- Using Virtual Care Tech to Curb Care Barriers in Rural South Carolina
- Research and Analysis: Rural Internet Subscribers Pay More, New Data Confirms
- A Prescription for Better Rural Nutrition
- A Reason to Care: How Students Choose Rural Health
- Focus on Fellows: Checking in with Three Rural Leaders
- In Texas' Panhandle, a Long-Awaited Oasis for Mental Health Care Is Springing Up
- City-Based Scientists Get Creative to Tackle Rural-Research Needs
- Public Payment of Dialysis Treatment Has Changed the Rural Healthcare Marketplace
- Reps. Sewell, Miller Introduce the Bipartisan Assistance for Rural Community Hospitals (ARCH) Act on National Rural Health Day
- How the Bad River Tribe Flipped the Script on the Native American Opioid Crisis
- Could a Solution to Provide Legal Care in Alaska Work in Rural Minnesota?
- How Telehealth Is Bringing Specialist Care to the North Country
- Western Alaska Salmon Crisis Affects Physical and Mental Health, Residents Say
- VA Announces New Graduate Medical Education Program to Help Expand Health Care Access to Veterans in Underserved Communities
- Rural Vermont Community Finds Success Distributing Narcan With a Vending Machine
Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for the Medicare Advantage (MA) and Part D prescription drug programs. The final rule makes a number of changes, including rural-relevant provisions to support network adequacy. Network adequacy standards, and requirements for health plans’ provider networks, can support access to care in rural areas. In this rule, CMS is requiring that MA applicants demonstrate they have a sufficient network of contracted providers to care for beneficiaries before CMS will approve an application for a new or expanded MA contract.
In 2017, the Centers for Medicare & Medicaid Services (CMS) launched the Million Hearts Cardiovascular Disease Risk Reduction Model. Designed by the CMS Innovation Center to test if health care costs could be lowered by prevention, the program called on participants to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries. A little more than a third (36 percent) of the original participants – primary care and specialty practices, health centers, and hospitals – were rural providers. While this report only evaluates the first four years of a five-year program, results show improved preventive care for cardiovascular disease. The annual report can be found here.
The Council on Graduate Medical Education, COGME, provides ongoing assessment of physician workforce trends and makes recommendations to federal policymakers. In this new report, COGME focuses on gaps in rural health care and makes six recommendations for federal policy and investment, including programs such as the National Health Service Corps, Rural Residency Planning and Development, and other training programs funded by HRSA.
The annual ranking of health for nearly every county in the nation takes a closer look at four specific social determinants that impact health outcomes: living wage, gender pay gap, childcare cost burden, and school funding adequacy. References to rural areas throughout the report highlight major geographic disparities before and after the pandemic.
The Centers for Medicare & Medicaid Services (CMS) is working to help build awareness about the Affordable Connectivity Program, a Federal Communications Commission (FCC) program. The new long-term benefit will help to lower the cost of broadband service for eligible households struggling to afford internet service.
The Affordable Connectivity Program provides:
- Up to $30/month discount for broadband service;
- Up to $75/month discount for households on qualifying Tribal lands; and
- A one-time discount of up to $100 for a laptop, desktop computer, or tablet purchased through a participating provider
- if the household contributes more than $10 but less than $50 toward the purchase price.
The Affordable Connectivity Program is limited to one monthly service discount and one device discount per household.
Who is Eligible?
A household is eligible for the Affordable Connectivity Program if the household income is at or below 200% of the / Federal Poverty Guidelines, or if a member of the household meets at least one of the criteria outlined at https://www.fcc.gov/acp.
Two-Steps to Enroll
- Go to ACPBenefit.org to submit an application or print out a mail-in application; and
- Contact your preferred participating provider to select a plan and have the discount applied to your bill.
- Some providers may have an alternative application that they will ask you to complete.
Eligible households must both apply for the program and contact a participating provider to select a service plan.
For more information and full details, visit https://www.fcc.gov/acp or call 877-384-2575.
Check out the Consumer Outreach Toolkit at https://www.affordableconnectivity.gov/community-resources/
Read more about the ACP in the recent White House Fact Sheet: https://www.whitehouse.gov/briefing-room/statements-releases/2022/05/09/fact-sheet-president-biden-and-vice-president-harris-reduce-high-speed-internet-costs-for-millions-of-americans/
From FIERCE Healthcare
Rural residents were the most likely to benefit from enhanced subsidies for Affordable Care Act coverage and face the greatest danger of losing coverage if those benefits expire after this year, a new study finds.
