- Traveling Nurses Help Rural Hospital Staffing Issues, But at a Cost
- Rural Americans Share Personal Stories to Inspire Confidence in COVID-19 Vaccines in Local Communities and Nationwide
- Study Finds Family Physicians Deliver Babies in Majority of Rural Hospitals
- State of Decay: Rural Areas in America Are at a Tooth Loss
- Rural Covid Infections Decline for Third Straight Week
- Rural U.S. Hospitals Stretched Thin After Nurse Shortage Exacerbated by the Pandemic
- New Vaccinations in Rural Counties Decline for Second Week
- CMS Clarifies Medicare Recognition of Interstate Licensure Compacts
- Making History, Despite History: The First Tribally Affiliated Med School Takes Flight in Oklahoma
- COVID-19 Cases and Deaths by Race/Ethnicity: Current Data and Changes Over Time
- The Surge of Telehealth During the Pandemic is Exacerbating Urban-Rural Disparities in Access to Mental Health Care
- Rural Infections Decline by 20%; Number of Covid Deaths Falls Slightly
- Rate of New Vaccinations Falls by 20%
- Telehealth has Rapidly Expanded. But Companies are Still Struggling to Reach Rural Populations
- Covid Is Killing Rural Americans at Twice the Rate of Urbanites
Raising awareness about health insurance options for Pennsylvania families is necessary so children do not go without health insurance. Keeping children covered is more important than ever during the COVID-19 pandemic. Providers can encourage patients and their families to enroll in public health insurance options like Medicaid and the Children’s Health Insurance Program (CHIP). Providers can also share the family flyer with their patients which instructs families about how they can sign up for health insurance.
Telehealth has become a path to provide safe, efficient, and accessible dental care during the COVID-19 pandemic. A survey of nearly 3,000 dentists conducted by the DentaQuest Partnership reveals that the oral health care system is ready to implement teledentistry as a viable tool to deliver preventative care, not only during the pandemic, but long-term. The results can be narrowed down by teledentistry usage type, state, financial considerations, and opportunities for growth.
Agency outlines flexibilities to maximize Acute Hospital Care at Home, Ambulatory Surgical Centers to decompress hospitals treating COVID-19 patients
The Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country. These flexibilities include allowances for safe hospital care for eligible patients in their homes and updated staffing flexibility designed to allow ambulatory surgical centers (ASCs) to provide greater inpatient care when needed. Building on CMS’s previous actions to expand the availability of telehealth across the nation, these actions are aimed at allowing health care services to be provided outside a hospital setting while maintaining capacity to continue critical non-COVID-19 care, allowing hospitals to focus on the increased need for care stemming from public health emergency (PHE).
“We’re at a new level of crisis response with COVID-19 and CMS is leveraging the latest innovations and technology to help health care systems that are facing significant challenges to increase their capacity to make sure patients get the care they need,” said CMS Administrator Seema Verma. “With new areas across the country experiencing significant challenges to the capacity of their health care systems, our job is to make sure that CMS regulations are not standing in the way of patient care for COVID-19 and beyond.”
Acute Hospital Care at Home
In March 2020, CMS announced the Hospitals Without Walls program, which provides broad regulatory flexibility that allowed hospitals to provide services in locations beyond their existing walls. Today, CMS is expanding on this effort by executing an innovative Acute Hospital Care At Home program, providing eligible hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes. This program was developed to support models of at-home hospital care throughout the country that have seen prior success in several leading hospital institutions and networks, and reported in academic journals, including a major study funded by a Healthcare Innovation Award from the Center for Medicare and Medicaid Innovation (CMMI).
The program clearly differentiates the delivery of acute hospital care at home from more traditional home health services. While home health care provides important skilled nursing and other skilled care services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.
To support these efforts, CMS has launched an online portal https://qualitynet.cms.gov/acute-hospital-care-at-home to streamline the waiver request process and allow hospitals and healthcare systems to submit the necessary information to ensure they meet the program’s criteria to participate. CMS will also closely monitor the program to safeguard beneficiaries by requiring hospitals to report quality and safety data to CMS on a frequency that is based on their prior experience with the Hospital At Home model.
Ambulatory Surgical Center Flexibility
As part of Hospital Without Walls, CMS also previously announced regulatory flexibility that allowed ASCs – facilities that normally provide same-day surgical care – the ability to be temporarily certified as hospitals and provide inpatient care for longer periods than normally allowed, with the appropriate staffing in place. ASCs are normally subject to a requirement that patients only remain in their care for less than 24 hours or require admission to a regular hospital.
