- 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
Support for the Rural ACO Improvement Act Builds
The Rural ACO Improvement Act (S.2648) is gaining momentum on Capitol Hill. The recently introduced Senate bill would revise the Medicare Shared Savings Program benchmarking process and level the playing field for rural accountable care organizations. NRHA supports and applauds the legislation as a critical step to ensure all providers, regardless of zip code, are able to benefit from the program. We are proud that other associations with vested interested in the future of rural health care, such as AAFP, are joining us in supporting this meaningful rural health legislation.
Several Hospital Associations in Rural States Support a Senate Finance Rural Health Package
Rural hospital leaders nationwide are urging lawmakers to respond to the rural health care crisis. As rural hospitals are left with tough choices, like shutting down their obstetric unit, policy changes are necessary. New reporting claims that several state hospital associations are in support Congress enacting legislative fixes to ensure the sustainability of rural hospitals. The various state hospital associations support a rural health package with NRHA-backed solutions, such as allowing struggling rural PPS hospitals to convert to CAHs, and a long-term solution of a new payment model. We look forward to working alongside these associations as we urge Congress to act.
NRHA Appropriations Watch Update
During the week of October 28, 2019, the Senate appropriators passed their four-bill minibus focused on domestic spending, yet they have not start debating the second minibus, which contains the L-HHS spending measures. According to Politico, the debate was postponed by Senate Democrats who believe that the 302(b) allocation for the L-HHS bill is too low. NRHA would also like to see more robust funding, particularly for rural health priorities, in the Senate’s version of the L-HHS bill, but we understand that as the appropriations process is postponed, another Continuing Resolution is likely to be employed to ‘buy’ time. However, there is support from congressional leaders and the White House to have the appropriations bills finalized before the end of the year. So, even with the impeachment inquiry underway, we remain optimistic that progress will be made on passing/finalizing federal funding measures.
Health Care Provider Deserts May Leave Patients in the Cold
Rural Affordable Care Act insurance consumers may need to travel farther for care
People with ACA health insurance may be more likely to find themselves in “artificial provider deserts,” according to new Penn State research.Image: GettyImages Adventure_Photo
UNIVERSITY PARK, Pa. — People with health insurance under the Affordable Care Act (ACA) may have access to fewer health care providers — and may also have to drive further to see them — than people with other plans, according to researchers.
In a new study — published Nov. 4 as part of the November issue of Health Affairs — researchers found that people with ACA health insurance are more likely to find themselves in “artificial provider deserts,” areas where the health care providers near a customer are not covered by their insurance plan, leaving them without access to care even though providers are nearby.
Simon Haeder, assistant professor of public policy, said this is usually not a problem for people living in cities, but it can quickly become an issue for people living in more rural areas.
“If you’re of high socioeconomic status and relatively healthy, traveling long distances for care might be easier or not be a big issue for you,” Haeder said. “But if you’re more economically disadvantaged, and if you potentially don’t speak English or have multiple medical conditions, these challenges with provider networks can have large implications for your health.”
The researchers said that after the ACA was passed, there was a lot of research done on how ACA plans compared to commercial plans, like the ones people access through their employers. Haeder said that while this previous work found that ACA plans covered fewer providers and had lower premiums, researchers did not factor in how far people had to travel to see the health care providers covered by their insurance.
Read the entire press release here.
Appalachian Hospital Merger Exposes Tension over Rural Healthcare Access
Daily Yonder, Olivia Paschal
Regulators have put in place measures they hope will protect consumers in rural Central Appalachia from harm that might result from the merger of competing healthcare systems into a regional monopoly. Some community members are skeptical.
Commentary: How Rural Areas Can Avoid Being Undercounted in the Census
Daily Yonder, Amanda Gold and Yipeng Su
Will rural America gain population in the next Census? Part of that depends on how well rural people get counted. With billions of dollars and political representation on the line, rural places have a lot of reasons to prepare for the 2020 Census.
Legislation Seeks to Decrease Rural Maternal Deaths
Daily Yonder, Liz Carey
The maternal death rate is 60% higher in ru
ral areas than central parts of metropolitan areas. A bill introduced by a member of Congress from New Mexico seeks to close the gap.
As pregnancy-related deaths in rural areas climb, federal lawmakers hope to reverse the trend with legislation that will attract more healthcare providers to rural areas and identify the causes of pregnancy-related deaths.
In September, U.S. Representative Xochitl Torres Small, D-New Mexico, introduced HB 4243, the Rural Maternal and Obstetric Modernization of Services Act (the Rural MOMS Act). The bill would add incentives to attract healthcare providers, fund equipment purchases, and support data collection on maternal health and morbidity in rural areas.