The study, released by the Robert Wood Johnson Foundation Tuesday, comes as healthcare groups are making a major effort to get Congress to renew the boosted subsidies. ACA enrollment grew to a record-setting 14.5 million people this year thanks in part to the higher subsidies.
“The enhanced premium subsidies have been transformational in high-cost rural areas,” said Kathy Hempstead, Robert Wood Johnson’s senior policy adviser, in a statement. “If the tax credits are allowed to expire, rural residents will have few if any policies to choose from that are both affordable and comprehensive.”
Researchers with the Urban Institute on behalf of the foundation looked at average benchmark premiums across several states on the ACA exchanges. The benchmark plan—which is the second-cheapest silver tier plan—is what the federal government uses to calculate income-based subsidies. The government ties the benchmark premium to a certain percentage of the household income.
“Because the percentage-of-income caps do not vary with premiums, the higher the benchmark premium, the greater the size of the federal government’s premium contribution for the household,” the study said.
Mental Health Matters: Care, Support Available to Those Facing Challenges
Mental health is an incredibly important part of overall health. We all struggle during challenging times and need support and access to care to thrive.
May is Mental Health Awareness Month. Each year millions of Americans face the reality of living with a mental illness. One in 5 American adults — and 1 in 6 youths — experience mental illness each year, and less than half of them receive treatment. Each year we fight stigma, provide support, educate the public and advocate for policies that support people with mental illness and their families.
Taking steps to improve mental health can look different for everyone. Perhaps you’d like to talk to someone, focus more on self care, consider medication, and/or seek other treatments. No matter your challenges, there are options to help you.
Please know that you are not alone.
- Mental Health Resources — Commonwealth of Pennsylvania
- Mental Health in PA — Department of Human Services
If you or someone you know is experiencing a mental health crisis, please reach out for help.
- Call 911: If there is an immediate risk of endangering oneself or others, contact 911. Inform the operator that you are calling about a mental health crisis.
- Crisis Text Line: Text PA to 741741 to start the conversation 24/7.
- National Suicide Prevention Lifeline: 800-273-8255
If you or someone you care about is experiencing thoughts of suicide, please call the Lifeline. (Español: 888-628-9454)
- PA Crisis Hotlines: Find a crisis line in your county.
988: Reimagining Crisis Response
PA residents made more than 76,000 calls to the National Suicide Prevention Lifeline in 2020. In fall 2020, the National Suicide Hotline Designation Act was passed by Congress establishing 988 as a three-digit nationwide mental health and suicidal crisis number to be available in communities by July 2022. Dialing 988 will route callers directly to the National Suicide Prevention Lifeline.
What does this mean for Pennsylvanians?
- PA has 13 call centers that are members of the National Suicide Prevention Lifeline, with trained staff who assist callers and connect them to local resources across the state. They will continue to provide these services for callers who dial 988.
- Approximately 80-90 percent of calls are resolved through conversation with the trained call center staff, and without need for mobile response dispatch.
By directing callers with a behavioral health crisis that isn’t life threatening to contact 988 for assistance, the response provided by law enforcement, EMS, and other public safety services personnel can be reserved for situations in which lives are endangered.
Mental Health Resources for Pennsylvanians
- PA Support & Referral Hotline: 1-855-284-2494 (TTY:724-631-5600)
The Department of Human Services’ mental health support and referral helpline is available 24/7 and is a free resource staffed by skilled and compassionate caseworkers available to counsel Pennsylvanians struggling with anxiety and other challenging emotions.
- Get Connected to Help
- Office of Advocacy and Reform (OAR)
A group of volunteers focused exclusively on setting guidelines and benchmarks for trauma-informed care across the commonwealth.
For Service Members/Veterans
Are you a veteran in crisis or are you concerned about a veteran in crisis? Here’s how to connect with the Veterans Crisis Line:
- Call the National Suicide Prevention Lifeline’s Veterans Crisis Line:
1-800-273-8255, then press 1
- Send a text to 83825
- Chat with someone online
- Connect with the Veterans Crisis Line online
For Violence Survivors
- Pennsylvania Sexual Assault Helpline: 1-888-772-7227 or pcar.org/help-in-pa
- National Domestic Violence Helpline: 1-800-799-7233 or www.PCADV.org
For Older Pennsylvanians
- SOLO: Strengthening Older Lives Online — View in English or Spanish
The Pennsylvania Department of Aging’s Council on Aging (PCoA) released an interactive guide with information and resources to help older adults cultivate a healthy mind, body and spirit amidst the challenges of the COVID-19 pandemic
For Substance Use
- Get Help Now Helpline — 1-800-662-HELP (4357)
A toll-free helpline maintained through the Department of Drug and Alcohol Programs (DDAP) that connects callers looking for treatment options for themselves or a loved one to resources in their community. Calls are anonymous and available 24/7.
