Rural Health Information Hub Latest News

The Association of Rurality and Breast Cancer Stage at Diagnosis

A new study by the WWAMI Rural Health Research Center, led by David Evans, MD, found that patients from rural areas have lower breast cancer screening rates than urban patients.

The researchers found that a greater proportion of rural patients received an initial breast cancer diagnosis at a late stage compared with urban patients and that patients living in remote small rural counties had the highest rate of late-stage breast cancer at diagnosis. Breast cancer survival is known to be worse for rural patients compared to urban, and late stage at diagnosis may be a contributing factor. These disparities are longstanding and suggest areas for further research, advocacy, policy changes, and patient education.  Further study is needed to identify appropriate screening availability in rural areas and the burdens that travel presents for patients where screening is not available.

Read more about rural breast cancer screening and a companion study of rural colorectal cancer screening.

New Policy Brief on CAHs Addressing Community Social Needs

The Flex Monitoring Team has released a new policy brief summarizing characteristics of Critical Access Hospital (CAH) initiatives addressing the social needs of individuals in their communities. The brief, How Critical Access Hospitals Are Addressing the Social Needs of Rural Populations, highlights the importance of partnerships in rural communities, as well as the need for support of hospital leadership, ample funding, and dedicated staff to make these programs effective.

In tandem with the previously published report, Rural Initiatives Addressing Community Social Needs, this work can provide additional knowledge for developing population health initiatives in rural areas.

CMS Releases Updated Fact Sheet on Current Medicaid and CHIP Health Coverage Options Available for Afghan Evacuees

The Centers for Medicare & Medicaid Services (CMS) released an updated fact sheet, based on recent legislative changes, to help states and advocacy organizations understand what health coverage options are available to Afghan evacuees.

Afghan evacuees arriving in the United States will be eligible for health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), the Health Insurance Marketplace, or refugee medical assistance (RMA or other health coverage provided by the Office of Refugee Resettlement (ORR)).  RMA is provided through the Administration for Children and Families (ACF) and administered in most cases by state Medicaid programs.  Eligibility for each coverage program depends on the state where an evacuee is residing and the eligibility criteria for the respective program.

Learn more here:

Pennsylvania Trauma Systems Foundation Releases List of Current Accredited Trauma Centers in the State

In Pennsylvania, there are four levels of trauma centers. Level I trauma centers provide the highest degree of resources with a full spectrum of specialists and must have trauma research and surgical residency programs. Level II trauma centers require the same high level of care but do not require research and residency programs. Level III trauma centers are smaller community hospitals that do not require neurosurgeons and focus on stabilizing severe trauma patients prior to transport to a higher-level trauma center. They may admit patients with mild and moderate injuries. Level IV trauma centers provide enhanced care to injured patients within the emergency department and focus on stabilization and quick transfer to a higher-level trauma center. They may admit mildly injured patients.

Each trauma center regardless of its level is an integral component of the emergency medical services (EMS) system. The EMS system assures appropriate patient care management from the time of injury to treatment at a local hospital or trauma center through the rehabilitative phase of care.  Trauma centers are hospitals with resources immediately available to provide optimal care and reduce the likelihood of death or disability to injured patients. Accredited trauma centers must be continuously prepared to treat the most serious life threatening and disabling injuries. They are not intended to replace the traditional hospital and its emergency department for minor injuries.

Effective November 1, 2021, there are 49 accredited trauma centers in Pennsylvania.

Combined Adult Level I /Pediatric Level I Trauma Centers

  1. Hershey – PennState Health Milton S. Hershey Medical Center/ PennState Health Children’s Hospital

Combined Adult Level I/Pediatric Level II Trauma Centers

  1. Allentown – Lehigh Valley Health Network – Lehigh Valley Hospital Cedar Crest/ Lehigh Valley Reilly Children’s Hospital
  2. Danville – Geisinger Medical Center/ Geisinger Janet Weis Children’s Hospital

Adult Level I Trauma Centers

  1. Bethlehem – St. Luke’s University Health Network – St. Luke’s University Hospital Bethlehem
  2. Johnstown – Conemaugh Health System – Conemaugh Memorial Medical Center
  3. Lancaster – Penn Medicine Lancaster General Health – Lancaster General Hospital
  4. Philadelphia – Einstein Healthcare Network – Einstein Medical Center Philadelphia
  5. Philadelphia – Temple Health – Temple University Hospital
  6. Philadelphia – Jefferson Health – Thomas Jefferson University Hospital
  7. Philadelphia – Penn Medicine – Penn Presbyterian Medical Center
  8. Pittsburgh – Allegheny Health Network – Allegheny General Hospital
  9. Pittsburgh – University of Pittsburgh Medical Center – Mercy
  10. Pittsburgh – University of Pittsburgh Medical Center – Presbyterian
  11. West Reading – Tower Health – Reading Hospital
  12. York – WellSpan Health – WellSpan York Hospital

