Rural Health Information Hub Latest News

New Data Dashboard: County-level Drug Overdose Mortality 2003-2020

The National Center for Health Statistics has created a new data dashboard on drug overdose mortality in US counties:

The dashboard includes several tools which will be use for those agencies working with substance use disorder issues. Through drop-down menus tables can be generated for mortality trends for each county and urban/rural trends for each state. Urban/rural definitions are based upon the NCHS 6-part classification system with separate identification of non-metro Micropolitan counties and non-metro Non-Core counties.

ARC: $25M Available for 2022 POWER Grants!

The Appalachian Regional Commission (ARC) issued a Request for Proposals for our POWER (Partnerships for Opportunity and Workforce and Economic Revitalization) Initiative. POWER investments help economic diversification efforts in Appalachian communities affected by job losses in coal mining, coal power plant operations, and coal-related supply chain industries.

Since 2015, ARC has invested more than $294 million in 369 projects across 354 coal-impacted communities, helping create or retain 35K+ jobs and prepare thousands of students and workers for new opportunities in emerging sectors.

This year, ARC is investing ~$25 million in projects building entrepreneurship, broadband, workforce development, tourism, and more across Appalachian coal communities. Applications are due by April 29, 2022 to help economically diversify your coal-impacted community.

CMS Innovation Center Global and Professional Direct Contracting (GPDC) Model Transition Announcement

As part of its renewed vision and strategy for driving health system transformation (PDF), the Center for Medicare and Medicaid Innovation (CMS Innovation Center) is releasing a Request for Applications (RFA) (PDF) for the Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) Model.

ACO REACH is a redesign of the Global and Professional Direct Contracting (GPDC) Model in response to stakeholder feedback, participant experience, and the Biden-Harris Administration’s priorities, including a commitment to advancing health equity. Its new name better reflects the purpose of the model: to improve the quality of care for people with Medicare through better care coordination, reaching and connecting health care providers and beneficiaries, including those who are underserved.

Further, in an effort to improve transparency, CMS is releasing more information on current GPDC Model participants (PDF) and strengthening model monitoring to ensure beneficiaries whose providers participate in GPDC and ACO REACH continue to receive high-quality, patient-centered care.

GPDC will transition to ACO REACH on January 1, 2023. Current GPDC Model participants must agree to meet all the ACO REACH Model requirements by January 1, 2023 to continue participating in the ACO REACH Model as ACOs.

CMS will be hosting an overview webinar on the ACO REACH Model RFA on March 1 at 4 PM Eastern Time. Please click here to register for this event.

Additionally, CMS is announcing the permanent cancelation of the Geographic Direct Contracting Model (Geo). The Geo Model was announced in December 2020 and paused in March 2021 and is being canceled because it does not align with CMS’ vision for accountable care and concerns raised by stakeholders.

For more information about the CMS Innovation Center’s new strategy and the future of value-based care:

For more information on the ACO REACH Model, please see the ACO REACH Fact Sheet.

For more information on the current GPDC participants, please see the GPDC Model Participant Summary (PDF).

HHS Distributing $560 Million in Provider Relief Fund Payments to Health Care Providers Affected by the COVID-19 Pandemic

With this funding, nearly $19 billion will have been distributed from the Provider Relief Fund and the American Rescue Plan Rural provider funding since November 2021 

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4,100 providers across the country this week.

“Provider Relief Funds have been a lifeline for health care providers across the country,” said Health and Human Services Secretary Xavier Becerra. “From providing life-saving care to tackling workforce challenges, these funds will help many health care facilities weather the pandemic’s continued impact. The Biden-Harris Administration will continue to ensure our providers have the necessary support and tools to keep our families safer and healthier.”

With today’s announcement, nearly $11.5 billion in PRF Phase 4 payments has now been distributed to more than 78,000 providers in all 50 states, Washington D.C., and five territories. This is in addition to HRSA’s distribution of American Rescue Plan (ARP) Rural payments totaling nearly $7.5 billion in funding to more than 44,000 providers since November 2021.

Provider Relief Fund payments have been instrumental in helping health care providers prevent, prepare for, and respond to the coronavirus. Providers have used the funds to remain in operation and to continue supporting patient care. Health care organizations that are facing workforce shortages and staff burnout also are able to use these funds to support their recruitment and retention efforts – PDF.

“Health care providers have continued to lead the fight against COVID-19 from the frontlines,” said HRSA Administrator Carole Johnson. “The Provider Relief Fund is an important resource in helping to support this work and sustain health services and the dedicated health care workforce across the country.”

Phase 4 payments have an increased focus on equity, including reimbursing a higher percentage of losses for smaller providers and incorporating bonus payments for providers who serve Medicaid, Children’s Health Insurance Program (CHIP), and Medicare beneficiaries. Approximately 86 percent of all Phase 4 applications have now been processed. Remaining applications will continue to be processed throughout early 2022.

