Rural Health Information Hub Latest News

New Resource from CMS OMH – Rural Crosswalk: CMS Flexibilities to Fight COVID-19

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) has released a Rural Crosswalk: CMS Flexibilities to Fight COVID-19 (also attached via Connect). This new resource documents all current COVID-19-related waivers and flexibilities issued by CMS that impact Rural Health Clinics, Federally Qualified Health Centers, Critical Access Hospitals, rural hospitals generally, and long-term care facilities, and describes the significance of each provision for these rural providers and facilities. This new resource can be found here:…

The Crosswalk is divided into six sections for easy navigation:

  • Telehealth
  • CMS Hospitals Without Walls
  • Patients Over Paperwork
  • Workforce
  • Payment
  • Additional guidance

CMS OMH created the Rural Crosswalk to boost providers’ understanding of the many CMS regulatory waivers and new rules that have been issued in response to COVID-19 since the start of the emergency declaration.

For more information and resources for rural providers, please visit You can also contact us at or reach out to one of the CMS Regional Rural Health Coordinators.

340B Hospitals Report New Data on How They Use Savings to Help Patients with Low Incomes and Rural Communities

Hospitals participating in the 340B drug pricing program report new data on how they use their savings from prescription drug price discounts to maintain or expand patient care, to support uncompensated care for patients living with low incomes, and in the case of rural hospitals, to keep their doors open in an era of frequent closures.

A survey of nearly 500 hospitals participating in 340B found that their annual program savings vary based on hospital size. For small, rural hospitals, median savings were $564,000, while disproportionate share (DSH) hospitals had median savings of $8.9 million. The largest savings were reported by a relatively small number of children’s hospitals, with a median of $12.6 million.

Hospitals that qualify for 340B status can obtain discounts on many outpatient prescription drugs to treat their patients with cancer, heart disease, diabetes, and other conditions. These hospitals use those savings to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. The program, created in 1992, uses no tax dollars to support the care being provided. Savings come from discounts provided by pharmaceutical manufacturers.

“Congress created 340B for a specific reason, to make sure safety-net hospitals, health centers, and clinics are there to care for patients who cannot afford their care,” said Maureen Testoni, president and CEO of 340B Health, which conducted the survey. “340B hospitals are on the front lines of caring for people in need, whether in the face of global pandemic or chronic disease, so that patients can live fuller lives.”

Hospitals also report that they use 340B savings to dispense free or low-cost drugs, combat the opioid epidemic, and improve health outcomes for their patients, including though improved medication adherence, increased access to care, and reduced readmissions.

340B is particularly critical to rural hospitals. According to the U.S. Census Bureau, one in five Americans live in rural areas, many of which are sparsely populated and far from urban centers. Over the past decade, more than 120 rural hospitals have closed. Nearly three-quarters of small critical access hospitals (CAHs) report that 340B savings are a key element to maintaining their operations. More than a third of CAHs reported using their 340B benefits to support telemedicine programs. More than half (57%) of rural hospital respondents reported that a loss of 340B savings could force them to close.

More broadly, hospitals reported that a loss of some or all of their 340B savings would force them to reduce their provision of uncompensated care, including the free or low-cost drugs they offer to patients who can’t otherwise afford them. Hospitals also indicated that they likely would have to cut back certain clinical areas, including treatment for cancer, diabetes, mental health and substance abuse, and HIV/AIDS, if their 340B savings were scaled back.

“This report provides more clear evidence of the critical role 340B savings play in providing care for patients in need. Hospitals are fulfilling the mission set out by the enactment of the 340B statute in documented ways that contribute to the continuing, broad, bipartisan support for the program,” Testoni said.

Read the report and see our infographic summarizing the key findings.

Tracking COVID-19 Cases in Appalachia

As of August 13, 2020, at 10:30 am, there were 280,626 cumulative cases throughout Appalachia and 6,033 cumulative deaths.

As of August 12, 2020, there were 280,021 cumulative cases in Appalachia and a seven-day rolling average of 3,950 new cases per day (down from 4,225 a week ago) and 78 new deaths per day (up from 64 a week ago. The presence of COVID-19 has been confirmed in all 420 counties in the Appalachian Region.

Drawing on data from the Johns Hopkins University, COVID-19 Cases in Appalachia maps COVID-19’s spread in the Region in relation to the rest of the country. More county-level information regarding COVID-19 cases – including demographic data snapshots of confirmed cases and deaths in relation to hospital bed counts, population and businesses, and categories of people at risk for COVID-19 – can be found using this searchable database. By hovering over each statistical icon, users can learn more about the supporting data. COVID-19 related data is updated daily.