CMS is announcing an update to that regulatory flexibility, clarifying that participating ASCs need only provide 24-hour nursing services when there is actually one or more patient receiving care onsite. The program change provides ASCs enrolled as hospitals the ability to flex up their staffing when needed and provide an important relief valve in communities experiencing hospital capacity constraints, while not mandating nurses be present when no patients are in the ASC. The flexibility is available to any of the 5732 ASCs throughout the country seeking to participate and will be immediately effective for the 85 ASCs currently participating in the Hospital Without Walls initiative. CMS expects this flexibility will allow these and additional ASCs enrolled as hospitals to serve as an added access point that will allow communities to maintain surgical capacity and other life-saving non-COVID-19, like cancer surgeries. Allowing these types of treatments to occur in designated ASCs enrolled as hospitals while hospitals are managing any surges of COVID-19 would allow vulnerable patients to receive this needed care in settings without known COVID-19 cases.
The announcement builds upon the critical work by CMS to expand telehealth coverage to keep beneficiaries safe and prevent the spread of COVID-19. CMS has expanded the scope of Medicare telehealth to allow Medicare beneficiaries across the country to receive telehealth services from any location, including their homes. CMS also added over 135 services such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, that could be paid when delivered by telehealth. The flexibilities announced today, and the aggressive action taken by CMS to remove barriers to telehealth, ensure patients and providers have options when receiving and providing care given the challenges and additional stress placed on hospitals and the health care system during the COVID-19 PHE.
To view the Acute Hospital Care At Home initiative and application, please visit: CMS’: https://qualitynet.cms.gov/acute-hospital-care-at-home
For more on the ambulatory surgical center flexibilities, please see: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-processing-attestation-statements-ambulatory-surgical-centers-ascs-temporarily-enrolling
To view comments from health systems participating in the Acute Hospital Care at Home, please visit: https://www.cms.gov/files/document/what-are-they-saying-hospital-capacity.pdf
The CDC has established a new MMWR reporting feature, “COVID-19 Stats.” This edition of COVID-19 Stats highlights rural-urban disparities in COVID incidence rates.
For more information on COVID-19 incidence by Urban-Rural classification, click here.
Additionally, CDC Science Clips recently featured articles on rural health in conjunction with the observance of National Rural Health Day.
The HRSA Rural Residency Planning & Development (RRPD) Technical Assistance Center (RRPD-TAC) recently compiled a state by state summary on the 37 grant programs that are developing new rural residency programs across 26 states. Please see the program summaries by downloading here.
The RRPD program is a multi-year cross-bureau collaboration between HRSA’s Federal Office of Rural Health Policy and the Bureau of Health Workforce that provides start-up funding for the development of new, accredited, and sustainable rural residency programs in family medicine, internal medicine, and psychiatry. In FY19, HRSA awarded $20M to organizations across 21 states to support the planning and development costs of establishing sustainable residency program, while obtaining accreditation through the Accreditation Council of Graduate Medical Education (ACGME). More recently, HRSA awarded over $8M to 11 new grant recipients up to $750,000 per award in August 2020.
Awarded in FY18, the RRPD-TAC provides resources and tools to support RRPD grant recipients and other organizations interested in developing new graduate medical education programs in rural communities. To learn more about the RRPD-TAC and to sign up for resources, please visit www.ruralGME.org or contact info@ruralGME.org.
For questions related to the RRPD program, please contact Sheena Johnson (Program Coordinator) at email@example.com.
A new publication targeting our provider community, “Stay Protected – Get a Flu Shot” will be available for order on December 1. And best of all, there is no charge! In order to request your copies, simply set up an account on the CMS Product Ordering page here: https://productordering.cms.hhs.gov/pow/?id=pow_login; and once approved, you can order the publication by either searching by the title (above), or entering pub. no. 12115. General delivery time is approximately one week.
The U.S. Department of Agriculture (USDA) announced the official launch of the AskUSDA Contact Center program. The AskUSDA Contact Center will serve as the “one front door” for phone, chat, and web inquires, transforming how the public interacts with USDA and providing an enhanced experience for the public.
