Rural Health Information Hub Latest News

ARC on Appalachian Diseases of Despair

The federal Appalachian Regional Commission (ARC) provides information on mortality disparities due to overdose, suicide, and alcoholic liver disease/cirrhosis among people ages 15-64.  The report is a collaboration among ARC, East Tennessee State University Center for Rural Health Research, and the NORC Walsh Center for Rural Health Analysis.

Government Accountability Office (GAO) Issues a New Report on Behavioral Health

 The Government Accountability Office (GAO), the federal agency that examines how taxpayer dollars are spent, issued a new report on behavioral health benefit availability under Medicare and Medicare Advantage (MA) programs. The GAO reports findings on what beneficiaries pay out of pocket, and oversight by the Centers for Medicare & Medicaid Services of cost-sharing in MA plans for behavioral health services. Behavioral health conditions were estimated to affect at least a quarter of the 66.7 million Medicare beneficiaries in 2023.  The 2023 National Survey on Drug Use and Health estimated approximately 7.7 million nonmetropolitan adults reported having any mental illness (AMI) in 2023, accounting for 22.7 percent of non-metropolitan adults.

PHC4 Looks to Broaden Value to Pennsylvania Stakeholders, Offering Insight into Non-Compete Agreements in Health Care and Public Comment Period

PHC4 has released a new resource on its website, intended to support informing interested Pennsylvanians on current topics that impact health care in the Commonwealth. This first occurrence aims to offer insight into non-compete agreements in health care and includes an extensive summary of the events on both state and federal levels.

PHC4 believes this coincides with its mission to empower Pennsylvanians through transparency, providing access to data, research, analysis, and reporting focused on the cost, utilization, and quality of health care delivery in the Commonwealth. Barry D. Buckingham, Executive Director at PHC4, stated, “I’m proud to be a part of expanding the reach of PHC4’s value by offering additional resources in support of every person in the Commonwealth making informed decisions.” He went on to say offering key insights and support to Pennsylvania’s stakeholders is paramount in assessing the relevance of this new requirement through Act 74 of 2024, as well as in the development of additional resources.

Announced alongside this is a public comment period in response to the Fair Contracting for Health Care Practitioners Act, Act 74 of 2024. This recent legislation requires PHC4 to perform a study on the effects of the Act, and to report its findings. In support of this study PHC4 will be collecting public comment for analysis and inclusion within the final report. To ensure comments are included for analysis, the comment must be received by October 21, 2024. Those interested in commenting on Act 74 of 2024, may do so by sending an email or letter by mail to PHC4.

Email: publiccomment@phc4.org

Letter by Mail: PA Health Care Cost Containment Council, 225 Market St, Suite 400, Harrisburg, PA 17101

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.

For more information, visit phc4.org.

ARC Seeks Applicants for Capacity-Building Projects Across Appalachian Region

READY Grants to Grow is making $9 million available for projects that will build individual, organizational and/or community capacity to help the region’s most underserved areas and populations create positive change.

The Appalachian Regional Commission (ARC) announced the launch of READY Grants to Grow, a new, $9 million funding opportunity that will award grants of up to $500,000 to organizations seeking to build individual, organizational and/or community capacity across Appalachia. Any organization that is eligible to apply for an ARC grant can apply for READY Grants to Grow, though certain requirements apply.

READY Grants to Grow is the latest offering from READY Appalachia, ARC’s capacity-building initiative offering no-cost training and funding access to nonprofits, local development districts (LDDs), local governments and community foundations serving the region. This new funding opportunity aims to make even more resources available to a wider range of community and economic development organizations.

“Many of our Appalachian communities do not have the staff to fully take advantage of valuable opportunities for growth,” said ARC Federal Co-Chair Gayle Manchin. “Through the READY Grants to Grow initiative, ARC is working to help these communities to address these economic inequalities, so they can increase their grant success potential and create long-lasting, transformative change for their residents and the region.”

To be selected, organizations must propose projects that strengthen underserved communities and economies in the Appalachian Region, and/or demonstrate low capacity themselves. Proposed projects must address one or more of the following:

  • Individual capacity building, including skill training for organization staff or professional development for leaders.
  • Organizational capacity building, including hiring new staff for expanded services, developing internal strategic plans, or purchasing goods and services that will improve operation.
  • Community capacity building, including creating and expanding partnership networks, hiring a contractor for a community economic development plan, or launching a community-led planning process.

Successful projects will draw a clear connection between their capacity building proposal and the broader community’s economic development and improved services to underserved populations and areas.

pre-application webinar will be held on October 10, 2024 at 11:00 a.m. ET. Interested applicants must submit a letter of intent to apply by November 1, 2024 to access application portal. Grant applications are due February 14, 2025.

READY Appalachia was launched in July 2022 using Bipartisan Infrastructure Law funds. To date, ARC has provided no-cost training to 75 nonprofits, 90 local government entities, 41 LDDs and 30 community foundations to help them build internal capacity and better serve their communities. Nearly $4 million in funding (no match required) was awarded through READY LDDs and more than $1.6 million was awarded through READY Nonprofits, with more awards on the horizon through READY Local Governments and READY Community Foundations.

