- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Across the Country, Amish Populations Are on the Rise
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
- Biden-Harris Administration Takes Action to Support the Primary Care Workforce
Medicare Advantage Enrollment Update 2018
Medicare Advantage Enrollment Update 2018 
Onyinye Oyeka, MPH; Fred Ullrich, BA; and Keith Mueller, PhD
The RUPRI Center’s annual analysis of Medicare Advantage (MA) enrollment shows that there are 2.6 million nonmetropolitan beneficiaries (24.6 percent of eligible nonmetropolitan beneficiaries) enrolled in an MA plan. The number of nonmetropolitan beneficiaries enrolled in an MA plan increased by 9.5 percent from 2017 to 2018. Nonmetropolitan MA enrollment remains significantly lower than metropolitan enrollment (24.6 percent v. 36.4 percent), but in 2017 the nonmetropolitan rate of growth in MA plan enrollment was higher than the rate of growth in metropolitan areas (4.7 v. 2.0 percent).
Among MA plans, nonmetropolitan enrollment in private fee-for-service MA plans declined sharply between 2009 and 2018, while nonmetropolitan enrollment in health maintenance organizations (HMOs) and local preferred provider organizations (PPOs) saw significant increases.
Click to download a copy: Medicare Advantage Enrollment Update 2018
New Guide Brings Clarity to the Complexities of Funding Assistive Technology
As Vernon saw it, a Pennsylvania Assistive Technology Foundation (PATF) loan was the clear choice to pay for his new hearing aids, with a low interest rate, no fees, and affordable monthly payments. But sometimes finding the right funding isn’t so straightforward.
In 2018, when Vernon’s hearing had declined enough that he was missing large chunks of conversation due to background noise at work and at home, he knew he needed new hearing aids. Vernon has worked in upper management for York Water Company for 21 years. After speaking with the Office of Vocational Rehabilitation (OVR), Vernon was referred to PATF. He found the PATF interest rate was significantly lower than that of a traditional consumer loan and it was cheaper than charging the hearing aids on his credit card. He also described the monthly payments as very manageable. In Vernon’s case, with few other funding options for hearing aids, a low-interest loan made the most sense. Now, Vernon is grateful to have his hearing aids, and says that they have significantly improved his quality of life and made a drastic difference for him both at work and in his personal relationships.
But finding funding is not always so simple. In fact, one of the leading obstacles for many people in obtaining assistive technology (AT) is finding the money to pay for it. And, there are many factors to take into account when developing a funding solution. A person’s diagnosis, age, whether or not they are a student, where they live, whether or not they work, their financial situation, and their wants and needs all come into play when determining what funding options are available.
While PATF provides loans for the purchase of AT to Pennsylvanians of all ages, all income levels, and all disabilities and health conditions, we also provide free information and assistance services with the goal of helping people navigate the complex process of finding funding. Our recent publication, Funding Your Assistive Technology: A Guide to Funding Resources in Pennsylvania, includes the information we cover most frequently with callers. Chapters include topics such as what is assistive technology, tips and considerations when choosing your AT, how to develop a funding strategy, a list of funding resources, specifics on how to access AT through waivers including Community HealthChoices, and how to save safely for assistive technology using an ABLE account and a Special Needs Trust.
“This comprehensive guide is an easy-to-use resource for Pennsylvanians with disabilities, seniors, their families, service providers, and legislators. It empowers Pennsylvanians with the knowledge to gain access to 
devices and services that make independence and autonomy possible,” says Nancy Murray, President of The Arc of Greater Pittsburgh at ACHIEVA and incoming Board President at PATF.
SIM Initiative Evaluation: Model Test Year Five Annual Report
SIM Initiative Evaluation: Model Test Year Five Annual Report. In December 2018, the Center for Medicare & Medicaid Innovation released its fifth annual report on Round 1 of the CMS State Innovation Models (SIM) Initiative, which tests the ability of the governments in six states (Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont) to move providers to value-based payment. A number of these states had activities involving rural providers, including RHCs, FQHCs, and CAHs. As a key finding, states used SIM awards to provide resources to providers to enable provider participation in Medicaid alternative payment models. While most state-led models supported through SIM did not realize Medicaid savings, many results were promising considering the limited provider incentives. A 2017 guide from Rural Health Value highlights the rural focus within select SIM awards from Rounds 1 and 2.
CMS Releases Care Coordination Toolkit and Series of ACO Case Studies
CMS releases Care Coordination Toolkit and series of ACO Case Studies. The Centers for Medicare & Medicaid Services (CMS) has released a public Accountable Care Organization (ACO) Care Coordination Toolkit highlighting innovative strategies that ACOs and End-Stage Renal Disease Care (ESRD) Seamless Care Organizations (ESCOs) use to collaborate with beneficiaries, clinicians, and post-acute care partners to ensure high-quality, effective care is provided at the right time and in the right setting. CMS has also released seven case studies to describe innovative initiatives from ACOs and ESRD ESCOs on a variety of topics including engaging beneficiaries, coordinating care in rural settings, and promoting health literacy. Each case study includes detailed results and lessons learned.
