A study published by the Journal of Rural Health assesses how training in rural communities relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.  Here, a summary of the study is provided by 3RNET, a national nonprofit that helps rural practices expand their reach for posting job vacancies.

This infographic from the Centers for Medicare & Medicaid Services (CMS) provides a snapshot of demographics, health outcomes, risk factors, access and utilization, and disparities among Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries seeking pregnancy-related care and those with a recent live birth. It shows the states with the highest percentage of Medicaid and CHIP beneficiaries ages 15-49 living in rural areas as well as the number of general obstetrics and gynecology physicians and advanced practice midwives per 100,000 women ages 15–49. This data analysis informed the Medicaid and CHIP Maternal and Infant Health Initiative Summer 2024 Webinar Series, occurring every Tuesday at 2:00 pm Eastern, and the CMS Affinity Groups scheduled for this fall on maternal mental health and substance use and maternal hypertension and cardiovascular health.

Preventing Chronic Disease (PCD) welcomes submissions for its upcoming collection, Rural Health Disparities: Contemporary Solutions for Persistent Rural Public Health Challenges.

Public health challenges have been documented in rural geographical areas and remain persistent public health, medicine, and health services problems. These challenges include limited health care access, excessive tobacco use in poor counties, limited physical activities, socioeconomic inequities, behavioral and mental health conditions, and major chronic diseases. These persistent rural health challenges magnify and lead to racial and socioeconomic disparities.

The goal of this collection is to capture current solutions to these challenges. Peer-reviewed articles in this collection will help advance the discourse on rural public health beyond biomedical models for chronic disease prevention. For this collection, PCD encourages the submission of manuscripts covering diverse topics using various article types. We encourage authors to explore the social determinants of health, environmental influences, policy interventions, and community-based initiatives contributing to chronic disease prevention in rural areas.

PCD is a peer-reviewed public health journal published by the Centers for Disease Control and Prevention (CDC) and authored by experts worldwide. Visit the PCD website for more information about the journal, submission guidelines, and deadlines for this upcoming collection.

Key Dates: Accepted manuscripts will be published on a rolling basis. Please submit an inquiry to the Editor in Chief at PCDeditor@cdc.gov by July 19, 2024. All manuscripts intended for this collection are due by January 24, 2025. The collection will include published manuscripts along with a guest editorial, set to be published in Summer 2025.

From Axios

Hospitals’ business models are being upended by fundamental changes within the health care system, including one that presents a pretty existential challenge: People have far more options to get their care elsewhere these days.

Why it matters: Health systems’ responses to major demographic, social and technological change have been controversial among policymakers and economists concerned about the impact on costs and competition.

• Communities depend on having at least some emergency services available, making the survival of hospitals’ core services crucial.
• But without adaptation — which is already underway in some cases — hospitals may be facing deep red balance sheets in the not-too-distant future, leading to facility closures and shuttered services.

The big picture: Many hospitals have recovered from the sector’s post-pandemic financial slump, which was driven primarily by staffing costs and inflation. But systemic, long-term trends will continue to challenge their traditional business model.

• Many of the services that are shifting toward outpatient settings — like oncology, diagnostics and orthopedic care — are the ones that typically make hospitals the most money and effectively subsidize less profitable departments.
• When hospitals lose these higher-margin services, “you’re starving the system that needs profits to provide services that we all might need, but particularly uninsured or underinsured people might need,” said UCLA professor Jill Horwitz.

And hospitals have long claimed that much higher commercial insurance rates make up for what they say are inadequate government rates.

• But as the population ages and moves out of employer-sponsored health plans, fewer people will have commercial insurance, forcing hospitals to either cut costs or find new sources of revenue.

By the numbers: Consulting firms are projecting a bleak decade for health systems.

• Oliver Wyman recently predicted that under the status quo, hospitals will need to reduce their expenses by 15-20% by 2030 “to stay viable.”
• Boston Consulting Group last year projected that health systems’ annual financial shortfall will total more than $200 billion by 2027, and their operating margins will have dropped by 10 percentage points.
• To break even in 2027, a “typical” health system would need payment rate increases of between 5-8% annually — twice the rate growth over the last decade, according to BCG. If the load is borne solely by private insurers, hospitals will need a 10-16% year-over-year increase.

Between the lines: This is the lens through which to view health systems’ spree of mergers and acquisitions, which have increasingly drawn criticism from policymakers, regulators and economists as being anticompetitive.

• For better or worse, when hospitals have a larger market share, they are in a better position to negotiate and bring in more patients, and they can dilute some of the financial pain of poorer-performing facilities.
• And when they acquire physician practices or other outpatient clinics, they’re still getting paid for delivering care even when patients aren’t receiving it in a traditional hospital setting.
• “I think the hospitals have sort of said … ‘We can keep doing things the same way and we can just merge and get higher markups,'” said Yale economist Zack Cooper. “That push to consolidate is saying, ‘Let’s not move forward, let’s dig in.'”

Yes, but: A big bonus of outpatient care is that it’s supposed to be cheaper. But when hospitals charge more for care than an independent physician’s office would have, or they tack on facility fees, costs don’t go down.

This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.  The summary provides a quick overview of the study published in the Journal of Rural Health.

View the Study Summary here.

About PRISM

PRISM is a collaborative of State Primary Care Offices, Offices of Rural Health, Area Health Education Centers and other organizations that have partnered to collect data to identify and document outcomes to enhance the retention of clinicians.  Through its design, this collaborative approach builds shared interest, cooperation and group wisdom in best practices to promote retention among the states.

PRISM provides a standardized and state-of-the-art way for states to gather real-time data from clinicians as they serve in States’ and the National Health Service Corps’ (NHSC) loan repayment, scholarship and other incentive programs.  This retention data gathering system routinely surveys clinicians as they serve in these public programs to provide quality, consistent, real-time, convenient and ongoing data to inform the management and retention of clinicians in service programs.

PRISM is a complex, longitudinal data gathering system that incorporates the data collection, analysis and dissemination expertise of the Cecil G. Sheps Center for Health Services Research.  State offices can easily enter, track and manage retention questionnaires.

PRISM training and technical assistance is provided by 3RNET, supported through a contract with the National Rural Health Association with funds from the US Health Resources and Services Administration (HRSA). State collaborative members pay an annual fee to support enhancements to PRISM.

For more information contact Jackie Fannell