- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Louisiana
- EMS Receives $9.9 Million to Expand Ambulance-Based Telemedicine
- VA Awards $52.5M to Community Organizations Working to Prevent Veteran Suicide
- In Montana, 911 Calls Reveal Impact of Heat Waves on Rural Seniors
- Building Trust and Collaboration for Local Health Solutions
- In the Face of Climate Change, Ho-Chunk Nation Working Toward Food Sovereignty
- 'Dismayed, but Not Surprised:' Health Gap Between Urban and Rural America Is on the Rise
- Native-Led Suicide Prevention Program Focuses on Building Community Strengths
- Genetic Testing for Rare Diseases Is Hard to Find if You Live in Rural Kansas, but Now There's Help
- EMS Agencies, Communities Work to Make Wyoming Safer amid Serious Challenges
- Prescription for Crisis: Rural Pharmacies Struggle to Stay Open
- In a Rural Small Town, a Group of Locals Steps up to Support Senior Health
- As an Oklahoma Hospital Breaks Ground, USDA Looks to Better Health, High Speed Internet and Housing
- As an Oklahoma Hospital Breaks Ground, USDA Looks to Better Health, High Speed Internet and Housing
- The Cost of Senior Care: Why Aging Farmers Fear the Nursing Home
Oral Health Resources for Older Adults Available
PCOH has added two new resources on oral health care for older adults to their Request Materials page. “Oral Health Care Tips for Older Adults” is a resource with tips for oral health care for older adults including the importance of regular dental care and dental access. “Oral Care for Long-Term Care Residents” is a tri-fold brochure with tips providers need to know for treating adults in long-term care facilities. Topics include dry mouth, denture care, and gum disease. These resources, and many others, are available to download or ship for free from the Request Materials page.
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%)
Dive Into Appalachian Data!
Take a dip in facts and figures about the Appalachian Region!
ARC’s Chartbook has over 300K data points to explore, including statistics on population (see one map above). 📍 Though much of the region has experienced population decline, Appalachian South Carolina and Georgia have grown since 2010. Some counties in Georgia experienced population growth of over 18%.
Whether you’re interested in population data, education and employment, or how rural Appalachia compares to the rest of rural America, you’ll find an endless sea of interesting facts—all presented at regional, subregional, state and county levels.
Pennsylvania Rural Health Program Receives Award for Quality Excellence
The Pennsylvania Medicare Rural Hospital Flexibility Program received the 2024 Medicare Beneficiary Quality Improvement Project (MBQIP) Certificate of Excellence Award in recognition of outstanding critical access hospital state quality reporting and performance. The Pennsylvania program, which was ranked #1 nationally, has 16 critical access hospitals — these small hospitals of 25 beds or less are in rural counties and serve Medicare, low income and uninsured populations.
The award was presented on July 18 at the annual Medicare Rural Hospital Flexibility Program reverse site visit in Washington, D.C., by the Federal Office of Rural Health Policy in the U.S. Department of Health and Human Services’ Health Resources and Services Administration. Lannette Fetzer, quality improvement coordinator, and Sandee Kyler, rural health systems manager and deputy director, of the Pennsylvania Office of Rural Health (PORH), accepted the award on behalf of the state’s critical access hospitals. PORH, a partnership between the federal government, the state government and Penn State, is administratively housed in the Department of Health Policy and Administration in the Penn State College of Health and Human Development.
MBQIP is a quality improvement activity under the Medicare Rural Hospital Flexibility grant program of the Federal Office of Rural Health Policy. The goal of MBQIP is to improve the quality of care provided in critical access hospitals by increasing quality data reporting and driving quality improvement activities based on the data. MBQIP is a voluntary reporting system that includes quality and satisfaction measures from the Centers for Medicare and Medicaid Services Hospital Compare plus a critical access hospital-specific emergency department transfer communication measure set. Pennsylvania was one of the first four states to have 100% critical access hospital participation in MBQIP.
The Medicare Rural Hospital Flexibility Program improves access to preventive and emergency health care services for rural populations. Providing federal grant funding to eligible states, the program requires states to address rural health network development and directs significant effort into designating critical access hospitals.
