Rural Health Information Hub Latest News

CMS Issues Hospital Price Transparency Final Rule

On November 15, the Centers for Medicare & Medicaid Services (CMS) finalized policy changes to the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) on price transparency requirements for hospitals. This final rule establishes requirements for hospitals, including Critical Access Hospitals (CAHs) and other rural hospitals, to make public a machine-readable file online that includes all standard charges along with discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for a set of “shoppable services.” CMS is finalizing that the effective date of the final rule will be January 1, 2021, to ensure that hospitals have the time to be compliant with these policies.

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Comments Requested: Medicaid Fiscal Accountability Proposed Rule

Last week,  the Centers for Medicare & Medicaid Services (CMS) proposed changes to state Medicaid reporting and clarifications of key definitions in order to improve payment transparency and program integrity.  Proposals in this rule focus on four payment areas: fee-for-service (FFS) supplemental provider payments; disproportionate share hospital (DSH) payments; financing for the non-Federal share of payments; and health care-related taxes and provider-related donations.  CMS seeks comment on all elements of this proposal, including whether supplemental provider payments should be capped, if there should be a separate cap for rural areas and/or HRSA-designated geographic health professional shortage areas, and whether there should be other special considerations for providers in underserved areas.

Comments are due January 17th.

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Comments Requested: Transparency in Coverage Proposed Rule

On November 15, the U.S. Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury proposed requirements for group health plans and health insurance issuers in the individual and group markets to disclose cost-sharing information upon request, to a participant, beneficiary, or enrollee (or his or her authorized representative), including an estimate of such individual’s cost-sharing liability for covered items or services furnished by a particular provider. If you are looking for information on health insurance in rural areas, you can find resources on RHIhub.

Comments are due by January 14th.

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Differences in Preventive Care Among Rural Residents by Race and Ethnicity

Rural areas have long been racially and ethnically diverse. Yet most research on rural health focuses on rural-urban disparities without an explicit focus on within-rural differences in health by race and ethnicity. In that research on rural-urban disparities in health, rural residents tend to fare worse on most measures, including mortality, health status, access to care, and use of preventive services. Less is known about whether there are differences in healthcare use among rural residents by race and ethnicity. In this from the University of Minnesota Rural Health Research center, researchers examine differences in preventive care among rural residents by race and ethnicity.  The brief can be accessed here.

Severe Maternal Morbidity and Hospital Transfer Among Rural Residents

Rural residents often travel farther to access medical care, especially obstetric care, and are more likely to be uninsured or underinsured than urban residents, contributing to higher rates of maternal morbidity. To raise awareness and increase understanding of the relationship between transfer, delivery hospital location, and severe maternal morbidity and mortality (SMMM) for rural residents, researchers at the University of Minnesota Rural Health Research Center compared data for rural and urban residents who gave birth between 2008 and 2014, to describe the relationship between a need to transfer patients for specialized care and increased risk for maternal morbidity and mortality.  The report can be accessed here.

Hospitals Selected for Small Rural Hospital Transition Project

In an effort to better prepare and assist small rural hospitals in moving from a fee-for-service and volume-based payment system to one that is drive by value and quality, the Federal Office of Rural Health Policy (FORHP) administers the Small Rural Hospital Transition Project (SHRT).  The program provides technical assistance through onsite consultations to eligible hospitals that have 49 beds or less and are located in a federally-designated persistent poverty county. Core areas of technical assistance include: 1) financial operational assessment, and 2) quality improvement projects. Last month, nine hospitals were identified through the objective review process to receive this assistance in the 2019-2020 cohort of the project.  Now in its fifth year, the SHRT program shares what’s learned on issues relevant to rural health stakeholders through the National Rural Health Resource Center.  See the full list of hospitals by clicking here.

CDC Reports on Rural Health

The Centers for Disease Control and Prevention (CDC) recently released two reports that compare health issues between metropolitan and nonmetropolitan areas of the U.S.  In Potentially Excess Deaths from the Five Leading Causes of Death, researchers found that the gap in the percentages of preventable deaths between rural and urban counties widened over the eight-year study period for cancer, heart disease, and chronic lower respiratory disease, remained relatively stable for stroke, and decreased for unintentional injuries.  A study on Lung Cancer Incidence found that rates decreased in both urban and rural areas during the ten year period from 2007-2016, but the smallest decrease occurred among females living in nonmetropolitan counties.  Click here to access the report.

Flex Program Support for Rural EMS

This document is a practical guide for ambulance services to use in their pursuit of sustaining effective and efficient delivery of patient care and developing into an integrated system with other agencies. It provides insights from agencies to promote integration to the benefit of the agencies, the staff, and, most importantly, to the patients.   The guide can be accessed here.

Rural Community Ambulance Agency Transformation Toolkit Released

The primary goal of the Rural Community Ambulance Agency Transformation Readiness Assessment and associated resources is to help ambulance agency leaders in rural America assess the state of their agency’s readiness in the core competency areas outlined below. This assessment follows the Critical Access Hospital (CAH) Blueprint for Performance Excellence, adapted specifically for rural ambulance agencies, from the Baldridge Excellence Framework for Health Care. It provides resources and tools to assist rural ambulance agency leaders to succeed with moving from volume to value in their agency’s culture and operations. Leaders are encouraged to complete the assessment periodically to monitor their progress and receive updated resources to guide their journey.  The toolkit can be accessed here.

Report Looks at Drug Industry’s Profitability

Large, brand-name drugmakers could lose $1 trillion in sales and remain profitable enough to maintain their current investments in research and development, according to a report released last week by West Health and Johns Hopkins Bloomberg School of Public Health. Sean Dickson, director of health policy at the West Health Policy Center and the lead author of the analysis, said the findings suggest drug pricing regulations would not substantially harm the industry. (Source: Healthcare Finance News, 11/14)