- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- NRHA Continues Partnership to Advance Rural Oral Health
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
- Q&A: What Are the Challenges and Opportunities of Small-Town Philanthropy?
- HRSA Administrator Carole Johnson, Joined by Co-Chair of the Congressional Black Maternal Health Caucus Congresswoman Lauren Underwood, Announces New Funding, Policy Action, and Report to Mark Landmark Year of HRSA's Enhancing Maternal Health Initiative
- Biden-Harris Administration Announces $60 Million Investment for Adding Early Morning, Night, and Weekend Hours at Community Health Centers
CMS Celebrates 59 Years of Service
This week, the Centers for Medicare & Medicaid Services (CMS) celebrated the 59th Anniversary of Medicare and Medicaid programs. Signed into law in 1965, Pres. Lyndon B. Johnson formally established the Medicare program, which provides health insurance coverage for those over 65, people with disabilities and those with end stage renal disease. Medicaid is a federal and state program that provides health coverage for low-income children, pregnant women, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States covering 82+ million Americans including over 2.9 million Pennsylvanians. Over the years additional services and benefits have been added to both programs including Medicaid Part D Prescription Drug Coverage and the Children’s Health Insurance Program.
Reminder: Emergency Resources
The Health Resources and Services Administration (HRSA) Emergency Preparedness, Response, and Recovery Resources for Health Centers webpage provides a comprehensive set of resources and links to their Emergency Information Kit. Resources include some on CMS’ emergency preparedness rule and a full list of Federal Tort Claims Act (FTCA) resources. In addition, the Department of Health and Human Services (HHS) recently introduced a new Heat and Health Index, which helps identify communities where people are most likely to feel the effects of heat on their health. Visit CDC’s website to access the index and other Centers for Disease Control tools. HHS’ Catalytic Program aims to connect safety net health care providers to Inflation Reduction Act funding for resilient and renewable infrastructure. Learn more on HHS’ website, which includes an entire set of webinars for health centers (scroll a little over halfway down the page).
Best Online Health and Safety Practices for Children and Youth Released
The Online Health and Safety Task Force released a report with recommendations and best practices for safer social media and online platform use for youth. The recommendations underscore the Administration’s efforts to address the ongoing youth mental health crisis and support the President’s Unity Agenda for the nation. Read more and access the report via the press release.
Data Released to Promote Health Equity
A new report from Capital Link and the National Health Care for the Homeless Council aims to provide practical guidance for Health Care for the Homeless (HCH) health centers. It provides a thorough examination of financial and operational benchmark trends, empowering HCHs to leverage their data resources to effectively address health equity concerns. Visit Capital Link’s site to download.
American Cancer Society: Free Colorectal Cancer Screening Kits for Rural Patients
The American Cancer Society and Color Health are working together on a program to bring free at-home colorectal cancer screenings to patients in rural areas, who often face barriers to cancer screening. This program is free for both participating health centers and patients. Color Health will provide health centers with free Fecal Immunochemical Test (FIT) kits for patients (up to 50 per site). Support to help navigate through this screening process will also be provided by Color Health. Patients and health centers will be notified of results and instructions for next steps. Even clinics not in a rural area but that serve rural patients are eligible. Any interested health centers can reach out to kacie.jankoski@cancer.org for more info.
CMS Releases Guidance on Provider Directories, Services for Incarcerated Young People
In July, Centers for Medicare and Medicaid Services (CMS) released two pieces of guidance on provisions in the Consolidated Appropriations Act (CAA) of 2023. The first piece of guidance addresses new requirements around accurate, regularly updated, and searchable provider directories in Medicaid and CHIP. Medicaid agencies and managed care organizations will need to make these changes by July 1, 2025. The second piece of guidance discusses Section 5121 of the CAA, which creates a new requirement to provide screening, diagnostic, and case management services to “eligible juveniles” who are post-adjudication in correctional facilities. Medicaid agencies will also have the option, under Section 5122 of the CAA, to provide full Medicaid and CHIP benefits to incarcerated young people who are pre-adjudication.
New Data Show Highest Number of Health Center Patients in Nearly 60 Year History of the Program
HRSA-Funded Health Centers Served 2.7 Million More Patients Over Past Four Years, Reaching High of More than 31 Million Patients
Today, to mark National Health Center Week, the Health Resources and Services Administration (HRSA) released new data showing over 31 million total patients served at HRSA-funded health centers in 2023—an increase of 2.7 million since 2020.
