Rural Health Information Hub Latest News

CMS Releases 2022 Medicare Advantage and Part D Star Ratings to Help Medicare Beneficiaries Compare Plans

Today, the Centers for Medicare & Medicaid Services (CMS) released the 2022 Star Ratings for Medicare Advantage (Medicare Part C) and Medicare Part D prescription drug plans to help people with Medicare compare plans ahead of Medicare Open Enrollment, which kicks off on October 15. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance. Star Ratings are released annually and reflect the experiences of people enrolled in Medicare Advantage and Part D prescription drug plans. The Star Ratings system supports CMS’s efforts to empower people to make health care decisions that are best for them.

“The Medicare Advantage and Part D Star Ratings are important tools in the toolbox for beneficiaries to use as they consider Medicare coverage options,” said CMS Administrator Chiquita Brooks-LaSure. “CMS’s annual ratings deliver meaningful information about the quality of each plan to help people with Medicare make informed health care decisions.”

Medicare Open Enrollment begins October 15, 2021, and ends December 7, 2021. During this time, Medicare beneficiaries can compare coverage options like Original Medicare and Medicare Advantage, and choose health and drug plans for 2022. Medicare Advantage and Part D plan costs and covered benefits can change from year to year, so Medicare beneficiaries should look at their coverage choices and decide on the options that best meet their health needs. They can visit (, call 1-800-MEDICARE, or contact their State Health Insurance Assistance Program.

For more information on the 2022 Medicare Advantage and Part D Star Ratings, including a fact sheet, please visit:, and download the “2022 Star Ratings Data” zip file in the downloads section.

Pilot Cohort for NRHA Rural Hospital CNO Certification Program Graduates

The National Rural Health Association’s (NRHA) Rural Hospital CNO Certification Program has completed its first cohort, starting in April 2021.  The pilot cohort consisted of the following NRHA CNO-certified participants:

  • Andrea Hagist – Mahaska Health, Oskaloosa, Iowa
  • Carrie Owens – Lincoln Health, Hugo, Colo.
  • Jeremy Cannon – Kalkaska Memorial Health Center, Kalkaska, Mich.
  • Jyme Kinnard – Ochiltree General Hospital, Perryton, Texas
  • Katie Peterson – Pender Community Hospital, Pender, Neb.
  • Leslie Hackett – Covenant Hospital Plainview, Plainview, Texas
  • Lori Forneris – Nursetribe, Holstein, Iowa
  • Maegen Garner – Seminole Hospital District, Seminole, Texas
  • Megan Heath – Gordon Memorial Hospital, Gordon, Neb.
  • Nicole Thorell – Lexington Regional Health Center, Lexington, Neb.
  • Roxanne Stelle – Abraham Lincoln Memorial Hospital, Lincoln, Ill.
  • Shawn Nethery – Ward Memorial Hospital, Monahans, Texas
  • Steve Olson – Carthage Area Hospital, Carthage, N.Y.
  • SuLynn Mester – Childress Regional Medical Center, Childress, Texas
  • Mandy Graves – Lynn County Hospital District, Tahoka, Texas
  • Clay Jordan – Tri Valley Health System, Cambridge, Neb.
  • Kim Combs – Titusville Area Hospital, Titusville, Penn.
  • Kim Cicon – Penn Highlands Healthcare, DuBois, Penn.
  • Christina Peterson – Iowa Specialty Hospitals & Clinics, Clarion, Iowa
  • Lakin Lyon – Smith County Memorial Hospital, Smith Center, Kan.
  • Judy Geiger – Columbia Memorial Hospital, Astoria, Ore.
  • Jennifer Janssen – Cuero Regional Hospital, Cuero, Texas
  • Miranda Adams – Cuero Regional Hospital, Cuero, Texas
  • Kate Schaefer – Childress Regional Medical Center, Childress, Texas
  • Marlene Elliot – Coulee Medical Center, Grand Coulee, Wash.
  • Rachel Sem – Sakakewea Medical Center, Hazen, N.D.
  • Candy Detchon – Mayer’s Memorial Hospital District, Fall River Mills, Calif.

