion replaces unreimbursed visits by uninsured patients but only with well-below-cost Medicaid rates. Expansion also generates payer crowd-out: Some visits, previously well-reimbursed by commercial insurance, become low-paying Medicaid visits.
NRHA Rural Health Advocacy Campaign: Urge Congress to Invest in Rural Health
Congress has begun negotiating fiscal year (FY) 2022 appropriations bills, and the National Rural Health Association is advocating for investments in rural health. Now, more than ever before, it is crucial that Congress support programs that seek to address the severe health care crises in rural America. Rural health care providers, who were struggling to keep their doors open prior to COVID-19, have been hit hard by the pandemic. While current spending for rural health programs is relatively small, it plays a critical role in solidifying the fragile health care infrastructure in rural communities. We encourage you to participate in our advocacy campaign to urge your Members of Congress to invest in rural health via FY 2022 appropriations.
House Passes Traditional Infrastructure Package
The House passed a $760 billion surface transportation infrastructure package. The measure is not expected to be brought up in the Senate, but it adds pressure to the continuing bipartisan talks. Last week, the group of 22 bipartisan Senators brokered a deal on a $1.2 trillion infrastructure package. Text has yet to be released on the compromise, but NRHA continues to advocate for rural providers to be represented in the package.
House Appropriations Committee Passes Ag Appropriations Bill
The House Appropriations Committee held a full committee markup on the chamber’s fiscal year (FY) 2022 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies appropriations bill. The Committee has scheduled the subcommittee and full committee markups of their Labor, Health and Human Services, Education, and Related Agencies appropriations bill for July 12 and July 15, respectively.
HHS Opens Provider Relief Fund Reporting Portal
The U.S. Department of Health and Human Services’ (HHS) long-awaited Provider Relief Fund (PRF) Reporting Portal is now open for providers who need to report on the use of funds in Reporting Period 1. Providers who are required to report during Reporting Period 1 have until September 30, 2021, to enter the Portal and submit their information. The Health Resources and Services Administration (HRSA) has provided an extensive reporting guide, example excel data entry sheets, and a new edition of the FAQs.
Customizable COVID-19 Vaccine Communication Toolkit for Rural Communities
This toolkit from the HRSA-supported National Rural Health Resource Center helps rural community- and faith-based organizations, businesses, public health, schools, and health care organizations with internal and external COVID-19 vaccine communication materials. It provides easy access to customizable communication templates that include print ads, posters, brochures, social media posts and an online resource guide.
Pediatric Healthcare Professionals COVID-19 Vaccination Toolkit
CDC updated their COVID-19 toolkit for pediatric healthcare professionals. CDC specifically updated their two fact sheets: COVID-19 Vaccines for Preteens and Teens and How mRNA Vaccines Work.
A New Guide on Universal Screening for Health-Related Social Needs
The Accountable Health Communities Health-Related Social Needs Screening Tool is being used to quickly identify health-related social needs, such as food insecurity, housing instability, and lack of access to transportation, among community-dwelling Medicare and Medicaid beneficiaries. A new user guide can help health care or social service providers connect beneficiaries with community resources.
Health Advisory – Circulation of Non-Influenza and Non-COVID-19 Respiratory Viruses
A PA Health Advisory has been issued on the circulation of non-influenza and non-COVID-19 respiratory viruses, including respiratory syncytial viruses (RSV). In summary:
- Non-influenza, non-COVID-19 respiratory viruses, including respiratory syncytial virus (RSV), are circulating in the community at a higher rate than usual for this time of the year.
- Healthcare providers should consider testing symptomatic patients with a respiratory virus panel, especially if influenza and COVID-19 tests are negative.
- Report positive RSV tests to PA DOH through PA-NEDSS. Positive tests can be reported individually or in aggregate through the aggregate reporting module in PA-NEDSS. Hospitalizations and deaths should be reported individually in PA-NEDSS.
- Report RSV outbreaks to DOH at 1-877-PA-HEALTH (1-877-724-3258) or your local health department
Researchers Calculate More than 46,000 Kids Lost a Parent to COVID-19
COVID-19 has claimed more than 600,000 lives in the U.S., and researchers writing in the journal JAMA Pediatrics calculated that for every 13 deaths caused by the virus, one child under 18 has lost a parent. According to the researchers, that means that as of June 15:
- More than 46,000 kids in the U.S. have lost a parent to COVID-19.
- Three-quarters of the children are adolescents; the others are under age 10.
- About 20 percent of the children who’ve lost parents are Black, though they make up 14 percent of the population.
These deaths have led to a shadow pandemic of bereavement that could have long-lasting effects. The loss of a parent in childhood has been linked to higher risk of substance use, mental health issues, poor performance in school, lower college attendance, lower employment and early death. Read more.