Report Describes Disparities in Death By Rurality, Race, and Ethnicity
Dying Too Soon: Disparities in Death By Rurality, Race, and Ethnicity. A recently released brief by the Rural Health Research Gateway finds rural counties had higher rates of premature death (defined as years of potential life lost before age 75) than urban counties. Researchers analyzed data from the 2017 County Health Rankings, and found that counties with a majority of residents identifying as non-Hispanic Black or American Indian/Alaska Native had significantly higher rates of premature death.
Call for Manuscripts: Clinical and Translational Science to Improve Rural Health
Call for Manuscripts: Clinical and Translational Science to Improve Rural Health. Publishers of the Journal of Clinical and Translational Science have issued a call for papers for a special rural-themed edition. They are particularly interested in innovative studies with the intention of improving health care delivery and outcomes among underserved rural populations.
Increasing Number of Grandparents Raising Grandchildren
Increasing Number of Grandparents Raising Grandchildren. An analysis from the U.S. Census Bureau shows that, in 2016, there were over 7.2 million grandparents nationwide living with grandchildren under the age of 18. Reports from media outlets and nonprofit organizations suggested that a recent rise in these arrangements is due in part to the opioid crisis. To get an accurate and better understanding of what is happening, the Census Bureau examined data from its American Community Survey and data on opioid prescribing from the Centers for Disease Control and Prevention (CDC). Previous research focused on the national or state level, but levels of opioid prescriptions vary widely within states, and county level data allow for a more localized analysis. Data analysis showed a rural-urban divide in grandparents caring for grandchildren that is similar to the higher rates of overdose deaths in rural areas. In 2016, 32 percent of grandparents were responsible for grandchildren in urban areas, compared to 46 percent of grandparents in rural areas. The Census Bureau created an overview of their analysis, with methods, maps and data. See frequently asked questions answered by the Administration for Children and Families on this topic and the Funding Opportunities section below for related resources.
Podcasts: Rural Chronic Obstructive Pulmonary Disease (COPD) and its Prevalence in Rural America
The National Rural Health Resource Center (The Center) has partnered with Dr. Bill Auxier of Rural Health Leadership Radio to produce a six-part podcast series about Rural Chronic Obstructive Pulmonary Disease (COPD) and its prevalence in rural America. This series from The Center provides information about COPD, how rural providers are meeting the needs of their communities, and the importance of billing and coding appropriately while ensuring quality of care is being addressed. Each podcast features a guest with expert knowledge in COPD and rural health.
Available now: Episode 6A featuring Tracy Conroy, Valerie Roark, and Connie Wilson of Daviess Community Hospital
Listen here.
- In this episode, Tracy, Valerie, and Connie discuss Daviess Community Hospital’s pulmonary rehab program and how it started, what they have learned so far in the three years of their program, COPD from both a patient and hospital aspect, and the future of COPD care.
- Daviess Community Hospital is a 74-bed, non-profit hospital in Washington, Indiana with an extensive pulmonary rehabilitation program. Tracy Conroy serves as the chief executive officer and provides operational, financial, and strategic leadership that supports the mission and vision of Daviess. She has over 25 years of leadership experience in both acute and long-term care, population health management, outpatient clinics, and regional partnerships. Valerie Roark is a Registered Respiratory Therapist working with Daviess Community Hospital for the past 30 years as the Director of the Cardiopulmonary Department, EEG’s, Sleep Diagnostics and Cardiac and Pulmonary Rehabilitation. Connie Wilson is currently the Cardiac/Pulmonary Rehabilitation nurse. Connie has been an RN for 34 years with 28 years in Cardiac Rehabilitation and 25 years in Pulmonary Rehabilitation.
Available now: Episode 6B featuring Dr. Steve Barnett of McKenzie Health System
Listen here.
- In this episode, Dr. Barnett discusses their new cardiac rehab program, how it relates to pulmonary rehab programs, the financial risk, innovation, and resources necessary for this new program, and the future of COPD care.
- McKenzie Health System is a critical access hospital in Sandusky, Michigan. Dr. Steve Barnett, President and CEO of McKenzie Health System, began his career in health care as a respiratory therapist before receiving a bachelor’s in nursing from Oakland University in Rochester, Michigan. Dr. Barnett received a master’s degree in anesthesia and practiced that for many years before getting more involved in administrative work. Dr. Barnett eventually transitioned to the CEO role of a critical access hospital and went back and received his doctorate in health care administration.
Available Now: Episode 5 featuring Lindsay Corcoran and Laurie Daigle, Stroudwater
Listen here: http://ruralcenter.libsyn.com/the-rural-copd-podcast-episode-5
- In this episode, Lindsay and Laurie discuss the billing and coding considerations for hospitals and pulmonary rehab programs, the financial challenges hospitals with these programs face, opportunities for hospitals within their existing pulmonary rehab programs, where to find up-to-date financial resources on COPD programs, and the future of COPD care.
