Rural Health Information Hub Latest News

HHS is Seeking Input on Smoking Cessation Framework Draft 

Last week, the U.S. Department of Health & Human Services (HHS) released a draft framework for an initiative that aims to ensure every person in America has access to comprehensive, evidence-based treatment.  The framework is organized around six goals that range from increasing awareness of the benefits of smoking cessation to finding the best measures for the success of the effort.  Research released last year showed that, in 2020, smoking prevalence was higher in rural (19.2 percent) than in urban areas (14.4 percent). From 2010 to 2020, the odds of quitting were lower in rural versus urban areas. HHS invites all potentially interested parties—individuals, associations, governmental and non-governmental organizations, academic institutions, and private sector entities—to respond by July 30.

The CDC Awards for High Obesity Program

  This week, the Centers for Disease Control and Prevention (CDC) announced awards totaling more than $11 million for its program specifically designed to reach U.S. counties with high rates of obesity.  Most awards for the five-year program are in rural areas, cited by the CDC as having a higher obesity prevalence.  Sixteen land grant universities will work with local cooperative extension services to increase the availability of affordable, healthy foods and safe, convenient places for physical activity.

CMS Proposes Remedy for 340B Medicare Drug Payment Policy

 This proposed rule describes the actions that the Centers for Medicare & Medicaid Services (CMS) proposes to take to comply with the United States Supreme Court’s decision about the adjustment of Medicare payment rates for drugs acquired under the 340B Program from calendar year (CY) 2018 through September 27th of CY 2022.  As background, in 2018, CMS decreased the Medicare payment rate for 340B drugs from average sales price (ASP) plus 6 percent to ASP minus 22.5 percent.  They also made a corresponding increase to payments to all hospitals (340B hospitals and non-340B hospitals) for outpatient non-drug items and services, so the policy change was budget neutral.  The Supreme Court unanimously ruled that the differential payment rates for 340B-acquired drugs were unlawful because, prior to implementing the rates, HHS failed to conduct a survey of hospitals’ acquisition costs under the relevant statute.  To comply with the ruling, CMS proposes to pay affected 340B providers an estimated $7.8 billion in lump sum payments and to reduce future outpatient non-drug item and service payments to all hospitals starting in CY 2025. CMS would continue to adjust the OPPS payments until the full $7.8 billion is offset, estimated to be 16 years. The proposed actions in this rule would affect all hospitals. Comments are by September 5, 2023.

Read About the Differences in the Merit-Based Incentive Payment System (MIPS) Performance of Clinicians in Metropolitan and Nonmetropolitan Counties in 2018

  The Merit-based Incentive Payment System (MIPS) is a pay-for-performance system for clinicians under the Medicare Quality Payment Program designed to reward clinicians for providing higher quality of care and lower costs. This study from the RUPRI Center for Rural Health Policy Analysis compared clinicians’ MIPS performance in 2018 based on their practice location, size, and minority population proportion.

Spatial Clustering of COVID-19 Mortality Rates Across Counties and by Noncore, Micropolitan, and Metropolitan County Characteristics, December 2020–January 2021.

  Among the key findings from the RUPRI Center for Rural Health Policy Analysis: a higher percentage of clusters of high mortality rates were in noncore and micropolitan counties; these clusters had the highest average nursing home bed density and the highest average proportion of Medicare beneficiaries with multiple chronic conditions.

The Impact of COVID-19 Funding on Profitability of Critical Access Hospitals

Using data from the Centers for Medicare & Medicaid Services (CMS) researchers report on the challenges faced by CMS-designated Critical Access Hospitals during the federal Public Health Emergency, and the impact of special funding on their financial performance. The report is the work of the Flex Monitoring Team, a consortium of researchers from the Universities of Minnesota, North Carolina-Chapel Hill, and Southern Maine, funded by the Federal Office of Rural Health Policy to evaluate the impact of the Medicare Rural Hospital Flexibility Grant Program (the Flex Program).

Research is Characterizing Social Insecurity in a Rural North Carolina Emergency Department

 From May-June 2018, researchers collected 312 survey responses from patients at a rural emergency department and identified three key determinants of social insecurity: 1) access to transportation, 2) food insecurity, and 3) exposure to violence.  Findings show significant differences among the three major racial/ethnicity groups represented – Native Americans (34.3 percent), Blacks (33.7 percent), and Whites (27.6 percent).