- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Across the Country, Amish Populations Are on the Rise
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
- Biden-Harris Administration Takes Action to Support the Primary Care Workforce
A New Podcast Has Been Released, Rural Roads – The RCORPodcast
Get an inside look at the Rural Communities Opioid Response Program (RCORP) in this series of interviews with federal project officers (our own Kim Nesbitt in episode 2), grantees, and experts from the organization that provides technical assistance to community-based organizations in rural areas across the country.
Here You Can Read About A New Focus on Hepatitis
The White House’s budget request to Congress included an $11 billion ask to tackle the spread of the hepatitis C virus (HCV) over the next five years. Though it’s not a crisis that’s well-known or understood, public health efforts in the last 10 years have made strides toward prevention and treatment. Direct-acting antivirals developed less than a decade ago have been proven effective in 95 percent of the people who take a curative pill for 8 to 12 weeks. The challenge has been getting infected persons in for diagnosis and moving them toward treatment. For rural communities, the rise in prevalence has been labeled epidemic and closely related to injection drug use. Data show a substantial number of people are unaware they’re infected; of those with some kind of public or private insurance, only a third are actually treated. Left untreated, HCV can lead to liver failure, cancer, and death. The proposed federal program includes a significant push for screening and treatment – accelerating the availability of point-of-care diagnostic tests and providing broad access to medication – with a focus on populations at greatest risk for infection: Medicaid beneficiaries, justice-involved populations, people without insurance, and American Indian and Alaska Native individuals who are treated through the Indian Health Service. Also last week: the Centers for Disease Control and Prevention updated recommendations for hepatitis B virus screening and testing. Considered more common than HCV, hepatitis B causes more liver-related cancer and death.
Here You Can Read About Long COVID’s Lingering Effects on Rural Health
The latest feature article in The Rural Monitor shares what’s known about the post-COVID illness that’s estimated to affect as many as 3 million in rural areas. As of December 2022, data from the Centers for Disease Control and Prevention show that the top five states for self-reported symptoms are mostly rural: Montana, Wyoming, Mississippi, Kentucky, and Alaska.
Explore Rural Perspectives of Buprenorphine Here!
Researchers at Indiana University conducted one-on-one interviews with clinical providers and other stakeholders in the recovery arena to better understand the slow uptake of the drug most used to treat opioid use disorder. Biases against buprenorphine were the most consistent theme, though the reason for bias differed amongst stakeholders. Clinical providers and behavioral health care providers preferred the abstinence approach rather than the use of medications. Hospital administrators, peer recovery coaches, and criminal justice representatives tended to hold a bias against substance use in general and/or had a lack of knowledge of how buprenorphine was administered and how it works. Similar responses were reported in a 2020 study of attitudes in rural Ohio.
Read About the Changes HRSA has Made to the Budget
The U.S. Department of Health & Human Service’s budget request for FY 2024, Building a Healthy America, was released on March 9, 2023, and HRSA’s FY 2024 Congressional Budget Justification was released on March 13, 2023. The total request for the Federal Office of Rural Health Policy (FORHP) was a budget of $416 million, an increase of $63 million from the FY 2023 enacted budget. This budget request would enable FORHP to continue funding to our technical assistance partners, expand our reach to additional rural communities, and develop three new programs.
Notable increases would include:
- Rural Outreach Grants – $2 million increase
- Rural Communities Opioids Response Program – $20 million increase
The budget proposes three new programs targeting the unique and emerging needs of rural communities.
- Rural Health Clinic Behavioral Health Initiative: Rural areas represent nearly 60 percent of Mental Health Professional Shortage Areas, encompassing more than 25 million people who do not have adequate access to mental healthcare providers. $10 million would support an initiative to expand access to mental health services in rural communities where Rural Health Clinics serve as a key access point.
With 143 hospital closures since 2010, including 19 closures in 2020, the FY 2024 budget requests an investment of $30 million towards helping rural communities sustain their hospital (including Critical Access Hospitals and Rural Emergency Hospitals) healthcare infrastructure.
