Rural Health Information Hub Latest News

New Report: The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System

Telehealth usage increased during the Public Health Emergency (PHE), and this has fueled discussions on the optimum use of telehealth in healthcare delivery. Based on experiences during the PHE, and new applications of telecommunications technologies, this report assesses potential improvements in rural health service delivery, as well as potential unintended consequences that could undermine goals to improve services for currently underserved populations. The assessment is guided by the over-arching framework of the high-performing rural health system (HPRHS), to understand the benefits of telehealth in improving health equity as affecting four pillars of the HPRHS – access, affordability, community health, and quality.

Click here to open the full document.

Principal Authors: Joel M. James, MPH and Keith J. Mueller, PhD (Panel Chair) 

Prepared by the RUPRI Health Panel: Alva O. Ferdinand, DrPh, JD; Alana D. Knudson, PhD; Jennifer P. Lundblad, PhD, MBA; A. Clinton MacKinney, MD, MS; Timothy D. McBride, PhD; Nancy E. Schoenberg, PhD


USDA Rural Development Launches the Rural Data Gateway Expanding Access to Data on USDA Funded Projects in Rural Communities

New integrated Rural Investment Dashboards make more than a decade of USDA Rural Development (RD) investment history instantly accessible to the public!

This uncomplicated interface allows users to sift through RD data gleaned from investments in rural housing, health care, broadband, businesses, infrastructure and much more. With its project-level county and congressional district data, the Rural Data Gateway opens a new chapter in RD’s ongoing commitment to investment transparency. To learn more, read the full news release.

Eight Pennsylvania Municipalities Solve EMS Crisis by Creating First-of-its-Kind Regional Municipal Authority

After a year-long cooperative process, eight municipalities in Pennsylvania have incorporated a first-of-its-kind regional municipal authority to address the region’s emergency medical services crisis.

The new Municipal Emergency Services Authority of Lancaster County will fund, manage and provide EMS services to member municipalities in northwest Lancaster County. It will be the first rate-setting regional municipal emergency services authority in Pennsylvania. The founding municipalities are Conoy Township, East Donegal Township, Elizabethtown Borough, Elizabeth Township, Marietta Borough, Mount Joy Township, Penn Township and West Donegal Township.

The path to forming the authority began in 2018, when municipalities in the northwest portion of Lancaster County were at a crossroads with the future of emergency medical services at risk.

Many EMS agencies are struggling to maintain services in the face of soaring costs, funding shortfalls and staffing challenges. Northwest EMS in northwest Lancaster County, which was recognized as Pennsylvania EMS Agency of the Year in 2020 by the Pennsylvania Emergency Health Services Council, was facing insolvency due to insufficient revenue and rising costs.

“Although Northwest EMS is widely known for outstanding service, less than half of municipal residents contribute to the organization through subscriptions,” said Marc Hershey, Elizabethtown Borough Council President and chair of the committee of municipal leaders who convened to address the local EMS crisis. “The average gap between gross billings and insurance payments was averaging over $4 million a year. And increasing expenses for equipment, fuel, certifications, trainings and employee benefits were taking a heavy toll. In short, municipalities in our region needed a bold solution to continue to meet their statutory obligation to ensure EMS readiness to answer the call.”

At the start of 2021, the committee began studying and exploring alternatives. Upon conducting a collaborative analysis, the committee arrived at an innovative solution: Creation of a regional municipal emergency services authority under the Pennsylvania Municipality Authorities Act to fund and provide EMS readiness and services on a regional basis.

Over a period of several months, the committee engaged in municipal public meetings, additional public education initiatives and a public hearing on the proposed solution. The process culminated in eight municipalities in the region enacting ordinances to form the Municipal Emergency Services Authority of Lancaster County. The authority was incorporated on February 7.

“This initiative demonstrates how municipal cooperation can solve regional problems,” said Rob Brady, president of ROBB Consulting and a consultant on the project. “Bringing municipalities together for a common regional cause is no small feat but, as a group, this committee of local leaders embraced a regional mindset to drive the process. Looking forward, the authority will enable each of the member municipalities to ensure that EMS services continue to be available with readiness to respond.”

The board of the authority consists of a representative from each of the authority’s founding municipalities. The board will be responsible for determining the authority’s services and fees.

Instead of generating operating revenue through municipal and membership contributions, the authority will set a reasonable and uniform annual fee to property owners, on par with Northwest EMS subscription rates. As a regional municipal entity, the authority will hold public hearings, enabling community members to have a voice regarding any changes to services or rates.

The authority will begin holding board meetings in March. A public hearing is expected to be held in late summer on the authority’s emergency services and fee structure. The authority plans to be operational and begin providing services by early 2024.

“It is our hope that the Municipal Emergency Services Authority of Lancaster County will serve as a model for other municipalities in Pennsylvania facing an EMS crisis,” Hershey said. “Paving a path to this solution took hard work, but there was never a question that a municipal-led solution was needed. EMS is an essential public service. As municipal leaders, we recognized that we not only needed to solve this problem to meet our statutory obligation. We needed to solve this together to potentially save the lives of our neighbors, family members and friends.”

CMS Proposes Benefit Expansion for Mobility Devices, Advancing Health Equity for People with Disabilities

The Centers for Medicare & Medicaid Services (CMS) released a proposed National Coverage Determination (NCD) decision that would, for the first time, expand coverage for power seat elevation equipment on certain power wheelchairs toMedicare individuals. The proposed NCD is open for public comment for 30 days.

“Millions of people with Medicare rely on medically necessary assistive devices to perform daily tasks that directly impact their quality of life. CMS remains committed to ensuring persons with disabilities are receiving available benefits that improve their health,” said CMS Administrator Chiquita Brooks-LaSure. “Today’s proposal promotes a first of its kind benefit expansion providing people with Medicare additional tools to improve their lives.”

