Rural Health Information Hub Latest News

FY23 Funding Negotiations Still in Progress

Congress has until December 16, when the current short-term government funding agreement ends, to finalize an FY23 budget or face a government shutdown. We expect Congress will extend the negotiating period until Dec. 23. That way they can complete this year’s budget before the next Congress is sworn in on Jan. 3, 2023. The current gridlock stems from disagreements on top-line annual defense and domestic spending numbers. NACHC sent a letter to House and Senate leaders who will decide on final funding amounts, asking them to use the funding levels that the House Committee approved for Community Health Centers and related primary and workforce programs earlier this year.

Telephonic Psychiatric Services (TiPS) Program for Behavioral Health Begins

TiPS is a real-time, provider-to-provider behavioral health consultative service for children up to age 21 covered by Medicaid or CHIP (Children’s Health Insurance Program). The goal of TiPS is to improve treatment and access by providing psychiatric consultation to providers. There are no “wrong calls” to TiPS but common examples include patient-specific consults or general questions related to child psychiatry, behavioral health, medication, or accessing community resources. TiPS Teams are staffed by child psychiatrists, licensed therapists, and care coordinators. Call the TiPS Team in your region during business hours Monday through Friday to receive assistance within 30 minutes.

Executives Grapple with Decisions on CMS’ Rural Emergency Hospital Designation

The new Rural Emergency Hospital designation is putting providers between a rock and a hard place, offering an infusion of cash from the federal government that is available only if they eliminate inpatient care, The New York Times reported December 9.

CMS released the final rule for the new designation in November. The rule aims to curb rural hospital closures by offering them a chance to shutter infrequently used inpatient beds and focus on providing outpatient and emergency department services. The new designation is set to go into effect in January.

Hospitals that convert will receive monthly payments of $272,866, with annual increases based on inflation, according to the report. They will also receive higher Medicare reimbursements than larger hospitals.

Some rural healthcare providers and health policy analysts said officials behind the rule are “out of touch with the difficulties of transferring rural patients,” according to the Times. Bigger hospitals are dealing with their own set of challenges and are increasingly unwilling to accept transferred patients, especially from small field hospitals that are unaffiliated with their systems.

Katy Kozhimannil, PhD, director of the University of Minnesota Rural Health Research Center, told the Times she is concerned that gambling with transfers could mean “some of the most extremely remote and marginalized communities could end up with no care at all — and that’s what we were trying to avoid in the first place.”

Some hospitals, such as Sturgis (Mich.) Hospital, have said they are planning to convert to a rural emergency hospital. The hospital was on the verge of closing when the Michigan Hospital Association suggested it convert to a rural emergency facility. Sturgis Hospital CFO Bobby Morin said 80 percent of the facility’s revenue comes from outpatient services, and a sizable portion of its expenses comes from the inpatient side.

Others, such as Bucktail Medical Center in Renovo, Pa., have ruled out the conversion because there would be nowhere to transfer patients in the case of another pandemic surge, according to the report. Bucktail’s financial margin for patient services was minus-43 percent in 2021.

“Am I going to lose some revenue? Possibly,” CEO Time Reeves told the Times. “But is it more important to provide the services needed? That’s the position we’re taking.”

Broadband Listening Sessions to Be Held Across Pennsylvania

Pennsylvanians can learn about the new FCC broadband map, and how to challenge its inaccuracies

Pennsylvania Broadband Development Authority (Authority) Executive Director Brandon Carson today announced listening sessions will be held across the commonwealth beginning December 13 to give Pennsylvanians the opportunity to learn about the Authority, federal funding for broadband, and to hear about the important role they have in reviewing the new Federal Communications Commission (FCC) broadband access map. The map’s accuracy is crucial for the commonwealth to receive sufficient federal funding to ensure high-speed internet access for all Pennsylvanians.

“In today’s world, having access to high-speed internet is a necessity,” said Carson. “Pennsylvanians need broadband access for school, work, and to ensure public safety, and it is critical that we close the digital divide across the commonwealth. The more accurate we can make the FCC map, the more we ensure we get a fair allocation of federal funding to expand broadband.”

The FCC’s broadband access map shows all broadband serviceable locations across the United States where fixed broadband internet access service is or can be installed. The commonwealth’s allocation of funding for broadband deployment under the federal infrastructure law is dependent upon the map being accurate. Pennsylvanians should visit the map to search for their home address to determine whether the information listed by the FCC is accurate.

Listening Sessions

The Authority will host the following broadband listening sessions across the commonwealth:

  • Tuesday, December 13 at 10:00 AM – Beaver County

In-person only listening session will be held at Community College of Beaver County, Library Conference Center 9103, 1 Campus Drive, Monaca, PA 16061

  • Tuesday, December 13 at 2:00 PM – Somerset County

In-person only listening session will be held at Glencoe United Church of Christ, 128 Critchfield Street, Fairhope, PA 15538

  • Wednesday, December 14 at 10:00 AM – Venango County

Hybrid listening session

  • In-person will be held at Venango County Training Center, 737 Elk Street (Corner of Elk & 8th), Franklin, PA 16323
  • Click here to register and attend virtually
  • Wednesday, December 14 at 2:00 PM – Elk County

Hybrid listening session

  • In-person will be held at North Central PA Regional Planning and Development Commission, 49 Ridgmont Drive, Ridgway, PA 1585
  • Click here to register and attend virtually
  • Thursday, December 15 at 10:00 AM – Luzerne County

Hybrid listening session

  • In-person will be held at Greater Wyoming Valley Chamber of Commerce, 7 South Main Street, Wilkes-Barre, PA 18701
  • Click here to register and attend virtually
  • Thursday, December 15 at 2:00 PM – Tioga County