The U.S. ranks as one of the worst developed nations for maternal mortality, with more pregnancy-related deaths than Saudi Arabia and Kazakhstan. Rural parts of the U.S. have 60% higher mortality rates, according to 2015 data from the Centers for Disease Control (CDC). The report says the mortality rate in large central metropolitan areas was 18.2 per 100,000 live births, compared to 29.4 per 100,000 live births in the most rural areas.
In May, Seema Verna, the director of the Center for Medicare and Medicaid Services, said in her statement to the National Rural Health Association Conference in Atlanta that maternal health was one of her department’s top priorities.
“Maternal health is a growing concern in the country,” she said in her remarks. “About 700 women die each year in the U.S. due to pregnancy or delivery complications.” Nearly two-thirds of those deaths are preventable, she said.
Rural America’s higher maternal mortality rate “is particularly concerning to me… because early in my career, I worked on a healthy babies program and here we are… decades later… dealing with the same challenges… some of which have gotten worse,” Verna said. “Statistics show that pregnancy-related mortality deaths have almost doubled in the last 30 years.”
Since Verna’s speech in May, there’s been lots of discussion and fact finding, said Katy Backes Kozhimannil, director of the University of Minnesota Rural Health Research Center.
Click here to access the full article.
Rural and Safety Net Hospitals Prepare for Cut in Federal Support
Daily Yonder, Michael Ollove
Absent action by Congress in the next couple of weeks, Dr. Michael Waldrum, CEO of Vidant Health, is going to have to figure out what medical services to deny hard-pressed communities in rural eastern North Carolina. “It runs the gamut,” Waldrum said in an interview last week. “Do we close hospitals? Do we close services within hospitals?”
With an operating margin of less than 0.5% — comparable to most other rural and safety net hospitals — and an expected loss of $7.7 million in federal money this year, which would double next year, Vidant, a multi-hospital safety net health system, could drop into the red.
Across the country, similar health systems face unwelcome choices about how to handle the coming funding cuts. They knew it was coming — the Affordable Care Act ordained a pullback in federal support for hospitals’ charitable care — and yet hospital leaders continue to hold out hope that Congress will protect the funding before the cuts go into effect in a few weeks.
“The consequences would be absolutely devastating,” said Beth Feldpush, a senior vice president for America’s Essential Hospitals, a trade association for safety net hospitals, which provide medical care for all comers, no matter their ability to pay.
Even without these prospective cuts, both safety net and rural hospitals, most of which have slim or negative operating margins, have been facing perilous economic times. At least 118 rural hospitals have closed since 2010, and a number of safety net hospitals also have shuttered or merged with for-profit health systems.
Hospitals in the 14 states that did not expand Medicaid will be hurt the worst, because they already miss out on the extra federal money that comes with expansion. “How many punches can you take?” said John Henderson, president and CEO of the Texas Organization of Rural and Community Hospitals. Texas, which has not expanded Medicaid, leads the country in the number of closed rural hospitals with 23 since 2005.
The federal money reimburses hospitals for the care they provide to people who can’t afford to pay and offsets the cost of care that hospitals provide to Medicaid patients that Medicaid does not cover. The federal cuts amount to $4 billion this year and $44 billion through 2025.
The hospitals’ total loss of funding could be even more significant because the program includes state matching funds. If state cuts are commensurate with federal ones, the overall reduction would go from $4 billion to more than $7 billion in 2020. As one example, the North Carolina Department of Health and Human Services said in an email to Stateline that if the federal cuts go into effect this year, the state would reduce its contribution by $47 million in addition to the expected $98 million cut in federal money.
Access the full article here.
Pennsylvania Title V Needs and Capacity Assessment Survey
The Pennsylvania Department of Health’s Bureau of Family Health is completing its Title V Five-Year Needs and Capacity Assessment. The assessment provides the opportunity to evaluate the health status of women, infants, children, adolescents, and children and youth with special health care needs in Pennsylvania, to identify priority health needs, and to guide state and local public health work over the next five years. The survey is for those who were not able to attend the in-person prioritization events to share input on potential priorities. Consider including the importance of oral health in responses. Complete the survey by November 14, 2019.
Dissemination of Rural Health Research: A Toolkit
The Rural Health Research Gateway released a Dissemination of Rural Health Research Toolkit to help researchers develop appropriate, timely, accessible, and applicable products as well as social media campaigns to get the word out about their work. The toolkit provides descriptions for multiple modes of dissemination, including: policy briefs, fact sheets, infographics, journal publications, poster presentations, chartbooks, PowerPoint presentations, working papers and reports, and promotional products. The toolkit, which is free and downloadable, also includes a brief discussion on the purpose of each product, which product is appropriate given the topic and intended audience, and how to format and design each product. Effective examples are provided.