- Financial and Community Sustainability for At-Risk Rural Hospitals Program: $10 million would support rural hospitals at-risk for imminent closure through targeted technical assistance, and
- Rural Hospital Stabilization Pilot Program, $20 million would go toward new pilot program supporting to at-risk rural hospitals to enhance and or expand needed service lines.
The request also proposes significant investments in the health workforce. HRSA’s Bureau of Health Workforce would see an overall increase of $892 million from the FY 2023 budget, of which National Health Service Corps would receive a $548 million increase to ensure even more providers are incentivized to practice in underserved and rural communities. Additionally, $125 million would be added to the Ending the HIV Epidemic in the United States Initiative, specifically to increase evidence-based practices and support HIV care for clients including those in the seven states with substantial rural HIV burden.
Pennsylvania Data Show Overdose Deaths May Be Declining
An analysis by the Center for Rural Pennsylvania has shown that the number of deaths from drug overdoses may be declining in rural areas. But optimism remains cautious, as many rural areas still have overdose rates above the state average and less access to lifesaving interventions. At a recent hearing, addiction treatment providers in the state stressed the need for regulatory changes to meet rural needs. Providers testified that finding transportation to get to treatment services is a challenge and the majority of people housed at the county’s jail have substance use disorders.
Linkages Between Rural Community Capitals and Healthcare Provision: A Survey of Small Rural Towns in Three U.S. Regions
New report from USDA’s Economic Research Service
Although healthcare is one of the largest and fastest-growing sectors in the rural U.S., many rural communities suffer from poor access to healthcare, in part due to difficulties recruiting and retaining healthcare professionals.
A report issued today by USDA’s Economic Research Service, Linkages Between Rural Community Capitals and Healthcare Provision: A Survey of Small Rural Towns in Three U.S. Regions, focuses on how rural communities can attract and retain healthcare professionals. The study is based on key informant interviews and a survey of healthcare professionals in 150 rural small towns in 9 U.S. states.
Here are a few key findings from the report:
- Social capital (the value of personal and professional relationships) was widely perceived by both key informants and healthcare professionals as important for the recruitment and retention of the professionals. Many key informants and most healthcare professionals highlighted the importance of relationships with family, friends, colleagues, and patients in recruitment and length-of-stay decisions.
- Physical capital such as the availability and quality of housing, medical facilities, and equipment was widely cited as a factor, though less often than social capital.
- Human capital, reflected in the quality of both schools and healthcare professionals, is also widely perceived as important for recruitment and retention, though cited less often than social capital. Key informants more often cited the importance of school quality for recruitment—while healthcare professionals often cited the quality of the medical community, colleagues, and staff as important to accepting and retaining employment.
For more information, please refer to the full report.
New Report Reveals Dental Insurance Dropouts
New monthly data from the American Dental Association (ADA) Health Policy Institute (HPI) reveal new insights into the status of practice participation in dental insurance networks. The data show that about 1 in 6 dental practices have dropped out of some insurance networks since January 2023. The February 2023 poll also revealed that one-third of dentists continue to report they are actively recruiting dental hygienists and dental assistants.
HHS Releases Initial Guidance for Historic Medicare Drug Price Negotiation Program for Price Applicability Year 2026
For the first time in history, Medicare will have the ability to negotiate lower prescription drug prices because of the Inflation Reduction Act. The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued initial guidance detailing the requirements and parameters—including requests for public comment— on key elements of the new Medicare Drug Price Negotiation Program for 2026, the first year the negotiated prices will apply. Alongside other provisions in the new drug law, the Medicare Drug Price Negotiation Program will strengthen Medicare’s ability to serve people currently in Medicare and for generations to come.
“For far too long, millions of Americans have had to choose between their prescription drugs and other monthly expenses,” said HHS Secretary Xavier Becerra. “President Biden is leading the fight to lower the cost of prescription drugs – and with the Inflation Reduction Act, we’re making historic progress. Through the Medicare Drug Price Negotiation Program, we will make sure seniors get a fair price on Medicare’s costliest prescription drugs, promote competition in the market, and ensure Medicare is strong for beneficiaries today and into the future.”