- Lindsay Corcoran is an accomplished senior consultant and practice management professional with over ten years of healthcare and medical office experience. At Stroudwater Associates, Lindsay focuses on supporting and sustaining healthcare access for rural communities through hospital operational improvement and affiliation strategies, and has assisted rural and community hospitals and clinics across the country to improve operational and financial performance. Results-oriented and highly organized, Lindsay is a skilled and effective communicator with medical providers, patients, and administration.
- Laurie Daigle, a senior consultant at Stroudwater Revenue Cycle Solution, is a certified professional coder with over 18 years of experience in medical insurance claim processing, medical billing software training, auditing, and healthcare financial management. She has years of experience as a manager for a national commercial payor, and extensive experience in Healthcare Management, from physician group practices to large academic institutions. She has been instrumental in the creation of Revenue Integrity resources to unify coding, billing, and compliance concerns for total and inclusive revenue cycle oversight. She has led successful initiatives to increase physician and departmental productivity, to improve business office efficiency and accuracy, and to develop policies and procedures for all areas within the Revenue Cycle.
Available Now: Episode 4 featuring Michelle Collins
Listen here: https://ruralcenter.libsyn.com/-the-rural-copd-podcast-episode-4
- Michelle Collins is a registered respiratory therapist at Lincoln Health, Franklin Memorial Hospital, and Central Maine Medical Center in Maine. Working in a rural, critical access, and tertiary hospital, Michelle has wide range of hospital experiences, a passion for cardio pulmonary medicine, and a strong concern for her patients and making sure they have access to the care that they need and the knowledge to utilize the tools at their disposal.
- Michelle discusses her definition of leadership, the history of respiratory therapy, the gaps in COPD healthcare, reimbursement issues related to COPD treatment and pulmonary rehab program closures, COPD Patient obstacles, respiratory treatment and medication, respiratory and medical training, and the hope going forward with COPD care.
Available Now: Episode 3 featuring Dan Doyle, MD
Listen here: http://ruralcenter.libsyn.com/the-rural-copd-podcast-episode-3
- Dan Doyle is a physician at New River Health Association, a Federally Qualified Community Health Center (FQHC) in West Virginia. He is a physician and consultant at Cabin Creek Health Center, another FQHC in West Virginia, Medical Director of New River Breathing Center, a Black Lung Clinic which is part of the West Virginia and Federal Black Lung Clinics Program. As of 2013, Dr. Doyle has been the Medical Director of the Grace Anne Dorney Pulmonary Rehabilitation project of West Virginia, which is a collaborative effort of Cabin Creek Health System FQHC, New River Health Association FQHC, Southern West Virginia Health System FQHC, West Caldwell County FQHC in North Carolina, Boone Memorial Hospital, and Jackson General Hospital providing community-based pulmonary rehabilitation services.
- Doyle discusses his medical background and how he initially got involved at the New River Health Association, the impact of COPD on rural communities, the lack of access to COPD care, diagnosing COPD and pulmonary function testing, the Dorney Koppel Foundation, the COPD National Action Plan, and the future of COPD care.
Available Now: Episode 2 featuring Paul Moore, DPh
Listen here: http://ruralcenter.libsyn.com/the-rural-copd-podcast-episode-2
- Paul Moore is a Senior Health Policy Advisor for the Federal Office of Rural Health Policy (FORHP) and Executive Secretary for the National Advisory Committee for Rural Health and Human Services.
- Paul discusses his background in rural health care and pharmacy, hospital administration turnover and rural recruiting challenges, the essential aspects of leadership, his professional and personal experiences with COPD, COPD’s lack of national attention and funding, COPD patient and financial statistics, the impact of COPD on rural communities, rural workforce issues with COPD, and the future of COPD care.
Available Now: Episode 1 featuring Grace Anne Dorney Koppel
Listen here: http://ruralcenter.libsyn.com/the-rural-copd-podcast
- Grace Anne Dorney Koppel is President of the Dorney Koppel Foundation, the immediate former President and a current board member of the COPD Foundation, and chair of the Advocacy and Public Policy Committee for the COPD Foundation. Grace Anne is also a patient of COPD, diagnosed in 2001.
- Grace Anne explains COPD’s prevalence, its symptoms, the stigma surrounding the disease, her personal experiences with COPD, the challenges of COPD treatment in rural communities, her work with the Dorney Koppel Foundation, and the path to success with COPD.
This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,100,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
2018 County Population Estimates Released
The U.S. Census Bureau has released estimates of the total population of counties in the nation and Pennsylvania as of July 1, 2018. The estimates show that the Southeast and South Central regions of Pennsylvania continue their growth since 2010 with Cumberland County in the lead as the fastest growing county. Click here to read the Penn State Data Center brief.
Enhancements to the CMS Mapping Medicare Disparities (MMD) Tool
The Mapping Medicare Disparities (MMD) tool provides interactive maps to illustrate disparities between subgroups of beneficiaries on key measures of health outcomes, use, and spending. CMS recently added rural and urban data to the population view, so users can view and compare across rural and urban counties. They also added four opioid use disorder indicators, including hospital and ER visits and medication-assisted therapy utilization.