- Find Treatment Near You: DDAP Treatment Search
The Department of Drug and Alcohol Programs’ (DDAP) search engine allows you to search by ZIP code, county, or statewide for programs that could help you.
- Naloxone Standing Order — www.pa.gov/opioids
Naloxone is still available to all Pennsylvanians through a standing order signed by Acting Secretary of Health Dr. Denise Johnson. Carrying naloxone on-hand at all times can be a life-saving action.
- Alcoholics Anonymous: Find resources and/or meetings that work for you.
- Cocaine Anonymous: Find a video or email meeting.
- Narcotics Anonymous: Narcotics Anonymous offers multi-lingual and multicultural support. Use the website to find meetings and resources.
- SMART Recovery: There’s life beyond substance use disorder. Find meetings that are free and open to everyone.
Treating Heroin and Opioid Use Disorder: Pennsylvania’s online guide of resources for those battling opioids
Additional Mental Health Resources
The National Rural Health Resource Center has an interactive Population Health Toolkit to assist in creating a movement toward wellness through population health strategies. In coordination with the Federal Office of Rural Health Policy (FORHP), this toolkit is a public source of information that includes understanding population health, assessments, and a web-based database for acquiring health data specific to your location. A recent data source update was launched and included three new data scenarios for state Flex Programs, critical access hospitals, and other rural health care providers to use.
Why Population Health?
Health care services, like critical access hospitals (CAHs), should help meet the health needs of their communities. Flex programs choosing to work in the population health improvement program area (3) have a unique opportunity to make measurable improvements in the health outcomes of their communities.
While each state is different, many population health initiatives are tied to accountable care organizations (ACOs) and other value-based purchasing initiatives. By improving the health of the communities we live and work in, we can change how health care is provided and help lower the cost of care while increasing quality of life.
If you wonder why population health is vital for your program, first ask why it is essential to you, personally? Think about programs that you or your family may need now or in the future. Consider chronic care management, behavioral health, substance and opioid prevention and treatment, food security, and exercise programs. These things all help you, and our communities live healthier lives and reduce the need for high-cost medical intervention.
It’s not “why” population health, but “when.”
Before the COVID-19 pandemic began, hospital closures were increasing in rural communities across the nation: 116 rural hospitals closed between 2010 and 2019. Over the past two years, federal relief has helped stabilize facilities, and the pace of closures slowed. However, this assistance was temporary, and rural hospitals continue to struggle financially and to recruit and retain nurses and other health care employees.
Against this backdrop, the Bipartisan Policy Center (BPC) conducted a series of interviews over the last year with rural hospital leaders from eight states—Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, and Wyoming—as well as with health policy experts from federal and state government, national organizations, provider organizations, and academia. The goal was to gain on-the-ground insights into today’s rural health care landscape, where the population is older, sicker, and less likely to be insured or seek preventive services than in urban areas.
Today in rural America, roughly 1 out of every 3 individuals are enrolled in the Medicare program and nearly 1 in 4 individuals under age 65 rely on Medicaid as their primary source of health care coverage. Although all payers should be part of the solution in ensuring access to quality rural health care, this report largely focuses on strengthening rural health care delivery in Medicare and Medicaid given the outsized role these public programs play in rural communities.
Due to the compounding physical and emotional challenges brought on by the COVID-19 pandemic over the last two years, the topic of mental health has never been more timely or critical. Whether it’s the mental health of our public health workforce and communicators, or developing messaging that helps communities manage mental health challenges, here’s a spotlight of resources we’ve compiled in service of Mental Health Awareness Month:
- How Right Now Campaign: CDC Foundation
- Improving Youth Behavioral Health Through School-Based Strategies: Association of State and Territorial Health Officials (ASTHO)
- Mental Health Awareness Month shareable graphics: National Alliance on Mental Illness (NAMI)
- The Public Health Workforce: Morale, Mental Health, and Moving Forward: PHCC Webinar
- Rising Stress + Burnout in Public Health: de Beaumont Foundation
- A Guide to Promoting Health Care Workforce Well-Being During and After the COVID-19 Pandemic: Well Being Trust