- Colorectal Cancer Is Rising among Younger Adults. Some States Want to Boost Awareness.
- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Rural RPM Program Is a Lifeline for Pregnant Women
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
New Medicaid Model for Treatment of Rare Diseases Introduced
The Centers for Medicare & Medicaid Services (CMS) announced the Cell and Gene Therapy (CGT) Access Model, an initiative that aims to improve the lives of people with Medicaid living with rare and severe diseases by increasing access to potentially transformative treatments. Initially the model will focus on increasing access to gene therapy treatment for sickle cell disease, a genetic blood disorder that disproportionately impacts Black Americans. CGT is a multi-year payment model with state Medicaid agencies and pharmaceutical companies acting as participants, with optional grant funding available for states to provide an increased level of support for patients receiving gene therapy. CMS expects to release a Request for Application (RFA) to manufacturers in early spring 2024 and an RFA and Notice of Funding Opportunity (NOFO) to states in summer 2024.
AHRQ Requesting Public Input: Severe Maternal Morbidity Measurement – Comment by March 4
The Agency for Healthcare Research and Quality (AHRQ) needs assistance with data on state-level rates of severe maternal morbidity, that help inform HRSA’s Maternal and Child Health Bureau Title V Block Grant. Among the questions AHRQ has for stakeholders representing consumers – including but not limited to state and local health departments, accountable care organizations, and providers such as Critical Access Hospitals and Rural Health Clinics – is what quantitative data would you need to make maternal health service improvements. The comment period closes on March 4th and comments should be sent to askahrq@ahrq.hhs.gov. Recently, the Government Accountability Office cited several factors that pose additional risks and challenges for pregnant women in rural areas.
The Economic Effects of Rural Hospital Closures Reported
Researchers at the North Carolina Rural Health Research Program report on changes to annual income, population size, unemployment, and size of the labor force in nonmetro counties that experienced a hospital closure between 2001 and 2018.
SAMHSA Finalizes Rule on Medications for the Treatment of Opioid Use Disorder
On January 31, the Substance Abuse and Mental Health Services Administration (SAMHSA) published final revisions to federal regulations surrounding opioid use disorder treatment standards, including accreditation and certification standards for opioid treatment programs (OTP). The final rule addresses several longstanding barriers to broader use of medications to treat opioid use disorder. Among other changes, the revised policy formalizes various methadone treatment protocols at OTPs that were put in place during the pandemic, and expands access to take-home methadone. The finalized rule also adds to the workforce and their capabilities, expanding the definition of OTP practitioner to include Nurse Practitioners and Physician Assistants, among other types of clinician, and allowing for MOUD prescribing via telehealth. The effective date of this final rule is April 2, 2024 and the compliance date is October 2, 2024.
An Update Released on the Federal Overdose Prevention Strategy
FORHP’s Rural Communities Opioid Response Program figures prominently among ongoing federal grant programs that are part of the strategy that is now entering its third year. The effort involves every one of the 12 operating divisions of the U.S. Department of Health & Human Services and, in 2023 alone, featured groundbreaking changes to policy that include:
- Eliminated the Drug Enforcement Agency waiver for prescribing medications for opioid use disorder (MOUD) and made temporary rules for prescribing via telemedicine permanent; (See more details about SAMHSA policy changes for MOUD in the next item.)
- Increased Medicare payment rates for opioid treatment programs (OTPs), including services provided by mobile units;
- Expanded the clinical workforce that may bill Medicare by including marriage and family therapists, licensed professional counselors, and others to provide behavioral health services;
- Established Medicare payment for Intensive Outpatient Program services, which can be furnished in hospital outpatient departments, Community Mental Health Centers, Federally Qualified Health Centers, Rural Health Clinics, and OTPs.
The latest initiative in the overdose prevention strategy was announced earlier this week. The Substance Abuse and Mental Health Services Administration will invest more than $20 million to advance health information technology in behavioral health care and practice settings.
Enhancing Rural and Geographic Health Equity: Latest Updates from CMS OMH
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) continues to address health care needs of rural, tribal, and geographically isolated communities through the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities. Learn more about our latest activities below.
Roundtable Discussions
Beginning in November 2023, CMS OMH hosted four roundtables with organizations that serve rural, Tribal, Pacific, and Caribbean communities to hear their feedback about health care challenges for Americans living in these areas. Participants discussed the need to address workforce shortages, communication barriers, and received specific research data for their populations. CMS OMH will use the feedback to inform future outreach strategies.
New Reports
CMS OMH has released two new reports focused on health care disparities among Americans who live in rural, tribal, and geographically isolated communities since November 2023, including:
- The Rural-Urban Disparities in Health Care in Medicare report, which found rural Medicare Advantage beneficiaries fell below the national average of clinical care measures, such as Prevention and Screening, in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
- The Advancing Health Equity in Rural, Tribal, and Geographically Isolated Communities FY2023 Year in Review report, which outlined the FY 2023 CMS actions and initiatives aimed to enhance health care access and quality for rural, tribal, and geographically isolated communities, including the CMS Health Equity Framework and CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities.
New Video: Coverage to Care (C2C) in Rural Areas
In December 2023, CMS OMH released a video titled, “Coverage to Care Community Connections Tour with Rural and Geographically Isolated Areas” that highlights the distribution of C2C resources in rural and Tribal communities to help Americans connect to their health care coverage. The video features Dawson County Family Partners and Servicios de La Raza. Visit go.cms.gov/c2c to learn more about C2C, the tour, and access materials.