About NRHA’s Rural Hospital CNO Certification Program

Leadership makes the difference. Today’s rural hospitals and clinics have tremendous challenges and uncertainty and are closing at an unprecedented rate. One out of three rural hospitals have been identified as “at risk.” According to Alan Morgan, CEO of the National Rural Health Association (NRHA), “Leadership is the biggest predicter of rural hospital success.” The NRHA Rural Hospital CNO Certification Program was developed by successful rural hospital CNOs for rural hospital CNOs with the intent of assisting current rural hospital CNOs strengthen their leadership skills to help lead their hospital to success. An individual with this certification will immediately be recognized as someone qualified to be a nurse leader in a rural hospital with excellence.

To see our pilot CNO Cohort’s Graduation Ceremony, click here!
For more information about available programs, click here.

HHS Study Finds COVID-19 Vaccine Linked to Saving Lives for Older Americans

A new report from the U.S. Department of Health and Human Services (HHS) shows that COVID-19 vaccinations may have helped prevent hundreds of thousands of new COVID-19 infections and tens of thousands of deaths among seniors. The study shows that COVID-19 vaccinations were linked to a reduction of approximately 265,000 COVID-19 infections, 107,000 hospitalizations, and 39,000 deaths among Medicare beneficiaries between January and May 2021.

The report reaffirms the importance of COVID-19 vaccinations in saving lives and controlling the pandemic. People 65 years and older are at a higher risk of becoming severely ill or death from COVID-19, which is why it’s so important to be vaccinated.

Learn more about the COVID-19 vaccine and if you have not yet been vaccinated remember it is free and you can find a place near you by visiting

To read more about the report here.

CMS recognizes that more than 57 million Americans live in rural areas, and face several unique challenges.  And those challenges can differ dramatically among the different kinds of rural areas across the country.  Rural residents tend to be older and in poorer health than their urban counterparts, and rural communities often face challenges with access to care, financial viability, and the important link between health care and economic development.

Pennsylvania Hospital Association Releases Hospital Economic Analysis, Interactive Dashboard

The Hospital and Healthsystem Association of Pennsylvania (HAP) released a new economic impact report based on an analysis of 2020 data.

This analysis examines how, even during the COVID-19 pandemic, the hospital community continued its vital economic role regionally and across the state. It assesses the effects of hospital spending and employment, documenting that hospitals remain among the largest employers across the commonwealth. It also recognizes the role hospitals play in attracting federal research dollars and the broader benefits hospitals provide by training tomorrow’s clinicians, providing charity and unreimbursed care.

Findings from this paper should be used to inform policy discussions surrounding topics that affect long-term hospital sustainability. This includes, but is not limited to, hospital funding, promoting health equity, prior authorization reform, telemedicine service reimbursement, credentialing process streamlining, adequate Quality Care Assessment support, and bolstering Pennsylvania’s health care workforce.

The overview, full report, and interactive dashboard can be accessed here.

CareQuest Addresses Oral Health of Low-Income Populations

The CareQuest Institute for Oral Health published “Addressing Oral Health of Low-Income Populations: A Call to Action” in the Journal of the American Medical Association (JAMA) Network Open. The article underscores the importance of strengthening Medicaid benefits to include dental coverage. The commentary was in response to the article and study that suggested that the combination of Medicaid expansion and addition of Medicaid dental benefits not only improved coverage and access to dental care among low-income adults but also produced significant improvements in clinical indicators of oral health.

Click here to read the article.

Health Workforce Research Centers Release Annual Report

The Health Resources and Services Administration- (HRSA)- sponsored Health Workforce Research Centers (HWRC) released their annual report. The report includes information on a variety of resources for physical, behavioriral, and oral health. See the image below from the report, depicting specific requirements in state laws and regulation that impact the ability of dental hygienists to apply silver diamine fluoride (SDF).

Click here to download the report.

Reminder to Pennsylvania Providers: Enroll in PA 211 Database

Every day, clients contact 211 to access free and confidential crisis and emergency counseling, disaster assistance, food, health care and insurance assistance, stable housing and utilities payment assistance, employment services, veteran services, and childcare and family services. If you are a dental or other service provider, please consider taking five minutes to enroll on the PA 211 website to be listed as a service provider in the statewide community database.

Click here to enroll.
Click here to check your eligibility.

PA Physician General Presents Water Fluoridation Awards

Pennsylvania Physician General Dr. Denise Johnson presented water fluoridation awards on behalf of the American Dental Association (ADA), the Association of State and Territorial Dental Directors (ASTDD), and the Centers for Disease Control and Prevention (CDC) this week at the Water Works Operators’ Association of PA conference. This was the first time PA is honoring award winners in-person at the conference.

