- Dental Therapists, Who Can Fill Cavities and Check Teeth, Get the OK in More States
- 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
What Rural Health Providers Want from Washington
Maya Goldman, author of Axios Vitals
Rural health providers have a long to-do list for Congress.
Driving the news: When the chairman of the powerful House Ways and Means Committee last month put out a call for ideas on shoring up rural America’s fraying health care system, rural providers came prepared.
- The National Rural Health Association sent a letter last week outlining actions Congress can take, ranging from enhanced support for staff retention at the poorest facilities to carveouts from some controversial policies strongly opposed by the broader hospital industry.
Why it matters: Eighty percent of rural areas in the country are medically underserved areas, while rural Americans tend to be older, sicker and poorer than their urban counterparts. Almost 200 rural hospitals have closed in the past two decades, and hundreds more are on the brink of financial collapse.
The rural providers called on Congress to:
- Exempt rural hospitals from price transparency rules, calling them “costly and burdensome” for the facilities.
- Increase payment rates and force Medicare Advantage plans, who account for a growing share of their patients, to speed up payments that providers say are taking too long to arrive.
- Authorize Medicare to extend a policy that boosts reimbursement to hospitals that pay lower wages to their employees, which aims to lessen pay disparities between rural hospitals and higher-wage facilities usually in urban areas.
- Maintain rural hospitals’ access to the 340B federal discount drug-purchasing program as Congress weighs changes to it, and make it easier for different rural provider types to participate in the program.
- Permanently extend telehealth flexibilities put in place during the pandemic.
- Help rural providers move away from fee-for-service payment and into value-based payment programs. The providers say they have been largely overlooked in alternative care models coming out of Medicare’s innovation lab.
Of note: NRHA said rural hospitals should be exempt from future site-neutral hospital payment policies that Congress is considering.
- The organization also pushed back on the Biden administration’s proposal to set required staffing levels in nursing homes, warning many rural facilities would struggle to satisfy the mandate.
Pennsylvania State EMS Office Releases 2023 Statewide Protocol Update
The Pennsylvania Department of Health, Bureau of Emergency Medical Services, is pleased to announce the release of the 2023 PA Department of Health Statewide Protocols via the Department’s website at Regulations (pa.gov).
Additionally, on October 21, 2023, the PA Bulletin will publish the updated Scope of Practice, Required Equipment, and Medication lists.
The educational update courses for the BLS, IALS and ALS protocols have been created and released to TRAIN-PA.
- 2023 BLS Protocol Update BEMS course #1000058611
- 2023 IALS Protocol Update BEMS course#1000058615
- 2023 ALS Protocol Update BEMS course #1000058613
These protocols will be in effect on January 1, 2024. All providers, Medical Command Physicians and Agency Medical Directors are required to complete the protocol update course(s) prior to this date. Once the training is complete, the EMS Agency Medical Director may authorize the use of these protocols prior to January 1, 2024.
EMS providers who are unable to complete the training on TRAIN-PA should contact their Agency Medical Director. A PowerPoint and Lesson Plan will be available for in person training.
The Rural Health Information Hub Has Released New Information on Capital Funding for Rural Healthcare
The Rural Health Information Hub recently updated this topic guide with information on different types of funding sources.
CMS Releases Additional Guidance for MFTs and MHCs
The Consolidated Appropriations Act of 2023 expanded the range of behavioral health practitioners that can serve Medicare beneficiaries by allowing marriage and family therapists (MFTs) and mental health counselors (MHCs) to bill Medicare directly beginning in 2024. CMS included policies that would implement this in the Medicare Physician Fee Schedule Proposed Rule for 2024. The agency has also recently released a document providing answers to Frequently Asked Questions on the details of Medicare enrollment for these providers, along with how this relates to other topics including telehealth. MFTs and MHCs can help to address behavioral health workforce shortages in rural areas, with recent research finding a much smaller proportion of rural counties lacked counselors compared to any other behavioral health provider type.
Researchers have Analyzed Competencies and Workplace Stressors: Comparing Rural and Urban Public Health Practice
Researchers analyzed survey responses to the 2021 Public Health Workforce Interest and Needs Survey to compare rural and urban skill proficiencies, training needs, turnover risk, and experiences of bullying due to working as a public health professional. Among the findings, rural staff had a higher likelihood than urban staff of reporting proficiencies in community engagement, data-based decision-making, and diversity, equity, and inclusion. Rural staff were also more likely than urban staff to report leaving because of stress, experiences of bullying, and avoiding situations that made them think about COVID-19.
Capital Funding for Rural Healthcare
The Rural Health Information Hub recently updated this topic guide with information on different types of funding sources.
Read About the Final Rule: Simplified Enrollment in the Medicare Savings Programs
The Centers for Medicare & Medicaid Services (CMS) issued a final rule that simplifies eligibility and enrollment processes for the Medicare Savings Programs (MSPs), a collection of programs that provide qualifying, low-income Medicare beneficiaries with state-based assistance paying for Medicare premiums and cost-sharing. For several years, estimates have shown low enrollment in these programs. In response, this rule requires States to simplify policies and procedures with the goal of enrolling more eligible Medicare beneficiaries. In 2020, over 1 million rural Medicare beneficiaries had limited Medicaid benefits through these programs.
Request for Input on Rural Participation in Value-Based Care Models
The Physician‐Focused Payment Model Technical Advisory Committee (PTAC), an independent federal advisory committee, seeks public input to inform their report to the Secretary with recommendations to encourage rural participation in value-based payment (VBP) models. They request information on what definitions of rural are most relevant for VBP, what are the needs of rural providers, what are the barriers to rural participation in VBP models, and what non-medical interventions rural populations need. Send questions or comments to PTAC@HHS.gov. Input Requested by October 20, 2023.
Addressing Social Needs Through Medicaid: Read the Report on Lessons from North Carolina
This report examines what was learned from North Carolina’s Healthy Opportunities Pilots, a project launched in 2021 with $650 million in Medicaid funding that focused on the health-related social needs of enrollees living in three primarily rural regions of the state.
Will the Availability of OTC Narcan Increase Access? Here You Can Find Recent Research Regarding Naloxone
The national nonprofit Kaiser Family Foundation highlights state policies and recent research related to over-the-counter (OTC) access to naloxone, a drug that rapidly reverses opioid overdose. A clue may be provided by a 2022 study linked in the brief that examines how pharmacies decided to stock the prescription version of the drug. The study identified that independent pharmacies, those in rural areas, and pharmacies in states with lower overdose rates or without expanded Medicaid were less likely to have it available.