Pediatric Level I Trauma Centers

  1. Philadelphia – Tower Health – St. Christopher’s Hospital for Children
  2. Philadelphia – The Children’s Hospital of Philadelphia
  3. Pittsburgh – University of Pittsburgh Medical Center – Children’s Hospital of Pittsburgh

Adult Level II Trauma Centers

  1. Abington – Jefferson Health – Abington Hospital
  2. Altoona – University of Pittsburgh Medical Center – Altoona
  3. Bethlehem – Lehigh Valley Health Network – Lehigh Valley Hospital – Muhlenberg
  4. Camp Hill – PennState Health Holy Spirit Medical Center
  5. Easton – St. Luke’s University Health Network – St. Luke’s Hospital Anderson Campus
  6. Erie – University of Pittsburgh Medical Center – Hamot
  7. Langhorne – Trinity Health Mid-Atlantic – St. Mary Medical Center
  8. Monroeville – Allegheny Health Network – Forbes Hospital
  9. Paoli – Main Line Health – Paoli Hospital Main Line
  10. Philadelphia – Jefferson Health – Jefferson Torresdale Hospital
  11. Sayre – Guthrie Robert Packer Hospital
  12. Scranton – Geisinger Community Medical Center
  13. Sellersville – Grand View Health – Grand View Hospital
  14. Upland – Crozer-Keystone Health System – Crozer-Chester Medical Center
  15. Wilkes-Barre – Geisinger Wyoming Valley Medical Center
  16. Williamsport – University of Pittsburgh Medical Center – Williamsport
  17. Wynnewood – Main Line Health – Lankenau Medical Center Main Line

Level III Trauma Centers

  1. East Stroudsburg – Lehigh Valley Health Network – Lehigh Valley Hospital Pocono

Level IV Trauma Centers

  1. Coaldale – St. Luke’s University Health Network – St. Luke’s Hospital Miners Campus
  2. Grove City – Allegheny Health Network – Grove City Hospital
  3. Hastings – Conemaugh Miners Medical Center
  4. Hazleton – Lehigh Valley Health Network – Lehigh Valley Hospital Hazleton
  5. Honesdale – Wayne Memorial Hospital
  6. Jersey Shore – Geisinger Jersey Shore Hospital (Effective 11/1/21)
  7. Lehighton – St. Luke’s University Health Network – St. Luke’s Hospital – Lehighton Campus (Effective 11/1/21)
  8. Lewistown – Geisinger Lewistown Hospital (Effective 11/1/21)
  9. McConnellsburg – Fulton County Medical Center
  10. Orwigsburg – Geisinger – St. Luke’s Hospital (Effective 11/1/21)
  11. Quakertown – St. Luke’s University Health Network – St. Luke’s Hospital Upper Bucks Campus
  12. Stroudsburg – St. Luke’s University Health Network – St. Luke’s Hospital Monroe Campus
  13. Troy – Guthrie Troy Community Hospital

The Pennsylvania Trauma Systems Foundation (PTSF) is a non-profit corporation recognized by the Emergency Medical Services Act (Act 1985-45). The PTSF is the organization responsible for accrediting trauma centers in the Commonwealth of Pennsylvania.

A comprehensive list of the Commonwealth’s trauma centers is located at

Racial & Ethnic Disparities in Health & Healthcare Executive Brief

ECRI and the Institute for Safe Medication Practices (ISMP), a Patient Safety Organization (PSO), recognizing the ubiquity of racial and ethnic disparities in health and health care and their far-reaching consequences, will be using data they receive, detailed research and expert evaluation for their upcoming 2022 Deep Dive. It will identify why addressing racial and ethnic disparities is important and what you can do to reduce them. They have also released Deep Dive: Racial and Ethnic Disparities in Health and Healthcare Executive Brief, key strategies for understanding, detecting, and reducing disparities that impact every area of health care.