See below for a list of awardees:

 50 Year Award (50 years of continuous service):
Beaver Falls Municipal Water Authority, Reading Area Water Authority, Chester Water Authority, Red Lion Municipal Authority, Aqua Pennsylvania – Shenango Valley,
and Suez Middleton Water

Community Water Fluoridation Reaffirmation Award:
Ebensburg Borough Municipal Authority and Shippensburg Borough Water Authority

Community Initiative Award:
Meadville Area Water Authority

Water Fluoridation Quality Award:
Greenville Water Authority and Municipal Authority of the Borough of Lewistown

New Data Highlight on Z Codes Now Available

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) released a new data highlight: Utilization of Z Codes for Social Determinants of Health among Medicare Fee-for-Service Beneficiaries, 2019.

Z codes are a set of ICD-10-CM codes used to report social, economic, and environmental determinants known to affect health and health-related outcomes. Nine broad categories of Z codes represent various hazardous social, economic, and environmental conditions. Z codes can be used in any health setting and by any provider as a tool for identifying a range of issues related to education and literacy, employment, housing, ability to obtain adequate amounts of food or safe drinking water, and occupational exposure to toxic agents, dust, or radiation.

The data highlight found that among the 33.1 million continuously enrolled Medicare fee-for-service (FFS) beneficiaries in 2019, 1.59% had claims with Z codes, an increase as compared to 1.31% in 2016.

Findings include:

  • The 5 most-utilized Z codes included those for homelessness, disappearance and death of family member, problems related to living alone, problems related to living in a residential institution, and problems in relationship with spouse or partner.
  • Beneficiaries who are dually eligible for Medicare and full-benefit Medicaid were overrepresented among the top 5 Z code claims.
  • Beneficiaries in rural areas were overrepresented (39.7%) among those coded as having problems related to living in a residential institution claim.
  • Male beneficiaries who accounted for 45.4% of the overall FFS population represented 67.1% of those with a homelessness claim.
  • Black and Hispanic beneficiaries accounted for 8.8% and 5.9% of the overall FFS population, respectively, but represented 24.8% and 9.2%, respectively, of those with a homelessness claim.
  • The top 5 provider types representing the largest proportions of those assigning Z codes to claims were family practice physicians, internal medicine physicians, nurse practitioners, psychiatry physicians, and licensed clinical social workers.

Using social determinants of health Z codes can enhance quality improvement activities, track factors that influence people’s health, and provide further insight into existing health inequities.

Looking for more information on Z Codes? Review the guide Using Z Codes: The Social Determinants of Health (SDOH) Data Journey to Better Outcomes, which provides step-by-step instructions for healthcare professionals on how to use Z codes.

For more CMS OMH health equity-focused resources, visit:

COVID Vaccine Mistrust is Fueling a Spike in Rural Deaths. Here’s What’s Fueling the Mistrust

By Kerry Thomson, Executive Director of the Center for Rural Engagement at Indiana University

When we think of the painful toll of Covid-19, we often picture urban scenes: lines for tests, overflowing hospitals, refrigerated trucks serving as makeshift morgues. Yet, staggering new data shows that the death rate from Covid in rural areas is now double what it is in urban ones. You would think that fact, coupled with medical professionals pleading with people in rural America to get vaccinated, would lead more to get their shots. Yet, people in rural states lead the list of those who remain unvaccinated, putting themselves and others at risk.

Instead of blaming them for their vaccine hesitancy, we need to acknowledge that we all share responsibility for the crisis.

It’s enough to make increasingly angry vaccinated people shout: “Why won’t you listen to your doctor?”  To which, I respond: “What if they don’t have one?”

Many in rural America aren’t vaccinated because two pernicious forces — the implosion of the rural health care system and the decay of local news — have left them with limited sources of information. That has allowed them to become prey to misinformation and overconfident quacks.

Instead of blaming them for their vaccine hesitancy, we need to acknowledge that we all share responsibility for the crisis. We all failed to invest in the doctors and nurses who could be trusted sources of accurate information for rural patients. We all failed to provide adequate funding for rural hospitals and local clinics. We all failed to help a rural health system adapt, instead of decay.

Read more.