View a state-by-state breakdown of all Phase 4 payments disbursed to date.

View a state-by-state breakdown of all ARP Rural payments disbursed to date.

As individual providers agree to the terms and conditions of Phase 4 payments, it will be reflected on the public dataset.

For additional information, visit

CMS Redesigns Accountable Care Organization Model to Provide Better Care for People with Traditional Medicare

Global and Professional Direct Contracting Model Transitioning to ACO Realizing Equity, Access, and Community Health (REACH) Model

Building on the Biden-Harris Administration’s priorities for a better health care system, today the Centers for Medicare & Medicaid Services (CMS) announced a redesigned Accountable Care Organization (ACO) model that better reflects the agency’s vision of creating a health system that achieves equitable outcomes through high quality, affordable, person-centered care. The ACO Realizing Equity, Access, and Community Health (REACH) Model, a redesign of the Global and Professional Direct Contracting (GPDC) Model, addresses stakeholder feedback, participant experience, and Administration priorities, including CMS’ commitment to advancing health equity.

In addition to transitioning the GPDC Model to the ACO REACH Model, CMS is canceling the Geographic Direct Contracting Model (also known as the “Geo Model”) effective immediately. The Geographic Direct Contracting Model, which was announced in December 2020, was paused in March 2021 in response to stakeholder concerns.

“The Biden-Harris Administration remains committed to promoting value-based care that improves the health care experience of people with Medicare, Medicaid and Marketplace coverage,” said CMS Administrator Chiquita Brooks-LaSure. “To fulfill that commitment, CMS, through the Innovation Center, is testing new models of health care service delivery and payment to improve the quality of care that people receive, including those in underserved communities. The Innovation Center is making improvements to existing models and launching new models to increase participation in our portfolio, and CMS will be a strong collaborator to health care providers that participate in those models.”

As CMS works to achieve the vision outlined for the next decade of the Innovation Center, CMS wants to work with partners who share its vision and values for improving patient care, guided by three key principles. First, any model that CMS tests within Traditional Medicare must ensure that beneficiaries retain all rights that are afforded to them, including freedom of choice of all Medicare-enrolled providers and suppliers. Second, CMS must have confidence that any model it tests works to promote greater equity in the delivery of high-quality services. Third, CMS expects models to extend their reach into underserved communities to improve access to services and quality outcomes. Models that do not meet these core principles will be redesigned or will not move forward.

Consistent with these principles, the ACO REACH Model, tested under the CMS Innovation Center’s authority, will adhere to the following priorities: a greater focus on health equity and closing disparities in care; an emphasis on provider-led organizations and strengthening beneficiary voices to guide the work of model participants; stronger beneficiary protections through ensuring robust compliance with model requirements; increased screening of model applicants, and increased monitoring of model participants; greater transparency and data sharing on care quality and financial performance of model participants; and stronger protections against inappropriate coding and risk score growth.

The ACO REACH Model builds on CMS’ ten years of experience with accountable care initiatives, such as the Medicare Shared Savings Program, the Pioneer ACO Model, and the Next Generation ACO Model. The ACO REACH Model provides novel tools and resources for health care providers to work together more closely to improve the quality of care for people with Traditional Medicare.  To help advance health equity, the ACO REACH Model will require all participating ACOs to have a robust plan describing how they will meet the needs of people with Traditional Medicare in underserved communities and make measurable changes to address health disparities. Additionally, under the ACO REACH Model, CMS will use an innovative payment approach to better support care delivery and coordination for people in underserved communities.

REACH ACOs will be responsible for helping all different types of health care providers — including primary and specialty care physicians — work together, so people get the care they need when they need it. In addition, people with Traditional Medicare who receive care through a REACH ACO may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays. They can expect the support of the REACH ACO to help them navigate an often complex health system.

“CMS is testing a redesigned model because accountable care organizations make it possible for people in Traditional Medicare to receive greater support managing their chronic diseases, facilitate smoother transitions from the hospital to their homes, and ensure beneficiaries receive preventive care that keeps them healthy,” said CMS Deputy Administrator and Director of the CMS Innovation Center Liz Fowler, PhD, JD. “Under the ACO REACH Model, health care providers can receive more predictable revenue and use those dollars more flexibly to meet their patients’ needs — and to be more resilient in the face of health challenges like the current public health pandemic. The bottom line is that ACOs can improve health care quality and make people healthier, which can also lead to lower total costs of care.”

The GPDC Model will continue until December 31, 2022 and then will transition to the ACO REACH Model. In the meantime, CMS will operate the GPDC Model with more robust and real-time monitoring of quality and costs for model participants. GPDC Model participants that do not meet model requirements, such as participants that restrict medically necessary care, will face corrective action and potential termination from the model.