“Community health centers play a pivotal, and growing, role in America’s health care system. They are especially important in our effort to reduce health care disparities in underserved communities,” said HHS Secretary Xavier Becerra. “More than 31 million people across the country – in every U.S. state, territory, and the District of Columbia – depend on health centers, making them a vital resource. The Biden-Harris Administration wants all Americans to have access to high-quality primary health care services, regardless of a patient’s ability to pay, and community health centers help make that possible.”
“HRSA-funded community health centers make it possible for anyone in the community to access high-quality primary health care, regardless of income,” said HRSA Administrator Carole Johnson. “We are proud to serve millions more people and expand the community health workforce in rural and underserved areas all across the country.”
HRSA-funded health centers are required to treat all patients regardless of ability to pay, and in 2023 more than 90 percent of health center patients had incomes less than 200 percent of the 2023 Federal Poverty Guidelines. Health centers are now serving one in eight children across the country, more than 9.7 million patients in rural areas, over 6.4 million patients who live in or near public housing, and over 1.4 million people experiencing homelessness. Health centers have also expanded their preventive services, screening hundreds of thousands more people for cancer and infectious diseases and caring for patients with substance use disorders.
Health centers continue to be leaders in quality of care, increasing access and improving clinical quality across the board. Quality improvements since 2020 include:
- Administering more than 4 million HIV tests;
- Treating 585,000 prenatal care patients; and
- Improving clinical quality measures for chronic conditions, including hypertension control (+8%) and depression screening (+7%).
For more details on these and other Health Center Program outcomes see Four Years of Health Center Outcomes.
HRSA’s Health Center Program is a cornerstone of our nation’s health care system, especially for those who are uninsured; enrolled in Medicaid; living in rural, remote, or underserved areas; struggling to afford their health insurance co-pays; experiencing homelessness; residing in public housing; or otherwise having trouble finding a doctor or paying for the cost of care.
Hospitals at Risk for Closure, State-by-State
From Becker’s Financial Management
More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure.
The latest analysis from the Center for Healthcare Quality and Payment Reform, based on CMS’s July 2024 hospital financial information, reveals the financial vulnerability of rural hospitals in two categories: risk of closure and immediate risk of closure.
In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with nine states having a majority of their rural hospitals in jeopardy.
The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 360 rural hospitals are at immediate risk of shutting down due to severe financial difficulties.
“The primary reason hundreds of rural hospitals are at risk of closing is that private insurance plans are paying them less than what it costs to deliver services to patients,” CHQPR notes in its report, identifying losses on private insurance patients as the biggest cause of overall financial losses.
“Most ‘solutions’ for rural hospitals have focused on increasing Medicare or Medicaid payments or expanding Medicaid eligibility due to a mistaken belief that most rural patients are insured by Medicare and Medicaid or are uninsured,” according to the CHQPR report. “In reality, about half of the services at the average rural hospital are delivered to patients with private insurance (both employer-sponsored insurance and Medicare Advantage plans). In most cases, the amounts these private plans pay, not Medicare or Medicaid payments, determine whether a rural hospital loses money.”
To preserve and enhance essential hospital services in rural areas, CHQPR recommends that small rural hospitals receive Standby Capacity Payments from both private and public payers. These payments would cover the hospital’s fixed costs for maintaining essential services, ensuring that rural communities continue to have access to necessary healthcare.
Below is a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years.
