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Rural Health Leadership Radio: A Conversation with Lisa Davis

The global budget is underway in Pennsylvania, but there is a lot more than that taking place. In this episode of Rural Health Leadership Radio™ we are talking about Medicaid expansion, rural hospital budget transformation, medical student community orientation and other topics of interest to rural health leaders.  We are having that conversation with Lisa Davis, Director of the Pennsylvania Office of Rural Health and Outreach Associate Professor of Health Policy and Administration at Penn State.

“Pennsylvania is considered to be one of the most rural states in the nation.”

In her role, Lisa is responsible for the overall direction and leadership of the state office of rural health, including ensuring that the office meets its mission of being a source of networking, coordination, and technical assistance to organizations focused on rural health care delivery; developing and sustaining linkages with state and national partners; and seeking ways to expand the office’s role in enhancing the health status of rural Pennsylvanians.

“Medicaid expansion has been very important here in the state for a number of reasons.”

On the national, state, and university levels, Davis serves on a wide range of boards of directors, advisory committees, and task forces focused on rural health policy, rural health research, economic development, outreach and education, and vulnerable populations and specific health issues such as oral health and cancer.  She has extensive experience in the field of rural health research.

“They learned about what it means to be those individuals, what it means to live there, what the social structure is, what the economy is like in those communities.”

Davis is the recipient of the Distinguished Service Award from the National Organization of State Offices of Rural Health, an Outstanding Leadership Award from the Pennsylvania Rural Health Association, and an Award for Individual Contributions to Public Health from the Pennsylvania Public Health Association.  The Pennsylvania Office of Rural Health received the Award of Merit from the National Organization of State Offices of Rural Health.

She holds a graduate degree in Health Administration from Penn State.

CDC: Tracking Transmission of HIV

CDC: Tracking Transmission of HIV.   On Monday, the Centers for Disease Control and Prevention (CDC) released their latest report on rates of HIV transmission in the United States.  Data for sexual and needle-sharing behaviors were obtained fromNational HIV Behavioral Surveillance, a system of research on behaviors of three populations at increased risk for HIV: 1) gay, bisexual and other men who have sex with men; 2) persons who inject drugs; and 3) heterosexuals at increased risk of infection.  These data for behavioral factors in 2016 were compared to data for newly diagnosed cases from the National HIV Surveillance System.  The analysis found that, of the 38,700 new infections diagnosed in 2016, approximately 80% of new HIV transmissions were from persons who did not know they had HIV infection, or who had received diagnosis but were not receiving care.  The report concludes that decreasing the rate of transmission relies on increasing the rate of testing and treating those who are HIV-positive with newer drugs proven to be effective at suppressing the virus.  Last year, the CDC identified 220 mostly rural counties experiencing or at-risk of significant increases of infection.  See the Approaching Deadlines section below for current funding opportunities related to the effort of reducing HIV transmission.

2019 County Health Rankings

2019 County Health Rankings.  Released on Tuesday of this week, the 2019 ranking of health for nearly every county in the nation reminds us that health outcomes are heavily influenced by where we live.  This year’s analysis focuses specifically on homes and the way they shape the health of individuals, families and communities.  Among the key findings is evidence showing that severe housing cost burden has decreased in large urban areas since the end of the real estate crisis that ended in 2010.  In that same period of time, however, nearly half of all rural counties experienced an increase in severe housing costs.

Ongoing Work on Rural Health Issues at the CDC

Ongoing Work on Rural Health Issues at the CDC.  In the latest edition of The Rural Monitor, Senior Policy Analyst Diane Hall answers questions about the work on rural health at the Centers for Disease Control and Prevention (CDC). What started as a series in 2017 for their Morbidity and Mortality Weekly Report (MMWR) has continued with ongoing work with representation from each of the CDC’s centers ensuring that rural communities are included in funding opportunities and projects.  The MMWR series oriented the public and policymakers to the rural specifics on topics such as drug overdose deaths, leading causes of death, suicide trends, and cancer incidence and deaths.

Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics

Abigail Barker, PhD; Lindsey Nienstedt, BA; Leah Kemper, MPH; Timothy McBride, PhD; and Keith Mueller, PhD

This brief uses data from the 2012–13 Medicare Current Beneficiary Survey (MCBS) to describe rural and urban differences in the populations that enroll in the Medicare Advantage (MA) program. Combined with county-level data on MA issuer participation, this dataset also allows us to assess the degree to which issuers may engage in selective MA market entry on the basis of observed demographic characteristics. Rural and urban MA and fee-for-service populations did not differ much by any characteristics reported in the data, including age, self-reported health status, cancer diagnosis, smoking status, Medicaid status, or by other variables assessing frailty and presence of chronic conditions. Most measures of access were similar across rural and urban respondents. While rurality on its own was often a significant predictor of lower issuer participation in a county’s MA market, the addition of other demographic characteristics did not influence the prediction. In other words, we found no evidence, based upon MCBS data, that issuers exclude rural counties due to other demographics. These findings suggest that poor health – as approximated by the demographic characteristics captured in MCBS data – is also captured similarly in risk adjustment formulas, meaning that MA issuers are compensated for this observed risk.

Click to download a copy: Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics

Implementation of the Flex Program’s Innovative Models Program Area: Final Evaluation Report

The Flex Monitoring Team’s latest briefing paper is a report on our evaluation of projects implemented under Flex Program Area 5: Integration of Innovative Health Care, which is a new program area in the current funding cycle.

We describe the initiatives of seven states in the areas of telehealth, care coordination, and quality improvement, and discuss their implementation and their early results. We also examine the role and impact of Program Area 5 in the Flex Program, and highlight key lessons learned from this first round of implementation.

Click through to access the paper.

CMS Opioid Prescribing Mapping Tool Improved with Medicaid and Rural Data

CMS Opioid Prescribing Mapping Tool Improved with Medicaid and Rural Data.

Recently, the Centers for Medicare & Medicaid Services (CMS) released an expanded version of its tool that tracks rates of opioid prescribing over time and across regions to help inform prevention and treatment efforts.   For the first time since the Opioid Prescribing Mapping Tool launched in 2015, the tool allows geographic comparisons of Medicare Part D opioid prescribing rates for urban and rural communities.  See the Learning Events section below for a CMS Rural Health Open Door Forum, taking place today, that will explain what’s new for rural stakeholders.