Road Project Expands Hospital Access in Coaldale, PA

St. Luke’s Miners Campus Hospital in Coaldale, Pennsylvania is one of the few hospitals with a Primary Stroke Center, Accredited Chest Pain Center, Level IV Trauma Center, and CMS 4 star rated hospital, in Schuylkill County, Pennsylvania. In partnership with ARC and the Federal Highway Administration, the Pennsylvania Department of Community & Economic Development (PA DCED), and the Northeastern Pennsylvania Alliance (NEPA), St. Luke’s Miners Campus Hospital will foresee construction to improve access to the building including narrowing and repaving connecting roadways to reduce speeds, building a pedestrian walking route and installing a transit bus shelter. In addition to making the hospital easier and safer to access, the project will prepare 15 acres of adjoining, undeveloped land for the construction of two new buildings for medical offices and clinical services. These improvements are projected to create and/or retain nearly 400 jobs.

“We are growing and are excited to work with Coaldale Borough, NEPA and the Appalachian Regional Commission to improve access to our small rural hospital. This project is so important as more people are coming from all over northeastern Pennsylvania for St. Luke’s Miners Campus’ nationally recognized care and highly engaged clinical teams,” said Wendy Lazo President of St. Luke’s Miners Campus.

New Brief: Addressing Opioid Use in Rural Communities

The opioid epidemic continues to have a devastating impact in rural areas disproportionately affected by a lack of infrastructure to provide treatment for opioid use disorders (OUDs). Critical Access Hospitals (CAHs), often the hubs of local systems of care, can play an important role in addressing OUDs. Using a substance use framework developed for the Flex Monitoring Team’s earlier study of CAH substance use strategies, this brief highlights strategies adopted by CAHs to combat opioid use in their communities. It also identifies resources that State Flex Programs can use to support CAHs with this challenging population health issue.

The report may accessed here or on the Flex Monitoring Team website.

Census 2020 Updates

U.S. Census Bureau Director, Steven Dillingham, recently provided updates to its operational plans including hiring employees to accelerate the delivery of data by the December 31, 2020 deadline.

Census taker will begin to interview households in select areas that have not yet responded to the 2020 Census. For Pennsylvania, those areas include areas managed by the following area census offices: Allentown, Norristown, Philly Franklin, Philly Penn, and Reading.

The U.S. Census Bureau has begun to email households in low response areas to encourage their response. Millions of emails are planned to be sent through September.

New data are available from the Household Pulse Survey, the result of an effort by the Bureau and other federal statistical agencies, to document trends in how individuals are affected by the pandemic.

Follow response rates to the 2020 Census with the U.S. Census Bureau’s Response Rates page. Or check out the Hard To Count 2020 tool created by SUNY’s Center for Urban Research which has a variety of other useful data in addition to response rates.

Avoid fraud and scams related to the 2020 Census by reviewing these tips from the U.S. Census Bureau.

Census 2020 Response Rates

The figure below, produced by the CUNY Mapping Service at the Center for Urban Research, CUNY Graduate Center, shows the difference between the current 2020 Census response rate and the 2010 Census response rate. See attached document for higher resolution image. While Pennsylvania, has fewer red counties, representing differences of 10 percentage points or more, than some other states, it does have five counties that fall within this range, including: Cameron, Jefferson, Montour, Philadelphia, and Tioga.


As of the end of July, Pennsylvania ranks 17th in the nation for its current 2020 Census response rate (66.0%). The five counties with the lowest response rates in Pennsylvania include: Forest (25.9%), Sullivan (30.6%), Pike (38.4%), Cameron (41.9%), and Wayne (45.7%). Those with the highest response rates include Bucks (75.3%), Lancaster (74.7%), Chester (74.6%), Montgomery (74.0%), and Cumberland (73.5%).

For more information on response rates, visit:

CDC Releases Provisional Overdose Mortality Data During the COVID-19 Pandemic

The Centers for Disease Control and Prevention (CDC) released provisional data showing a 6.6% increase in provisional drug overdose mortality for the 12 months ending in January 2020; this is compared to an increase of 4.8% and 3.0% for the 12 months ending in December 2019 and November 2019, respectively. Deaths involving synthetic opioids, cocaine, and psychostimulants with abuse potential (including methamphetamine) continue to rise when compared to the previous year. Even as we pour time, treasure, and talent into addressing the COVID-19 pandemic, there is still important work to do on the opioid crisis that has ravaged lives and communities across the county, especially now as we are also dealing with the COVID-19 pandemic that could markedly affect our nation’s mental health and risk of substance use. This provisional data comes as the CDC also releases a Morbidity and Mortality Weekly Report (MMWR) on Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic in the U.S. from June 24-30, 2020. Communities have faced mental health challenges related to COVID-19–associated morbidity, mortality, and mitigation activities.

To Fight Pandemics, We Need Rural Hospitals

Since 2010, 130 rural hospitals have closed across the country and this crisis has only been exacerbated by the COVID-19 pandemic. NRHA has led the fight in getting Congress to provide relief to rural America whose older populations are being hit hard by the virus. Sustainable relief in the form of eliminating cuts to Medicaid will be crucial to the survival of rural hospitals in and after the pandemic. Eased restrictions on telemedicine must also be made permanent so that senior citizens in rural areas have better accessibility to care. The virus is spreading rapidly in rural areas where the meatpacking industry is located, and there are fears that the vulnerable population here will be especially hard hit.