Rural Health Information Hub Latest News

The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S. 

Monitoring the rural and urban supply and distribution of clinicians who provide obstetrical (OB) services is important for identifying areas that may lack access to OB care and identifying solutions. A new brief, produced by the Washington, Wyoming, Alaska, Montana, and Idaho Rural Health Research Center (WWAMI), on the obstetric care workforce shortages describes the supply and geographic distribution of four types of OB care clinicians – obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians – using data from the 2019 National Plan and Provider Enumeration System and the American Board of Family Medicine. They monitor rural and urban supply and distribution of physicians who provide OB services by linking to county level Urban Influence Codes (UICs), and provide estimates of each clinician type per 100,000 women of child-bearing age (15 through 49 years), describing supply and distribution for rural versus urban counties and among rural counties, micropolitan versus non-core counties. Their findings reveal that significant disparities exist between rural and urban areas in the supply of clinicians who provide OB services, such as more rural areas without Obstetrical Service Clinicians, with less Obstetricians per 100,000 women of child bearing age, few advanced practice Midwives, etc.

NRHA Appropriations Update 

According to the Coalition for Health Funding, the Senate Appropriations Committee (SAC) had intended to meet this week to begin marking up the 12 FY 2021 bills. However, partisan fights over what should be included, specifically but not limited to coronavirus and criminal justice funding matters, have caused the SAC to pause consideration of the FY 2021 bills. Congress is internally debating if the spending levels set in the Bipartisan Budget Act of 2010, particularly the limit set for non-defense discretionary programs, are sufficient to meet the nation’s needs in the era of COVID-19. The Senate appropriations process may be stalled until September (after the August recess). Meanwhile, House Appropriations Committee (HAC) Chair Nita Lowey (NY-17) recently advised Members that subcommittee and full committee markups of the 12 federal appropriations bills will take place the weeks of July 6th and July 13th and House consideration of the FY 2021 appropriations bills are then expected the weeks of July 20th and July 27th. While progress on FY 2021 appropriations is encouraging, crises, elections, and politics will make enactment of these spending bills unlikely before September 30th—the end of the federal fiscal year.

Reps. Thompson and Butterfield Introduce the HEALTH Act 

Representatives Glenn ‘GT’ Thompson (PA-15) and G.K. Butterfield (NC-01) introduced the bipartisan Helping Ensure Access to Local TeleHealth, or the HEALTH Act, which will codify Medicare reimbursement for community centers and rural health clinics for telehealth services. Rep. Thompson remarks that, “The HEALTH Act will cut red tape and provide community health centers and rural health clinics the ability to offer these vital services to their patients on a more permanent basis.” Rep. Butterfield further states, “I am proud to join Congressman GT Thompson in introducing this vital legislation to address the telehealth needs of Medicare patients during this pandemic and beyond.” NRHA supports the passage of this bipartisan bill because telehealth has proven vital during COVID-19 and remain necessary in the future as well. However, issues like poor bandwidth internet connectivity and access to appropriate technology for rural providers and their patients must be addressed.

Increasing Rural Health Access During the COVID-19 Public Health Emergency Act 

Representatives Xochitl Torres Small and Dan Newhouse (R-WA) introduced the bipartisan bill, Increasing Rural Health Access During the Covid-19 Public Health Emergency Act. By investing $50 million in rural communities, this bill, introducing a pilot grant program, would help expand access to telehealth in rural areas by increasing remote patient monitoring. Senators Martha McSally (R-AZ) and Dan Jones (D-AL) also introduced the bill to the legislature, stating that it will aid rural health clinics, community health centers, community behavioral health centers, long-term care facilities, and rural hospitals. According to McSally, “Provider shortages, especially among specialists who care for Americans living with chronic conditions, are painfully evident in rural America and on tribal lands, where the prevalence of chronic conditions like diabetes and hypertension is often higher than the rest of the country.” She advocates that increasing access to telehealth in rural areas will “remedy these shortages” by allowing vulnerable populations to benefit from health care remotely.

New Analysis Highlights Rural and Racial Disparities in Accessing COVID-19 Testing

According to a new Surgo Foundation analysis: Nearly two-thirds (64%) of all rural counties in the United States do not have a COVID-19 testing site, leaving 20.7 million people in a ‘testing desert.’ Of the rural population without a COVID-19 testing site, 8.5 million (41% of this population, 20% of the total rural population) live in highly vulnerable areas geographically concentrated in four states: Kentucky, Mississippi, North Carolina, and Arkansas. Drilling deeper, 1.27 million rural Black Americans (35% of the rural black population) live in highly vulnerable testing deserts. Compared to the average rural American, Black Americans are 1.7 times more likely to live in these areas. And rural Black Americans are 2.7 times as likely to be living in a vulnerable area with a lack of testing sites and increasing deaths, compared to the average rural American.

Clarification on RHC and FQHC Cost Sharing Announced

On July 6, CMS updated MLN Matters Article SE20016 to clarify how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can apply the Cost Sharing (CS) modifier to preventive services furnished via telehealth. This update includes:

  • Additional claim examples
  • New section on the RHC Productivity Standard

COVID-19 Crisis Fire Company and EMS Grant Program Funding Available in Pennsylvania

The Pennsylvania Emergency Health Services Council has announced that COVID-19 Crisis Fire Company and EMS Grant Program funding is now available.  Organizations are urged to access the following links to check eligibility and for application details.

Providers Urged to Submit Data by July 20 Deadline for Medicaid and CHIP Relief Funds

HHS recently announced the additional distributions from the  Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs.  HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution.  Eligible providers must submit their data by July 20.

Before applying through the Enhanced Provider Relief Fund Payment Portal, applicants can watch a webinar about the application process for Medicaid/CHIP providers.  An additional webinar is scheduled for Wednesday, July 8 at 4:00 pm EDT, which you can register for here.  I also encourage you to review the most recent FAQs on the program and the Medicaid/CHIP targeted distribution here.