Researchers used data from electronic license renewals in 2021 to examine what factors affect the likelihood of providing medication-assisted treatment (MAT) for opioid use disorder.  Physicians and nurse practitioners who were younger, practiced in a public or community health center, and offered a sliding fee scale in their practice had a greater likelihood of providing MAT.  The study builds on previous research showing a lack of mental health services, professional burnout, and stigma associated with lower rates of MAT provision in rural areas, with a further look at organizational and personal barriers to prescribing.

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On the April 2, 2024 episode of Managed Care Cast, we talked with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care® and a health policy professor at Penn State University. Topics discussed include President Biden’s recent prescription drug proposals, prior authorization practices, price transparency, and the potential impact of health policy on the upcoming election.

Listen to the Podcast here.

In Matthew Roach’s two years as vital statistics manager for the Arizona Department of Health Services, and 10 years previously in its epidemiology program, he has witnessed a trend in mortality rates that has rural health experts worried.

As Roach tracked the health of Arizona residents, the gap between mortality rates of people living in rural areas and those of their urban peers was widening.

The health disparities between rural and urban Americans have long been documented, but a recent report from the Department of Agriculture’s Economic Research Service found the chasm has grown in recent decades. In their examination, USDA researchers found rural Americans from the ages of 25 to 54 die from natural causes, like chronic diseases and cancer, at wildly higher rates than the same age group living in urban areas. The analysis did not include external causes of death, such as suicide or accidental overdose.

The research analyzed Centers for Disease Control and Prevention death data from two three-year periods — 1999 through 2001 and 2017 through 2019. In 1999, the natural-cause mortality rate for people ages 25 to 54 in rural areas was only 6% higher than for city dwellers in the same age bracket. By 2019, the gap widened to 43%.

The researchers found the expanding gap was driven by rapid growth in the number of women living in rural places who succumb young to treatable or preventable diseases. In the most rural places, counties without an urban core population of 10,000 or more, women in this age group saw an 18% increase in natural-cause mortality rates during the study period, while their male peers experienced a 3% increase.

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U.S. Senator Maggie Hassan (D-NH) announced the introduction of her bipartisan Rural Obstetrics Readiness Act with Senators Susan Collins (R-ME), Katie Britt (R-AL), and Tina Smith (D-MN). The bill provides support for rural health care facilities to provide urgent obstetric care by helping to create training programs focused on obstetric emergencies, establish new federal grants to help these facilities buy specialized equipment for both training and patient care, and create a pilot program for rural facilities to get teleconsultations from maternal health experts to improve care.  Please find the press release here. Please find NRHA’s Rural Maternal Health legislative priorities here.

Congresswoman Yadira Caraveo, M.D. (D-CO) announced a bill to expand healthcare accessibility in rural communities. The Rural Residency Planning and Development Act of 2024 (H.R. 7855), introduced by Rep. Caraveo (D-CO), and Rep. Carol Miller (R-WV), would authorize the Rural Residency Planning and Development program to continue building a strong pipeline of rural physicians for years to come. Nearly 20% of Americans live in rural areas, but only 10% of physicians practice in these communities. Among current medical residency programs, only two percent of training occurs in rural areas. To tackle this shortage, the Rural Residency Planning and Development program, housed under the Health Services and Resources Administration (HRSA), awards funding to support start-up costs to establish new rural residency programs. As of November 2023, award recipients have created 39 new accredited rural residency programs or rural track programs and enrolled 306 resident physicians training in rural clinical settings. Please find NRHA’s rural workforce legislative agenda here.

The House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) and Subcommittee on Health Chair Brett Guthrie (R-KY) announced a subcommittee hearing to discuss telehealth permanency that will occur on April 10, 2024 at 10:00 AM ET. The hearing will focus on the discussion of legislative proposals that will support patients’ access to telehealth services. Establishing permanency of telehealth in rural communities via telehealth provides opportunity for essential access to health services and can greatly impact health outcomes for rural constituents. Key legislative proposals that are going to be considered that have rural relevance include:

• H.R. 4189: CONNECT for Health Act of 2023 (Reps. Mike Thompson, David Schweikert, Doris Matsui)
• H.R. 7623: The Telehealth Modernization Act of 2024 (Reps. Earl “Buddy” Carter, Lisa Blunt Rochester, Gregory Steube, Terri Sewell, Miller-Meeks, Debbie Dingell, Jefferson Van Drew, and Joseph Morelle)

Please find the press release here. Livestream of the hearing can be accessed here. Please find NRHA’s Rural Telehealth legislative priorities here.