The first performance year of the redesigned ACO REACH Model will start on January 1, 2023, and the model performance period will run through 2026. CMS is releasing a Request for Applications for provider-led organizations interested in joining the ACO REACH Model. Current participants in the GPDC Model must agree to meet all the ACO REACH Model requirements by January 1, 2023 in order to participate.

For a fact sheet on the ACO REACH Model, visit:

A comparison table of ACO REACH and GPDC is available at:

More information on the ACO REACH Model is available at:

More information on the Global and Professional Direct Contracting Model—including information on model participants for the 2021 and 2022 performance years, and performance and quality data for the 2021 performance year—is available at:

NRHA Receives $7 Million Donation from Philanthropist and Author MacKenzie Scott

The National Rural Health Association (NRHA) is proud to announce that it has received a one-time, unrestricted donation in the amount of $7 million from philanthropist and author MacKenzie Scott.

“These funds will be utilized in the priority areas of rural leadership development, health equity, state capacity building, and educational and policy programing,” says NRHA CEO Alan Morgan. “NRHA staff will work directly with the association’s elected member leaders to complete a rural health environmental scan and establish a process to ensure these funds are allocated to projects that will demonstrate a clear outcome and provide a direct benefit to the health of rural communities.”

At a time when the pandemic has particularly impacted rural communities and health care, this investment will help NRHA improve health care access and outcomes for all rural Americans.

NRHA has a strong grassroots network that helped secure more than $21 billion in emergency funding for rural health care providers, worked directly with federal agencies to boost rural COVID-19 vaccine confidence and uptake, and ensured vital legislative and regulatory changes to allow rural patients to receive health care via telehealth during the pandemic. NRHA has also worked directly with rural hospitals, rural health clinics, and federally qualified health centers across the country to ensure they have the resources to care for their communities. This generous donation will empower the association to provide even more long-term support beyond the public health emergency.

“This gift is a recognition of the history of outstanding work that NRHA has undertaken in addressing rural health issues and rural health disparities,” says NRHA President Beth O’Connor. “The funds will greatly expand our reach and ability to improve the health care system for 62 million Americans who call rural home.”

Backed by longstanding support from private and public partners, NRHA and its members have initiated and implemented critical rural programming that comprises three-fourths of the association’s overall revenue. These include developing and supporting the now 43 state rural health associations across the country since 1992, training and creating a network of more than 2,000 community health workers, developing rural medical education programming, and convening and establishing border health and oral health initiatives. Additionally, for 27 years NRHA has convened the Health Equity Council and Health Equity Conference – the only event of its kind in the nation – creating a forum for vital discussions related to underserved rural multiracial, multicultural, LGBTQ+, veteran, homeless, and other populations.

This unprecedented gift is the largest unrestricted donation in NRHA’s 45-year history and will be utilized to further the mission of the organization. Scott does not accept solicitations or proposals from organizations.

About NRHA
NRHA is a nonprofit organization working to improve the health and well-being of rural Americans and provide leadership on rural health issues through advocacy, communications, education, and research. NRHA’s membership consists of diverse individuals and organizations, all of whom share the common bond of an interest in rural health.

Test Your Oral Health Quotient

The Colgate-Palmolive Company has launched a public health initiative, “Know Your OQ™,”  to empower health professionals and consumers to understand and improve their oral health quotient (OQ). The initiative promotes compelling information about the global oral health crisis and provides oral health resources for primary care physicians, nurses, and educational leaders, as well as consumers, to improve oral hygiene, encourage healthier habits, and promote overall health. The interactive assessment is free.

Click here for more information and to take the assessment.

Oral Health and Children with Heart Conditions

A new study, “Preventive Dental Care and Oral Health of Children with and without Heart Conditions,” was recently published in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report. Children living with heart defects are more likely to develop infective endocarditis. The study found that 1 in 10 children with a heart condition had teeth in fair/poor condition and 1 in 6 had at least one indicator of poor oral health such as toothaches, bleeding gums, or cavities in the past year.

Click here to read the study.

Updated Telehealth Guide Released for Critical Access and Small Rural Hospitals

The Technical Assistance and Service Center (TASC) has partnered with the Northwest Regional Telehealth Resource Center (NRTRC) to produce an update to the Critical Access Hospital (CAH) Telehealth Guide. Recent federal guidance has been included in this edition. The updated guide provides information and guidance for assessing and implementing telehealth services for CAHs, including purchasing, staffing, maintenance, reimbursement, and reporting for outpatient services. For additional guidance on using this tool, please see the introductory webinar that was held with the original release of the guide in September 2021.

The guide includes best practices and resources developed by subject matter experts (SME), technical consultants, and telehealth resource centers (TRCs). The objective is to provide Flex Programs and CAHs with a comprehensive guide that will allow them a singular point of reference for CAH telehealth standards with direct content and links to appropriate public and federal resources.

Further questions and concerns can be directed to