Alabama
28 hospitals at risk of closing (54%)
24 at immediate risk of closing in next 2-3 years (46%)
Alaska
2 hospitals at risk of closing (12%)
1 at immediate risk of closing in next 2-3 years (6%)
Arizona
2 hospitals at risk of closing (7%)
1 at immediate risk of closing in next 2-3 years (4%)
Arkansas
25 hospitals at risk of closing (54%)
13 at immediate risk of closing in next 2-3 years (28%)
California
23 hospitals at risk of closing (40%)
10 at immediate risk of closing in next 2-3 years (17%)
Colorado
10 hospitals at risk of closing (23%)
6 at immediate risk of closing in next 2-3 years (14%)
Connecticut
2 hospitals at risk of closing (67%)
1 at immediate risk of closing in next 2-3 years (33%)
Delaware
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Florida
8 hospitals at risk of closing (36%)
5 at immediate risk of closing in next 2-3 years (23%)
Georgia
22 hospitals at risk of closing (32%)
11 at immediate risk of closing in next 2-3 years (16%)
Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing in next 2-3 years
Idaho
7 hospitals at risk of closing (24%)
0 at immediate risk of closing in next 2-3 years
Illinois
12 hospitals at risk of closing (16%)
7 at immediate risk of closing in next 2-3 years 9%)
Indiana
5 hospitals at risk of closing (9%)
4 at immediate risk of closing in next 2-3 years (7%)
Iowa
29 hospitals at risk of closing (31%)
10 at immediate risk of closing in next 2-3 years (11%)
Kansas
62 hospitals at risk of closing (63%)
31 at immediate risk of closing in next 2-3 years (32%)
Kentucky
13 hospitals at risk of closing (18%)
6 at immediate risk of closing in next 2-3 years (8%)
Louisiana
24 hospitals at risk of closing (44%)
12 at immediate risk of closing in next 2-3 years (22%)
Maine
10 hospitals at risk of closing (40%)
6 at immediate risk of closing in next 2-3 years (24%)
Maryland
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Massachusetts
2 hospitals at risk of closing (33%)
1 at immediate risk of closing in next 2-3 years (17%)
Michigan
15 hospitals at risk of closing (23%)
7 at immediate risk of closing in next 2-3 years (11%)
Minnesota
19 hospitals at risk of closing (20%)
7 at immediate risk of closing in next 2-3 years (7%)
Mississippi
35 hospitals at risk of closing (52%)
25 at immediate risk of closing in next 2-3 years (37%)
Missouri
20 hospitals at risk of closing (34%)
10 at immediate risk of closing in next 2-3 years (17%)
Montana
14 hospitals at risk of closing (25%)
4 at immediate risk of closing in next 2-3 years (7%)
Nebraska
5 hospitals at risk of closing (7%)
2 at immediate risk of closing in next 2-3 years (3%)
Nevada
5 hospitals at risk of closing (36%)
3 at immediate risk of closing in next 2-3 years (21%)
New Hampshire
2 hospitals at risk of closing (12%)
0 at immediate risk of closing in next 2-3 years
New Jersey
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
New Mexico
7 hospitals at risk of closing (26%)
6 at immediate risk of closing in next 2-3 years (22%)
New York
29 hospitals at risk of closing (56%)
20 at immediate risk of closing in next 2-3 years (38%)
North Carolina
6 hospitals at risk of closing (11%)
5 at immediate risk of closing in next 2-3 years (9%)
North Dakota
13 hospitals at risk of closing (33%)
5 at immediate risk of closing in next 2-3 years (13%)
Ohio
5 hospitals at risk of closing (7%)
2 at immediate risk of closing in next 2-3 years (3%)
Oklahoma
39 hospitals at risk of closing (50%)
26 at immediate risk of closing in next 2-3 years (33%)
Oregon
8 hospitals at risk of closing (24%)
2 at immediate risk of closing in next 2-3 years (6%)
Pennsylvania
13 hospitals at risk of closing (30%)
7 at immediate risk of closing in next 2-3 years (16%)
Rhode Island
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
South Carolina
10 hospitals at risk of closing (40%)
5 at immediate risk of closing in next 2-3 years (20%)
South Dakota
8 hospitals at risk of closing (16%)
4 at immediate risk of closing in next 2-3 years (8%)
Tennessee
19 hospitals at risk of closing (36%)
17 at immediate risk of closing in next 2-3 years (32%)
Texas
80 hospitals at risk of closing (50%)
30 at immediate risk of closing in next 2-3 years (19%)
Utah
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years
Vermont
8 hospitals at risk of closing (62%)
4 at immediate risk of closing in next 2-3 years (31%)
Virginia
9 hospitals at risk of closing (30%)
8 at immediate risk of closing in next 2-3 years (27%)
Washington
16 hospitals at risk of closing (36%)
4 at immediate risk of closing in next 2-3 years (9%)
West Virginia
11 hospitals at risk of closing (35%)
5 at immediate risk of closing in next 2-3 years (16%)
Wisconsin
7 hospitals at risk of closing (9%)
1 at immediate risk of closing in next 2-3 years (1%)
Wyoming
6 hospitals at risk of closing (24%)
2 at immediate risk of closing in next 2-3 years (8%)
Rural Community Health Worker Programs: Proving Value and Finding Sustainability
The latest feature article in The Rural Monitor features four rural health care organizations describing the impact of their community health worker programs and strategies for sustaining them.
Rural Center of Excellence on SUD Prevention: Reducing Stigma Rural Care Settings
This campaign from the University of Rochester (UR) Recovery Center of Excellence developed an awareness campaign to address stigmatizing beliefs around substance use disorder (SUD) that can pose a barrier to care in rural communities. The resource features perspectives of people in recovery from SUD as well as providers. UR has one of three FORHP-supported Rural Centers of Excellence on Substance Use Disorder.