Hybrid listening session

  • In-person will be held at Bradford County Public Safety Center, 29 VanKuren Drive, Towanda, PA 18848
  • Click here to register and attend virtually
  • Friday, December 16 at 10:00 AM – Union County

Hybrid listening session

  • In-person will be held at SEDA-Council of Governments, 201 Furnace Road, Lewisburg, PA 17837
  • Click here to register and attend virtually
  • Monday, December 19 at 11:00 AM – Chester County

In-person only listening session will be held at Borough of Kennett Square, 600 S. Broad Street, 3rd Floor, Kennett Square, PA 19348

Process to Challenge Inaccuracies in the FCC Broadband Map

Challenges to the map can include:

  • A location that meets the FCC’s definition of a broadband serviceable location is missing from the map.
  • A location’s broadband serviceability is incorrectly identified.
  • Information such as the address or unit count for the location is incorrect.
  • The location’s placement (its geographic coordinates) is incorrect.

Pennsylvanians should challenge the map to help improve its accuracy by January 13, 2023. There are two ways to submit a challenge: by a single location, or in bulk. The location challenge can be completed by individual consumers utilizing the map itself. Bulk challengers will be required to use the Broadband Data Collection (BDC) platform to submit information to the FCC.

Additional information about the Consumer Challenge Process can be found here, and additional information on the Bulk Challenge Process can be found here. A consumer may also challenge mobile data coverage through the FCC Speed Test App – a free application that can be downloaded from an Apple or Google Play Store.

Governor Tom Wolf announced the creation of the Authority in February 2022 to manage at least $100 million in federal aid to coordinate the rollout of broadband across Pennsylvania. The Authority was charged with creating a statewide broadband plan and distributing federal and state monies for broadband expansion projects in unserved and underserved areas of the commonwealth.

For more information about the Pennsylvania Broadband Development Authority, or the Department of Community and Economic Development, visit the Authority’s website and be sure to stay up-to-date with all of our agency news on FacebookTwitter, and LinkedIn.

CMS Updates Enrollment Information for Rural Emergency Hospitals

The Centers for Medicare & Medicaid Services (CMS) updated Chapter 10 of the Medicare Program Integrity Manual to instruct Medicare Administrative Contractors (MACs) on how to process enrollment applications for rural hospitals and Critical Access Hospitals converting to the Rural Emergency Hospital (REH) designation beginning January 1, 2023.  Included are instructions on how the change of enrollment form CMS-855A should be completed and the steps the MACs should take to review, approve, or deny the applications.  This guidance reflects the enrollment requirements for REHs published in the final 2023 Medicare Hospital Outpatient Prospective Payment Rule.

Understanding Barriers to COVID-19 Testing

Researchers used funding from the NIH-supported RADx-UP program to better understand barriers in underserved communities – rural and urban, as well as racial and ethnic minority populations – in Kansas.   The most commonly reported barrier was fear of lost income or employment resulting from quarantine.  Common barriers reported in both rural and urban communities were access issues, such as lack of transportation and lack of support for languages other than English.  Three subthemes appeared to be dominant in rural counties. Under the theme of “political beliefs,” the subtheme “politicization of COVID-19 mitigation and response efforts” was an identified barrier for most rural counties.  See Approaching Deadlines below for a RADx-UP opportunity that closes in January.

2017-2021 ACS 5-Year Estimates Data Now Available

The U.S. Census Bureau released new statistics from the 2017-2021 American Community Survey (ACS) 5-Year Estimates, now available at These estimates provide data for all Pennsylvania counties, municipalities, and other geographic areas regardless of population size.

Some highlights from the Pennsylvania State Date Center include:

  • Approximately 47.0% of renter households in PA spent more than 30.0% of their income on housing costs, compared to 40.0 percent of renter households nationally.
  • The counties with the highest percentage of renters experiencing a housing cost burden were Centre (58.0%), Pike (57.4%), Lawrence (52.5%), Monroe (51.9%), and Philadelphia (51.9%).
  • Between 2012-2016 and 2017-2021, 43 counties experienced a statistically significant increase in median household income.

Visit the Data Center’s Research Briefs page to read this brief and past releases.

New Site for Telehealth Centers of Excellence

 A new website from the two HRSA-supported Telehealth Centers of Excellence – The Medical University of South Carolina and the University of Mississippi Medical Center – offers a wealth of expertise and resources for telehealth organizations, researchers, providers, and other stakeholders.  Sign up for their newsletter to learn about publications, upcoming events, and webinars; use the contact form on the website to ask questions or schedule a consultation.

Policy Brief Released on New Changes to Medicare Shared Savings Program

This Rural Health Value Policy Brief summarizes the changes made to the Medicare Shared Savings Program that will take effect in January 2023 and 2024.  It discusses how the changes would reduce barriers to participation for potential or reentering Accountable Care Organizations that operate in rural areas. The Federal Office of Rural Health Policy funds Rural Health Value to provide technical assistance, raise awareness, and engage in communication strategies to support rural provider participation in value-based care.

Maternity Health Care Professional Target Area Scores are Now Available

  Scores that identify areas experiencing a shortage of maternity healthcare professionals are now available, including areas that are rural and partially rural.  The information is found in the Find Shortage Area Tool at the HRSA Data Warehouse, an interactive databank showing up-to-date information on the supply of primary care, dental, and mental health providers down to the county level.  Learn more about the criteria for determining Maternity Care Health Professional Target Areas in the Federal Register notice published earlier this year.