Prior to the creation and implementation of AskUSDA, members of the public had to navigate dozens of phone numbers and had no chat function or online platform for self-service, creating frustrations and inefficiencies. AskUSDA was created to make USDA more responsive to the public by providing a single destination for phone, chat, and web inquiries. Whether it’s talking to a USDA representative via phone, chatting with a live agent on our website, or communicating with USDA via e-mail, the public will have streamlined access.
The launch of AskUSDA delivers a centralized contact center that offers customer service and consistent information for the public. With over 29 agencies and offices, USDA’s mission impacts every single person in the U.S. and hundreds of millions around the globe. AskUSDA assures that farmers, researchers, travelers, parents, and more have efficient access to the information and resources they need.
AskUSDA is set up to handle common questions across programs that service a variety of audiences. For example, customers who may have basic questions about USDA’s nutrition services can be assisted across phone, e-mail, and web chat by trained AskUSDA representatives, and customers who may have complicated questions about loan programs can be quickly connected to agency experts. AskUSDA also hosts over five thousand articles for a self-service option to help with more common questions such as food safety inquiries or pet-travel guidance.
Over the course of its pilot program, AskUSDA successfully assisted with over 93,000 citizen inquiries, and the AskUSDA website resulted in over 1.4 million knowledge article page views. USDA looks forward to continuing to implement this enhanced best in class contact center across the Department.
The public can contact AskUSDA by phone at (833) ONE-USDA with representatives available 9:00am-5:30pm EST weekdays. The website (https://ask.usda.gov/) is available 24/7 and includes live chat agents available 10:00am-6:00pm EST on weekdays. Inquiries can also be sent via email at any time to firstname.lastname@example.org.
Advancing Cancer Prevention Practice Facilitation Work in Rural Primary Care During COVID-19, Dannell Boatman, Susan Eason, Mary E. Conn, Summer Miller, & Stephenie Kennedy-Rea
COVID-19 and Opioid Use in Appalachian Kentucky: Challenges and Silver Linings, Rachel Vickers-Smith, Hannah L.F. Cooper, & April M. Young
Improving Access to Treatment for Opioid Use Disorder in High-Need Areas: The Role of HRSA Health Centers, Michael Topmiller, Jennifer Rankin, Jessica L. McCann, Jene Grandmont, David Grolling, Mark Carrozza, Hank Hoang, Josh Bolton, & Alek Sripipatana
In Their Own Words: How Opioids Have Impacted the Lives of “Everyday” People Living in Appalachia , Patricia Nola Eugene Roberson, Gina Cortez, Laura H. Trull, & Katherine Allison Lenger
Qualitative Analysis of Maternal Barriers and Perceptions to Participation in a Federal Supplemental Nutrition Program in Rural Appalachian North Carolina , Sydeena E. Isaacs, Lenka H. Shriver, & Lauren Haldeman
Leveraging Electronic Health Records Data for Enhanced Colorectal Cancer Screening Efforts, Adam D. Baus, Lauren E. Wright, Stephenie Kennedy-Rea, Mary E. Conn, Susan Eason, Dannell Boatman, Cecil Pollard, Andrea Calkins, & Divya Gadde
Review & Special Articles
The Landscape of Connected Cancer Symptom Management in Rural America: A Narrative Review of Opportunities for Launching Connected Health Interventions , Ming-Yuan Chih, Anna McCowan, Sadie Whittaker, Melinda Krakow, David K. Ahern, Eliah Aronoff-Spencer, Bradford W. Hesse, Timothy W. Mullett, & Robin C. Vanderpool
Media Reviews & Reports
Notes from the Field
Rural Appalachia Battling the Intersection of Two Crises: COVID-19 and Substance Use Disorders, Margaret Miller, Rebekah Rollston, Kate E. Beatty, & Michael Melt
The Centers for Medicare & Medicaid Services (CMS) consulted with the Centers for Disease Control and Prevention to create training modules for basic infection control and prevention. The site also includes modules for management that address larger, institution-wide issues such as implementing telehealth, emergency preparedness, and vaccine delivery.
Starting December 1, Medicare.gov will compile the eight online tools to compare providers, such as Hospital Compare, Nursing Home Compare, and Physician Compare, into one place called Care Compare. It provides the same information but with a new, streamlined design. The Centers for Medicare & Medicaid Services urges providers to update hyperlinks on public-facing websites to the eight original care tools, so patients are directed to the new Care Compare.