“Drug price negotiation is a critical piece of how this historic law improves the Medicare program,” said CMS Administrator Chiquita Brooks-LaSure. “By considering factors such as clinical benefit and unmet medical need, drug price negotiation intends to increase access to innovative treatments for people with Medicare.”
The Biden-Harris Administration has made lowering high prescription drug costs and improving access to innovative therapies a key priority. CMS is releasing its initial guidance for how Medicare intends to use its new authority to effectively negotiate with drug companies for lower prices on selected high-cost drugs. The negotiation process will focus on key questions, including but not limited to the selected drug’s clinical benefit, the extent to which it fulfills an unmet medical need, and its impact on people who rely on Medicare. As a result of negotiation, people with Medicare will have access to innovative, life-saving treatments at costs that will be lower for both them and Medicare.
“Negotiation is a powerful tool that will drive drug companies to innovate to stay competitive, fostering the development of new therapies and delivery methods for the treatments people need,” said Meena Seshamani, M.D., Ph.D., CMS Deputy Administrator and Director of the Center for Medicare. “This initial guidance is the next step in the extensive engagement CMS has had to date with interested parties, and we look forward to continuing to receive comment on key policy areas and engage with the public as we implement the Negotiation Program.”
This initial guidance is one of a number of steps CMS laid out in the Medicare Drug Price Negotiation Program timeline for the first year of negotiation. The initial program guidance details the requirements and procedures for implementing the new Negotiation Program for the first set of negotiations, which will occur during 2023 and 2024 and result in prices effective in 2026. Key dates for implementation include:
- By September 1, 2023, CMS will publish the first 10 Medicare Part D drugs selected for initial price applicability year 2026 under the Medicare Drug Price Negotiation Program.
- The negotiated maximum fair prices for these drugs will be published by September 1, 2024 and prices will be in effect starting January 1, 2026.
- In future years, CMS will select for negotiation up to 15 more Part D drugs for 2027, up to 15 more Part B or Part D drugs for 2028, and up to 20 more Part B or Part D drugs for each year after that, as outlined in the Inflation Reduction Act.
CMS is seeking comment on several key elements in today’s guidance. Comments received by April 14, 2023, will be considered for revised guidance. CMS anticipates issuing revised guidance for the first year of negotiation in Summer 2023.
CMS is committed to collaborating and engaging with the public in the implementation of the Inflation Reduction Act. CMS is working closely with patients and consumers, Medicare Part D plan sponsors and Medicare Advantage organizations, drug companies, hospitals and health care providers, wholesalers, pharmacies, and others. Public feedback contributes to the success of the Medicare Drug Price Negotiation Program, and this initial guidance is one tool, among many, that CMS will use to ensure interested parties know when and how they can make their voices heard on implementation of this new drug law.
View a fact sheet on the Medicare Drug Price Negotiation Program Initial Guidance
Read the Medicare Drug Price Negotiation Program Initial Guidance.
Appalachian Regional Commission: 58 Years of Serving Appalachia
The Appalachian Regional Development Act of 1965, which formally established ARC to help strengthen economic growth in the region, was signed into law 58 years ago today! Since then, we have invested more than $4.5 billion in approximately 29,000 economic development projects across all 13 Appalachian states.
Despite this progress, there’s more work to be done, which is why we’re excited to award up to $145 million this year through ARISE, INSPIRE, and POWER! Explore our current funding opportunities and help us build on economic growth and progress in the Appalachian Region.
Learn more here.
Pennsylvania Organization for Women in Early Recovery
Since 1991, the Pennsylvania Organization for Women in Early Recovery (POWER) has offered tailored treatment and support services to women in recovery. An ARC INSPIRE grant helped them enhance treatments, expand support offerings, and widen their service area to help even more women sustain recovery and enter the workforce