“Pennsylvania’s 16 critical access hospitals work vigorously to ensure their hospital provides exceptional patient care, serving as a testament to superior quality service. It is a pleasure to work with them,” Fetzer said.
During the meeting, Fetzer was asked, for the second year, to serve as one of three panelists during a session called “Intersections of Flex: Working Across Program Areas for Greatest Impact,” where she discussed how quality affects the hospital’s bottom line and the importance of quality reporting.
“Successful quality improvement is not a one-time occurrence; it is a continuous and ongoing effort to improve outcomes in health care,” Kyler said. “Our critical access hospitals care about the people and communities they serve. This recognition demonstrates their commitment to high-quality health care in these rural communities. They are commended for their continuing efforts and focus on high-quality health care.”
PORH, which provides expertise in the areas of rural health, agricultural health and safety, and community and economic development, was formed in 1991 as a partnership between the federal government, the Commonwealth of Pennsylvania and Penn State. The office is one of 50 state offices of rural health in the nation funded under a program administered by the Federal Office of Rural Health Policy and is charged with being a source of coordination, technical assistance and networking; partnership development; and assisting in the recruitment and retention of health care providers.
Advocate for Vaccine Equity During National Immunization Awareness Month
Vaccines help protect people of all ages against many diseases and conditions. In August, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is working to increase access to vaccines and encouraging those served by CMS to get their routine shots in honor of National Immunization Awareness Month. The Centers for Disease Control and Prevention (CDC) advises that everyone aged 6 months and older receive updated COVID-19 vaccines and flu shots each year. The CDC also recommends other routine vaccinations based on age.
However, fewer than 1 in 4 adults aged 19 or older received all their recommended vaccines in 2019. Minority populations have even lower vaccination rates, with only 15.9% of Black adults and 17.3% of Hispanic adults receiving routine vaccines compared to 23.7% White adults. Black (39.0%) and Hispanic (37.5%) Americans, as well as people who identify as other or multiple race (41.4%), also have lower flu vaccination coverage when compared with White (49.3%) adults. Significant disparities in access and health coverage, as well as a history of discrimination and distrust, contribute to these racial inequities in vaccination.
Disparities also exist in vaccination rates among children. In 2019, only 48.9% of Black children and 60.6% of Hispanic children between the ages of 6 months and 4 years old received their flu shot, compared to 64.1% of White children. Additionally, fewer children in rural areas received flu vaccines (51.8%) than those in urban areas (64.7%). The CMS Connecting Kids to Coverage National Campaign encourages families to enroll their children in health coverage so they can get the care and vaccines they need, especially as they go back to school.
During National Immunization Awareness Month, you can help your communities get vaccinated and stay healthy. Review and share the resources below to help those you serve learn more about recommended vaccines and how to access them.
Resources
- Immunization and Vaccine Resources
- Coverage to Care Prevention Resources
- Annual Influenza Vaccination Disparities in Medicare Beneficiaries
- Flu Vaccine Partner Toolkit
- Adult Vaccine Assessment Tool
- Vaccine Information for Adults
- Vaccines for Your Children
- Adult Immunization Schedule
- Child & Adolescent Immunization Schedule
- CDC “Back-to-School” Campaign
- Connecting Kids to Coverage
- Resources to Encourage Routine Childhood Vaccinations
- Vaccines for COVID-19
New Report: Oral Health Care for Children and Youth with Developmental Disabilities
The American Academy of Pediatrics published “Oral Health Care for Children and Youth With Developmental Disabilities.” This clinical report highlights the oral health needs of children and youth with developmental disabilities and calls for coordinated care.
Maternity Care in Rural Areas Is in Crisis. Can More Doulas Help?
When Bristeria Clark went into labor with her son in 2015, her contractions were steady at first. Then, they stalled. Her cervix stopped dilating. After a few hours, doctors at Phoebe Putney Memorial Hospital in Albany, Georgia, prepped Clark for an emergency cesarean section.
It wasn’t the vaginal birth Clark had hoped for during her pregnancy.
“I was freaking out. That was my first child. Like, of course you don’t plan that,” she said. “I just remember the gas pulling up to my face and I ended up going to sleep.”
