Rural Health Information Hub Latest News

418 Rural Hospitals at Risk of Closure; Breakdown by State

From Becker’s CFO Report

There are about 418 rural hospitals at risk of closure, according to a new report from Chartis, a healthcare advisory services firm.

The organization analyzed 16 vulnerability indicators and found nine were statistically significant in predicting hospital closures, including: case mix index, Medicaid expansion, average daily census swing, occupancy, government control status and years of negative operating margin. The hospital’s average length of stay and change in net patient revenue also factored into its risk of closure.

States in the Southeast region of the country had the highest percentage of rural hospitals at risk of closure, followed by the Great Plains. The states with the most hospitals vulnerable to closures include:

  1. Texas: 45
  2. Kansas: 38
  3. Nebraska: 29
  4. Oklahoma: 22
  5. North Carolina: 19
  6. Georgia: 18
  7. Mississippi: 18

The percentage of rural hospitals at risk of closure by state is as follows:

More than 41% of hospitals
Florida
Tennessee
Nebraska

31% to 40%
Utah
South Dakota
Kansas
Oklahoma
Alabama
North Carolina
South Carolina

26% to 30%
Wyoming
Texas
Louisiana
Arkansas
Mississippi
Georgia

21% to 25%
Missouri
Illinois

16% to 20%
Wisconsin
New York
Massachusetts
Hawaii

10% to 15%
California
Idaho
North Dakota
New Mexico
Indiana
Pennsylvania
Virginia

0% to 9%
Oregon
Montana
Arizona
Alaska
Colorado
Minnesota
Iowa
Michigan
Ohio
Kentucky
West Virginia
Maryland
Rhode Island
Delaware
Connecticut
New Hampshire
Maine
Vermont
Nevada
Washington
New Jersey

New Research Results: Colon Cancer Rates Higher in Rural Areas

For health care professionals, it’s maddening. The technology needed to stop colorectal cancer before it turns deadly has never been better.

Yet in 2024, the American Cancer Society expects it to cause 106,590 new cases and 53,010 deaths. In Pennsylvania, about 34% of those diagnosed with colorectal cancer die from the disease. Though rates have decreased overall, they’re increasing among adults younger than 55.

And in a time when information can circle the globe in nanoseconds, barriers like geography still get between doctors and patients.

Health care professionals are finding higher rates of advanced colorectal cancer in rural areas compared with urban centers, said Dr. Karen Kim, dean of Penn State College of Medicine and Dorothy Foehr Huck and J. Lloyd Huck Chair in Rural Health Research. Also, mortality rates related to the disease are higher in less populated areas “largely because people there tend to be diagnosed in the later stages,” she said.

As a clinician, Kim knows the heartbreak and frustration firsthand. With multiple choices for colorectal cancer screening available, she explained, medical science can stop and prevent this fatal disease. But barriers get between her and some of her patients who need it most.

“Unlike some cancers where we think about early detection, with colon cancer it’s really about finding premalignant lesions before they even become cancer,” she said. “It’s so difficult as a gastroenterologist to continue to watch people die from this preventable disease.”

Kim discussed why people in less populated areas are seeing colon cancer more often than people living in cities, and what you can do to help protect your own health.

Read more.

Information Session on CMS Interoperability and Prior Authorization Final Rule Being Offered

Tuesday, March 26 at 1:00 pm Eastern

In January, the Centers for Medicare & Medicaid Services (CMS) released a final rule to enhance access to health information and streamline prior authorization processes for medical items and services.  CMS’s Office of Burden Reduction & Health Informatics is hosting an online session to educate patients, providers, and administrative, health IT, and government affairs professionals about the provisions in final rule and how it builds on current CMS interoperability policies. Questions can be submitted beforehand via the registration form.  If you register and receive a message that the event is full, you will receive an email after the event with a link to both a recording and transcript of the presentation. The use of various electronic exchange methods among hospitals and physicians has increased in recent years, but use among small and rural hospitals is lower than that of other hospitals.  Please reach out to CMSInteroperability@cms.hhs.gov with questions.

Read the full article here.

Expanding Medicaid Skilled Professional Medical Personnel and Nurse Advice Lines

The Centers for Medicare & Medicaid Services (CMS) recently issued guidance allowing State Medicaid Directors to expand the pool of skilled professional medical personnel (SPMP) they may employ to include certain additional behavioral health professionals, such as Marriage and Family Therapists, Mental Health Counselors, and Professional Counselors. This expansion will allow states to claim higher administrative federal match and help bolster state resources to provide appropriate behavioral health care coverage and service delivery. The guidance also informs states that they may claim administrative federal match dollars for nurse advice lines, a tool that builds a lifeline between coverage and critical health services, particularly in rural areas.

Read the full article here.

CMS Releases Updated Medicare Learning Network Information for Rural Health Clinics

The Centers for Medicare & Medicaid Services released an updated MLN booklet entitled, Information for Rural Health Clinics (RHCs) which provides updates on RHC patient services, care management services. Specifically, this MLN provides updated billing information for the following new RHC provider types and services: Marriage and Family Therapists (MFTs), Mental Health Counselors (MHCs), remote physiologic monitoring (RPM), remote therapeutic monitoring (RTM), community health integration (CHI) services, principal illness navigation (PIN), PIN-peer support (PIN-S) and Intensive Outpatient Program (IOP) services.

Read the full article here.

CMS Provides Flexibilities in Response to Cyber Attack

Last week, the Centers for Medicare & Medicaid Services (CMS) announced increased flexibilities for processing claims as well as guidance to help providers serve patients. Hospitals affected by the cyber attack reported difficulties providing patient care, filling prescriptions, submitting insurance claims, and receiving payment for the essential health care services they provided in the weeks since the attack. The CMS guidance is intended to remove or relax prior authorization and other filing requirements for Medicare Advantage and Part D programs, as well as offer waivers or extensions to Medicare providers. Providers should contact their Medicare Administrative Contractors for details.

Read the full article here.

CMS Releases Updated Guidance on Prospective Payment System for Certified Community Behavioral Health Clinic (CCBHC) Demonstration

In 2023, the Centers for Medicare & Medicaid Services (CMS) provided a forum for states, providers, and other stakeholders to comment on proposed changes to payment for services for individuals experiencing a crisis related to substance use and/or mental health.  In response to that feedback, CMS updated Prospective Payment System (PPS) guidance for the Certified Community Behavioral Health Clinic Demonstration addressing the high-cost and specialized care delivered through mobile and on-site crisis intervention.  This guidance was effective on January 1, 2024 for existing CCBHC Demonstration states, and on July 1, 2024 for newly selected states added to the program in 2024 and 2026. Requests for technical assistance may be submitted to CCBHCDemonstration@cms.hhs.gov.

Read the full article here.

Report Released on Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022

This policy brief from the RUPRI Center for Rural Health Policy Analysis describes differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.

Read the policy brief here.