Stay Informed, Connected, and Engaged
CMS OMH is here to support you every step of the way. You can reach out to us anytime at RuralHealth@cms.hhs.gov or sign up for our listserv at bit.ly/CMSOMH to receive timely updates directly to your inbox. CMS OMH encourages you to utilize the Health Equity Technical Assistance Program, offering personalized coaching and resources to start your journey toward promoting health equity within your organizations. For assistance, contact HealthEquityTA@cms.hhs.gov. mailto:RuralHealth@cms.hhs.gov
Relevant Resources
- CMS Rural and Geographic Health webpage
- CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities
- Advancing Rural Maternal Health Equity Report
- Roadmap to Better Care, which is available in nine languages and includes a Tribal Version specific to American Indian/Alaska Native communities.
- CMS Cross Cutting Initiative – Rural Health
- CMS Announces New Model to Advance Integration in Behavioral Health
- Rural Health Clinics Center
- Rural Health Information Hub
Pennsylvania Oral Health Coalition Published 2023 Impact Report
PCOH is pleased to announce the release of our 2023 Impact Report. Thank you to all of our stakeholders, partners, and funders for making this work possible. We look forward to working collaboratively to improve oral health in 2024 and beyond!
USDA ReConnect Round 5 Application Workshops
The USDA Rural Development Rural Utilities Service (RUS) is providing a three-day workshop for those interested in applying for ReConnect Program funding. The ReConnect Program offers loans, grants, and loan/grant combinations to facilitate broadband deployment in areas of rural America without sufficient access to broadband. To learn more about the ReConnect Program, please visit: https://www.usda.gov/reconnect.
The workshop will take place in-person at Silver Legacy located at 407 N. Virgina Street, Reno, NV.
The three-day workshop will provide attendees with an understanding of the ReConnect program application system and program requirements for FY2024. Topics will include:
- Program Eligibility
- Live Demonstrations of the Application System
- Evaluation Criteria
- Overview and deep dive sessions on financial, network, environmental, and mapping requirements
Dates and Times
- February 27-29, 2024
- Tuesday, February 27th, 8:30 a.m.- 5:30 p.m.
- Wednesday, February 28th, 8:30 a.m.- 5:00 p.m.
- Thursday, February 29th, 8:30 a.m.- 12:00 p.m.
Please Note: Registration should only be submitted once and is not required for each day. After registering you will not receive an email confirmation. The workshop agenda is now available and has been posted to the Events Page on the ReConnect website.
Contact
Please submit any ReConnect questions using the Contact Us Form on the ReConnect website.
USDA ReConnect Program Webinar: Round 5 Preparing to Apply
We added an additional webinar for those who could not previously attend. No new information will be provided.
Presented by USDA Rural Development’s Rural Utilities Service, the webinar will provide information about the ReConnect Program and help prepare applicants ahead of the next Notice of Funding Opportunity (NOFO).
This webinar will include:
- What applicants can do now to prepare for the next NOFO.
- Registration and system requirements.
- A high-level look at ReConnect Program eligibility requirements.
- Tips on using the Application System.
- An opportunity to ask RUS staff questions about the application preparation.
We’ll address as many questions as time permits during each session. Once the NOFO is published, RUS will host a NOFO Overview webinar and include an updated list of the most common questions on our frequently asked questions page on the ReConnect website.
Date and Time:
February 7, 2024 from 1:00 PM-2:30 PM EST
Contact
If you have questions after the event, please submit them using Contact Us.
HHS Finalizes Rule on Telehealth at Opioid Treatment Programs
From Healthcare Dive
The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years, the government said.
Dive Brief:
- The HHS on Thursday finalized a rule that will allow opioid treatment programs to begin some medication treatment via telehealth.
- Under the rule, these providers will be able to initiate treatment with buprenorphine through audio-only or audio-visual telehealth. They can begin methadone treatment via an audio-visual platform — but not through an audio-only option due to its higher risk profile, the Substance Abuse and Mental Health Services Administration said.
- The regulation makes permanent telehealth flexibilities that began during the COVID-19 pandemic to preserve access to care and tackle a worsening opioid epidemic.
Dive Insight:
The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years, SAMHSA said.
The updates — which also include expanding eligibility for patients to receive take-home doses of methadone and allowing more provider types to order medications — aim to reduce stigma and expand care access, which can be challenges to treating people with substance use disorders.
Telehealth could be a significant aid on that front, experts say. Virtual care use soared during the COVID pandemic, helped by loosened regulations that allowed patients to receive care while maintaining social distance.
Some research has shown telehealth can expand who can access mental healthcare and opioid use disorder treatment, potentially preventing overdoses. Provisional data suggests drug overdose deaths reached nearly 107,000 during the 12 months ending in August 2023, according to the Centers for Disease Control and Prevention.
“While this rule change will help anyone needing treatment, it will be particularly impactful for those in rural areas or with low income for whom reliable transportation can be a challenge, if not impossible,” Miriam Delphin-Rittmon, the HHS assistant secretary for mental health and substance use, said in a statement.
Regulators have made other changes that could improve access to substance use disorder treatment. During the pandemic, the Drug Enforcement Administration granted exceptions to the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which required most practitioners to have at least one in-person evaluation before prescribing controlled substances.
The DEA and the HHS announced in the fall that they would extend pandemic-era prescribing rules through 2024. Advocates cheered the extension, arguing in-person requirements limited access, particularly for opioid use disorder care.