If finalized, power seat elevation equipment would be covered by Medicare for individuals with a Group 3 power wheelchair, which are designed to meet the needs of people with Medicare with severe disabilities, in order to improve their health as they transfer from the wheelchair to other surfaces. Transfers often strain shoulder and back muscles and constrain an individual’s daily mobility at home and other customary locations.

CMS follows a long-standing process established by Congress to determine whether a medical item or service can be covered nationally by Medicare, including when an item or service is reasonable and necessary for the diagnosis of and/or treatment of an illness or injury. Today’s proposed NCD follows an evidence-based clinical analysis CMS initiated in August 2022 to examine whether the use of power seat elevation equipment on power wheelchairs: 1) falls within a Medicare benefit category and 2) if yes, whether it is reasonable and necessary.

Today’s NCD proposal incorporates feedback from interested parties, particularly those who are focused on eliminating health disparities for people with disabilities. CMS encourages comments from all interested parties, in particular, people with Medicare and their families, providers, clinicians, consumer advocates, health care professional associations, and from individuals serving populations facing disparities in health and health care. Additionally, CMS is specifically interested in gathering additional scientific literature that provides evidence surrounding the medical necessity for seat elevation systems through studies that include measurable characteristics related to the performance of transfers.

The proposed National Coverage Determination decision memorandum is available to review here. The 30-day comment period will close March 17, 2023.

For more information on the Medicare coverage determination process, please visit: Medicare Coverage Determination Process

Announcing the First CMS Health Equity Conference 

The Centers for Medicare & Medicaid Services, CMS, is pleased to announce its inaugural CMS Health Equity Conference, to be held June 7-8, 2023 at Howard University’s Armour J. Blackburn University Center and streamed virtually for online participation. The two-day, free conference will convene leaders in health equity from federal agencies, health provider organizations, academia, community-based organizations, and others, both in person and virtually. Conference attendees will have the opportunity to hear from CMS’s leadership on recent developments and updates on CMS programs; up-to-date research on health equity; discuss promising practices and innovate solutions and collaborate on community engagement efforts.

The Call for Proposals will open soon and registration will open in Spring 2023. More information will be available at the CMS Health Equity Conference website.

CMS is pleased to host the CMS Health Equity Conference, and we look forward to your attendance.

USDA Announces Investments in Essential Community Facilities and Equipment in Rural Pennsylvania

U.S. Department of Agriculture (USDA) Rural Development State Director Bob Morgan announced that USDA is investing $460,900 to support five projects in rural Pennsylvania.

“Emergency services and transportation for students with special needs are vital to quality of life in our rural communities,” Morgan said. “These projects directly support those organizations that often find it difficult to raise the capital funds to guarantee these essential services to their communities.”

The projects awarded today are listed below.

  • Manor Township in Armstrong County received a Community Facilities grant of $28,900 to purchase a police vehicle with accessories and upfitting. This will replace a 2017 vehicle with high mileage and is costly to maintain.
  • Cranesville Volunteer Fire Department in Erie County received a Community Facilities grant of $30,200 to purchase a new boiler system and vinyl siding for their building.
  • Jeannette EMS, Inc. in Westmoreland County received a subsequent Community Facilities Direct Loan of $12,300 to provide financing for the purchase of two new ambulances. The initial investment to the organization was a $128,500 loan and $100,000 grant to help purchase these vehicles, but due to higher equipment costs, the subsequent funding will cover the additional project costs.
  • The Township of Penn in Clearfield County received a loan of $35,000 and a grant of $50,000 to purchase a freightliner truck chassis with dump box and appurtenances.
  • The Shenandoah Valley School District in Schuylkill County received a loan of $23,600 and a grant of $52,400 to purchase two passenger vans to transport special needs students.

In total, these projects are expected to benefit more than 20,000 rural Pennsylvanians.

You can read the complete news release on our website.

A New Resource Released for Beneficiaries Dually Eligible for Medicare and Medicaid

This resource from an agency that provides analysis and advice to the U.S. Congress gives an overview of dual-eligible beneficiaries who receive benefits from both Medicare and Medicaid. Data from the calendar year 2020 depicts beneficiary demographics, eligibility pathways, utilization and spending patterns, and more. A table on page 35 includes a breakdown of beneficiaries based on urban or rural residence.

Celebrate National Children’s Dental Health this February

  To bring awareness, the Connecting Kids to Coverage National Campaign is reminding families that dental services are covered for children and teens who are eligible for Medicaid and the Children’s Health Insurance Program (CHIP).  Enrollment in Medicaid and CHIP is open year-round; however, coverage must be renewed annually. Parents and caregivers should enroll their child today, or if already covered, call their healthcare provider to schedule an appointment. Visit the “Find Coverage for Your Family” map on to access information by state or call 1-877-KIDS-NOW (1-877-543-7669).  It’s also a critical time to remind families enrolled in Medicaid or CHIP to update their contact information with their state Medicaid office so they can receive information about Medicaid Unwinding – an end to expanded public health insurance coverage that was allowed during the pandemic.

HUD is Awarding $315 Million in First Rural Investment

On February 2, the U.S. Department of Housing and Urban Development (HUD) announced 46 communities that will receive grants and vouchers to help people experiencing homelessness in rural areas.  With this funding, the awarded communities will develop an approach that involves coordination with healthcare providers, housing agencies, and people with lived experience.  It is the first time the federal agency has targeted the issue in rural areas. It is also the first push of a broader Federal Strategic Plan to Prevent and End Homelessness, launched in December 2022, that aims to reduce all homelessness by 25 percent by 2025.