The Role of Value-Based Care Using Enabling Services

The 2021 Technical Assistance Outcomes Report issued by the HRSA Bureau of Primary Health Care (BPHC) is an annual report highlighting the significant resources, impacts and outcomes achieved by the BPHC awardees between June 2020 and June 2021. This report, broken down by categories, includes a publication by Health Outreach Partners on the role of value-based care as a primer for outreach and enabling services staff. Enabling services are non-clinical services that do not include direct patient services that enable individuals to access health care and improve health outcomes. Enabling services include case management, referrals, translation/interpretation, transportation, eligibility assistance, health education, environmental health risk reduction, health literacy, and outreach.

For more, click here.

Applications Sought for Pennsylvania Maternal Mortality Review Committee

The Pennsylvania Maternal Mortality Review Committee (PA MMRC) is accepting applications for new membership. The PA MMRC reviews de-identified summaries of all pregnancy-associated deaths in the commonwealth, regardless of cause of death and including drug-related deaths, homicides, and suicides. The committee determines if the death was related to the pregnancy, identifies contributing factors, determines if the death could have been prevented, and makes recommendations to prevent future deaths.

Learn more about the committee and member expectations. If you are interested in becoming a member, please complete the application and return it to by the deadline of Tuesday, November 30, 2021.

Pennsylvania Senate Moves Telemedicine Bill

The Pennsylvania Senate passed SB 705 authorizing the regulation of telemedicine by professional licensing boards and providing for insurance coverage of telemedicine. Sponsored by Sen. Elder Vogel, SB 705 now heads to the House of Representatives for its consideration. The bill has language that was in the previous version of the bill that led to the governor vetoing the bill last session. When vetoing SB 857 last session, Gov. Wolf noted that “this legislation arbitrarily restricts the use of telemedicine for certain doctor-patient interactions. As amended, this bill interferes with women’s health care and the crucial decision-making between patients and their physicians.” At this time, the Pennsylvania House of Representatives is not expected to act on this legislation.

Research Brief: CMS Hospital Quality Star Ratings of Rural Hospitals

Researchers at the North Carolina Rural Health Research Program released a brief on CMS Hospital Quality Star Ratings of rural hospitals.

The brief details how rural hospitals were more likely to be unrated than their urban counterparts (41.6% vs. 12.0%) and the percentage of unrated rural hospitals has increased dramatically between 2016 and 2021 (34.3% to 41.6%). Nearly all unrated rural hospitals are Critical Access Hospitals, and almost half of unrated rural hospitals are in the Midwest census region. Star ratings can give patients important information and help them compare hospitals locally and nationwide, but patients should consider a variety of factors when choosing a hospital – not just their star rating or lack thereof.

CMS Office of Minority Health: Welcome to the Third Edition of Health Equity Quarterly

November brings us an opportunity to welcome two health observances, National Diabetes Awareness Month and National Rural Health Day.

CMS OMH will recognize National Diabetes Awareness Month as part of our ongoing strategy to share resources and initiatives that aim to improve access to health care services and improve health equity. Factors including lack of access to health care, quality of care received, and socioeconomic status have disproportionately affected racial and ethnic minority populations in both the prevalence of this disease and health outcomes. Type 2 diabetes is the most prevalent form of diabetes, with about 90-95% of the estimated 34 million people living with diabetes having type 2 diabetes. There are also an additional 88 million Americans with prediabetes. As incidences of new diabetes cases have become more prevalent among non-Hispanic Blacks, coupled with existing cases being highest among American Indian and Alaska Native people, it’s important to highlight and address health disparities in diabetes impacting minority populations. Visit our Health Observances website to find resources to help promote diabetes awareness.

As we approach National Rural Health Day on November 18, CMS recognizes that more than 57 million Americans live in rural areas and face several unique challenges. 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. Starting in November, our Rural Health webpage will highlight multiple tools and resources that can be distributed to providers, patients, and other organizations to help improve the health of rural Americans.

To further support the health of rural communities and recognize National Rural Health Day, please join CMS, along with representatives from the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention, for a partner webinar to discuss federal COVID-19 resources, health care workforce mandates, health care coverage related to the COVID-19 vaccine, and more.

Date: Monday, November 15

Time: 1:00-2:30 p.m. ET

To register:

All Americans deserve the opportunity to have comprehensive, affordable, and accessible health care. Join CMS OMH this Diabetes Awareness Month, National Rural Health Day, and beyond to make that a reality.  – Dr. LaShawn McIver