Across all READY Appalachia opportunities, special emphasis is placed on serving Appalachia’s most underrepresented communities, including economically distressed areas, organizations located within the Rural Partners Network’s Community Networks, counties prioritized by the Interagency Working Group on Coal and Power Plant Communities, and marginalized populations.

About READY Appalachia
READY Appalachia is an ARC initiative building individual, organizational and community capacity in the Appalachian Region. Offerings include no-cost, cohort-based training and funding access (no match required) for nonprofit organizations, Local Development Districts (LDDs), local governments and community foundations serving the Appalachian Region. Additionally, READY Grants to Grow offers capacity building grant awards of up to $500,000, available to entities that are currently eligible to apply for ARC grants. Across all READY Appalachia offerings, special emphasis is placed on helping the region’s most under resourced and economically distressed communities increase their ability to solve pressing issues and create lasting, positive change.

About the Appalachian Regional Commission
The Appalachian Regional Commission is an economic development entity of the federal government and 13 state governments focusing on 423 counties across the Appalachian Region. ARC’s mission is to innovate, partner, and invest to build community capacity and strengthen economic growth in Appalachia to help the region achieve socioeconomic parity with the nation.

New Resource! Explore Career Paths In the U.S.

Many workers are looking for ways to move up the economic ladder. The updated Occupational Mobility Explorer from the Federal Reserve Banks of Philadelphia and Cleveland allows you to trace a career path by visualizing how skills needed for lower-paying jobs can transfer to similar jobs with higher pay in the same local market.

You can now explore nearly 600 job titles across 500-plus U.S. locations. You can build a path from your current role by exploring jobs with higher pay in the same local market that share skills with that role while identifying the additional skills you may need to develop to grow your career. Or select a higher-paying role to start, and the tool will show lower-paying roles with shared skills in that local market that could lead to that career goal.

What else is in the enhanced tool? You can see how similar the skills are between jobs in your path, their median wages, whether they require a college degree, and what their projected growth rate is. You can also view local job postings for jobs within your career path and write a skills-based resume using resources featured on the site.

Start exploring now.

703 Hospitals at Risk of Closure, State by State

From Becker’s Financial Management

More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure.

The latest analysis from the Center for Healthcare Quality and Payment Reform, based on CMS’s July 2024 hospital financial information, reveals the financial vulnerability of rural hospitals in two categories: risk of closure and immediate risk of closure.

In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with nine states having a majority of their rural hospitals in jeopardy.

The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 360 rural hospitals are at immediate risk of shutting down due to severe financial difficulties.

“The primary reason hundreds of rural hospitals are at risk of closing is that private insurance plans are paying them less than what it costs to deliver services to patients,” CHQPR notes in its report, identifying losses on private insurance patients as the biggest cause of overall financial losses.

“Most ‘solutions’ for rural hospitals have focused on increasing Medicare or Medicaid payments or expanding Medicaid eligibility due to a mistaken belief that most rural patients are insured by Medicare and Medicaid or are uninsured,” according to the CHQPR report. “In reality, about half of the services at the average rural hospital are delivered to patients with private insurance (both employer-sponsored insurance and Medicare Advantage plans). In most cases, the amounts these private plans pay, not Medicare or Medicaid payments, determine whether a rural hospital loses money.”

To preserve and enhance essential hospital services in rural areas, CHQPR recommends that small rural hospitals receive Standby Capacity Payments from both private and public payers. These payments would cover the hospital’s fixed costs for maintaining essential services, ensuring that rural communities continue to have access to necessary healthcare.

Below is a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years.

Alabama
28 hospitals at risk of closing (54%)
24 at immediate risk of closing in next 2-3 years (46%)

Alaska
2 hospitals at risk of closing (12%)
1 at immediate risk of closing in next 2-3 years (6%)

Arizona
2 hospitals at risk of closing (7%)
1 at immediate risk of closing in next 2-3 years (4%)

Arkansas
25 hospitals at risk of closing (54%)
13 at immediate risk of closing in next 2-3 years (28%)

California
23 hospitals at risk of closing (40%)
10 at immediate risk of closing in next 2-3 years (17%)

Colorado
10 hospitals at risk of closing (23%)
6 at immediate risk of closing in next 2-3 years (14%)

Connecticut
2 hospitals at risk of closing (67%)
1 at immediate risk of closing in next 2-3 years (33%)

Delaware
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years

Florida
8 hospitals at risk of closing (36%)
5 at immediate risk of closing in next 2-3 years (23%)

Georgia
22 hospitals at risk of closing (32%)
11 at immediate risk of closing in next 2-3 years (16%)

Hawaii
8 hospitals at risk of closing (62%)
0 at immediate risk of closing in next 2-3 years

Idaho
7 hospitals at risk of closing (24%)
0 at immediate risk of closing in next 2-3 years

Illinois
12 hospitals at risk of closing (16%)
7 at immediate risk of closing in next 2-3 years 9%)

