The Rural Hospital and Health System Affiliation Landscape – A Brief Review

Onyinye Oyeka, MPH; Fred Ullrich, BA; A. Clinton MacKinney, MD, MS; Joseph Lupica, JD; Keith Mueller, PhD

The shift from traditional fee-for-service to value-based payment requires major capital investment. Rural hospitals may be challenged by the volume-to-value transition because they may lack resources necessary to support new delivery models. As a result, many rural hospitals have considered affiliations with larger, better-funded regional health systems. However, rural hospital leaders often struggle to find the appropriate balance between local decision-making control and health system affiliation requirements. In this policy paper, we examine rural hospital and health system motivations for affiliation and present a non-exhaustive list of common affiliation structures with representative examples. Although hospital affiliation can take many forms, rural hospital leaders should develop a thoughtful strategy that weighs the benefits of affiliation versus independence.

Click to download a copy: The Rural Hospital and Health System Affiliation Landscape – A Brief Review

Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018

Abiodun Salako, MPH; A. Clinton MacKinney, MD, MS; Fred Ullrich, BA; and Keith Mueller, PhD

The Quality Payment Program (QPP) was established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The QPP consolidates existing Medicare pay-for-performance programs – the Physician Quality Reporting System, the Physician Value-based Payment Modifier, and the Medicare Electronic Health Record Incentive Program for Eligible Professionals – into a unified, cohesive program. MIPS is one of the two tracks of the QPP program and the regulatory framework for MIPs was originally provided by MACRA and CMS’s calendar year (CY) 2017 QPP final rule. This brief discusses changes to the original MIPS regulatory framework brought about by the Bipartisan Budget Act of 2018 and the CY2018 QPP final rule.

Click to download a copy: Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018

Cancer Epidemiology, Biomarkers & Prevention

Multilevel issues of place and access confront American rural populations and intensify disparities in cancer risk factors, incidence, mortality, and other outcomes. Rural cancer control is a national priority and a key target in any strategic plan to sanction research and policy initiatives to reduce cancer health disparities. CEBP presents this Rural Cancer Control Focus Issue following a recently held NCI-sponsored conference assessing the current state of rural cancer control research.



Cancer Epidemiology, Biomarkers & Prevention Editorial Office 
American Association for Cancer Research  |  Publications Division
615 Chestnut Street  |  17th Floor  |  Philadelphia, PA 19106-4404
Phone: (215) 440-9300  |  Fax: (215) 440-9337  |  E-mail:  cebp@aacr.org

Reports from the Exploring Strategies to Improve Health and Equity in Rural Communities project

The NORC Walsh Center for Rural Health Analysis is pleased to share the final report and a series of practice briefs from the Exploring Strategies to Improve Health and Equity in Rural Communities project. These documents are the result of a one-year formative research project exploring rural strengths, cross-sector partners, cultural and historical assets, and opportunities for action to improve health and equity in rural communities. We welcome and would appreciate wide dissemination of these materials through your networks and established dissemination channels. Please let us know if we can support you in doing so.

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The National Quality Forum (NQF) is Excited to Release a New Rural Health Report

The National Quality Forum (NQF) is excited to release the following rural health report: A Core Set of Rural-Relevant Measures and Improving Access to Care. This report highlights the work of the NQF-convened Measure Applications Partnership (MAP) workgroup regarding the best available quality measures and recommendations for improving access for the rural population.

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2017 American Community Survey 1-Year Estimates released today

Median household incomes Pennsylvania increased to $59,195 in 2017, up 2% from 2016 according to the latest estimates from U.S. Census Bureau’s American Community Survey. The 2017 American Community Survey 1-Year Estimates provide data on a variety of economic and demographic subjects for areas with populations of 65,000 or more.

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