She remembered feeling a rush of relief when she woke to see that her baby boy was healthy.
Clark, a 33-year-old nursing student who also works full-time in county government, had another C-section when her second child was born in 2020. This time, the cesarean was planned.
Clark said she’s grateful the physicians and nurses who delivered both her babies were kind and caring during her labor and delivery. But looking back, she said, she wishes she had had a doula for one-on-one support through pregnancy, childbirth, and the postpartum period. Now she wants to give other women the option she didn’t have.
Clark is a member of Morehouse School of Medicine’s first class of rural doulas, called Perinatal Patient Navigators.
The program recently graduated a dozen participants, all Black women from southwestern Georgia. They have completed more than five months of training and are scheduled to begin working with pregnant and postpartum patients this year.
USDA Rural Development Invests in Rural Communities to Lower Energy Costs and Create Jobs in Pennsylvania
U.S. Department of Agriculture (USDA) State Director for Rural Development Bob Morgan announced four additional projects being funded through the Rural Energy for America Program (REAP) for a total of $1.4 million.
“The Biden-Harris Administration is partnering with people in rural communities across our Commonwealth to expand access to clean energy and save rural Americans money,” Morgan said. “We are hard at work, continuing what we’ve always done, supporting rural small businesses and farmers as they create jobs for their communities and drive economic prosperity.”
Here are the projects being announced today:
In Cambria County, Saint Francis University will use a REAP Renewable and Energy Audit Program grant of $100,000 to conduct 26 renewable energy assessments for rural small businesses and agricultural producers throughout Pennsylvania. These on-site assessments will provide analysis to install renewable energy systems aimed at reducing overall energy costs. This program strengthens American energy independence by increasing the private sector supply of renewable energy and decreasing the demand for energy through energy efficiency improvements.
In Northampton County, Northampton County Area Community College will use a REAP Technical Assistance grant of $449,990 to provide technical assistance for stakeholders interested in REAP Energy Efficiency Improvement opportunities for rural small businesses and agricultural producers throughout the State of Pennsylvania. Northampton County Area Community College (NCC) will provide technical assistance as well as energy audits and assessments to applicants interested in applying for REAP funds. NCC will target projects requesting $20,000 or less in grant funds, projects located in distressed or disadvantaged communities and projects with agricultural producers.
In Juniata County, Reinford Farms Inc., a dairy farm and trucking operation located in Mifflintown, Pennsylvania, will use a REAP grant of $712,572 to purchase and install a replacement motor upgrade for its anaerobic digester. Reinford Farms has been operating since 1991. The project is estimated to generate 3,705,000 kilowatt hours (kwh) per year, which is enough energy to power 341 homes.
In York County, Miller-Redding Partnership dba Mr. Storage will use a REAP grant of $132,500 to purchase and install a 104.7-kilowatt (kW) solar photovoltaic (PV) system. Mr. Storage, a 102-unit storage facility located in Hanover, Pennsylvania has been operating since 2019. This project is expected to generate 129,191 kilowatt hours (kWh) of electricity, which is enough energy to power 11 homes.
In 2024, USDA Rural Development has invested in 119 projects for a total of $19 million. Since 2021, RD has invested $44 million in 366 projects across the Commonwealth through the REAP program. Many of the projects are funded by President Biden’s Inflation Reduction Act, the nation’s largest-ever investment in combating the climate crisis. The projects also advance President Biden’s Investing in America Agenda to grow the nation’s economy from the middle out and the bottom up.
You can read the USDA national program announcement made today here.
Pennsylvania Broadband Authority BEAD Challenge Summary Now Available
The Pennsylvania Broadband Authority (PBDA) has posted details about the challenges received during the Challenge Submission phase of the BEAD Challenge process. The Challenge Summary can be reviewed on the PBDA’s BEAD Challenge Process webpage. The Adjudication phase is currently in-progress which means PBDA is reviewing evidence submitted during the Rebuttal phase. All final outcomes of the Adjudication phase will be posted publicly on our website when NTIA Curing is complete.
Additional questions regarding the BEAD Challenge Process, please reach out to the PBDA via the BEAD Resource Account.