Indiana
5 hospitals at risk of closing (9%)
4 at immediate risk of closing in next 2-3 years (7%)

Iowa
29 hospitals at risk of closing (31%)
10 at immediate risk of closing in next 2-3 years (11%)

Kansas
62 hospitals at risk of closing (63%)
31 at immediate risk of closing in next 2-3 years (32%)

Kentucky
13 hospitals at risk of closing (18%)
6 at immediate risk of closing in next 2-3 years (8%)

Louisiana
24 hospitals at risk of closing (44%)
12 at immediate risk of closing in next 2-3 years (22%)

Maine
10 hospitals at risk of closing (40%)
6 at immediate risk of closing in next 2-3 years (24%)

Maryland
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years

Massachusetts
2 hospitals at risk of closing (33%)
1 at immediate risk of closing in next 2-3 years (17%)

Michigan
15 hospitals at risk of closing (23%)
7 at immediate risk of closing in next 2-3 years (11%)

Minnesota
19 hospitals at risk of closing (20%)
7 at immediate risk of closing in next 2-3 years (7%)

Mississippi
35 hospitals at risk of closing (52%)
25 at immediate risk of closing in next 2-3 years (37%)

Missouri
20 hospitals at risk of closing (34%)
10 at immediate risk of closing in next 2-3 years (17%)

Montana
14 hospitals at risk of closing (25%)
4 at immediate risk of closing in next 2-3 years (7%)

Nebraska
5 hospitals at risk of closing (7%)
2 at immediate risk of closing in next 2-3 years (3%)

Nevada
5 hospitals at risk of closing (36%)
3 at immediate risk of closing in next 2-3 years (21%)

New Hampshire
2 hospitals at risk of closing (12%)
0 at immediate risk of closing in next 2-3 years

New Jersey
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years

New Mexico
7 hospitals at risk of closing (26%)
6 at immediate risk of closing in next 2-3 years (22%)

New York
29 hospitals at risk of closing (56%)
20 at immediate risk of closing in next 2-3 years (38%)

North Carolina
6 hospitals at risk of closing (11%)
5 at immediate risk of closing in next 2-3 years (9%)

North Dakota
13 hospitals at risk of closing (33%)
5 at immediate risk of closing in next 2-3 years (13%)

Ohio
5 hospitals at risk of closing (7%)
2 at immediate risk of closing in next 2-3 years (3%)

Oklahoma
39 hospitals at risk of closing (50%)
26 at immediate risk of closing in next 2-3 years (33%)

Oregon
8 hospitals at risk of closing (24%)
2 at immediate risk of closing in next 2-3 years (6%)

Pennsylvania
13 hospitals at risk of closing (30%)
7 at immediate risk of closing in next 2-3 years (16%)

Rhode Island
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years

South Carolina
10 hospitals at risk of closing (40%)
5 at immediate risk of closing in next 2-3 years (20%)

South Dakota
8 hospitals at risk of closing (16%)
4 at immediate risk of closing in next 2-3 years (8%)

Tennessee
19 hospitals at risk of closing (36%)
17 at immediate risk of closing in next 2-3 years (32%)

Texas
80 hospitals at risk of closing (50%)
30 at immediate risk of closing in next 2-3 years (19%)

Utah
0 hospitals at risk of closing
0 at immediate risk of closing in next 2-3 years

Vermont
8 hospitals at risk of closing (62%)
4 at immediate risk of closing in next 2-3 years (31%)

Virginia
9 hospitals at risk of closing (30%)
8 at immediate risk of closing in next 2-3 years (27%)

Washington
16 hospitals at risk of closing (36%)
4 at immediate risk of closing in next 2-3 years (9%)

West Virginia
11 hospitals at risk of closing (35%)
5 at immediate risk of closing in next 2-3 years (16%)

Wisconsin
7 hospitals at risk of closing (9%)
1 at immediate risk of closing in next 2-3 years (1%)

Wyoming
6 hospitals at risk of closing (24%)
2 at immediate risk of closing in next 2-3 years (8%)

Funding Announcement for Pennsylvania Community Planning Handbook

The Center for Rural Pennsylvania welcomes proposals to revise its Community Planning Handbook to address community planning and visioning in light of rural population change. As noted in a 2023 report by the Center and the Pennsylvania State Data Center, rural Pennsylvania’s population will shrink by approximately 5.8% by 2050.

Currently in its Fourth Edition (2013), a revised and significantly updated Community Planning Handbook will incorporate new community planning materials consistent with best practices, informed by the scholarly and/or community development literature and the practical experiences of the authors. Furthermore, the revised Handbook will focus on addressing population change within rural communities.

Proposals are welcomed from independent stakeholders, nonprofit groups, and any entities eligible to enter into a contract with an agency of the Commonwealth of Pennsylvania, in addition to higher education institutions in the state.

The review of proposals will begin on October 21, 2024, and continue until a successful proposal is accepted. Final proposals should be submitted to commission@rural.pa.gov.

Learn more and download a proposal submission form here.