Information about the most recent Rural Communities Opioid Response Program grantee cohorts is now available on the Rural Health Information Hub at the following links:

• RCORP – Behavioral Healthcare Support Grantee Directory: 2022 Cohort
• RCORP – Implementation IV Grantee Directory: 2022 Cohort
• RCORP – Medication Assisted Treatment Access Grantee Directory: 2022 Cohort
• RCORP – Psychostimulant Support II Grantee Directory: 2022 Cohort

 The Centers for Medicare & Medicaid Services recently published payment policy updates to Medicare Advantage (also known as Medicare Part C) and Medicare Prescription Drug Program (also known as Medicare Part D) for the calendar year 2024. The updates include a payment increase of 3.32% compared to 2023, Star Rating updates, and finalized growth rates for Medicare Advantage, as well as alignment of Medicare Advantage, plans with the Internal Classification of Diseases (ICD)-10 system which has been in place since 2015 for many other payors in the U.S. The updates also include policies addressing Puerto Rico payment rates, prior authorization practices, access to behavioral health services, and marketing of Medicare Advantage plans. Part D updates for 2024 include the elimination of cost-sharing in catastrophic phase coverage, expanding the low-income subsidy program, eliminating deductibles for certain adult vaccines and insulin products, and limiting a month’s supply of covered insulin products to $35 per month. Medicare Advantage has continued to grow faster in rural areas, with enrollment growing 13.4 percent between 2021 and 2022 in rural and 7.9 percent in urban counties.

In response to a change in the way the Census Bureau defines rural and urban areas, the Centers for Medicare & Medicaid Services (CMS) released an interim process for determining locations of new Rural Health Clinics. For now, CMS will use the 2010 and 2020 Census urban criteria when determining rural location, and locations meeting either standard will be eligible.  The 2010 criteria defined two types of urban areas: 1) urbanized areas with a population of 50,000 or more; and 2) urban clusters with at least 2,500 but fewer than 50,000 people. So under the 2010 criteria, a rural location is one that is not in an urbanized area but might be in an urban cluster. Under the 2020 criteria, the Census Bureau no longer subdivides urban areas by population size so all developed areas are simply called urban areas – and housing density, not population, is the primary determining factor. The population is still considered at the lower end: the minimum population for an urban area designation increased from 2,500 people to 5,000 people or at least 2,000 housing units. The Federal Office of Rural Health Policy is housed in a different agency (HRSA) under the U.S. Department of Health & Human Services and uses different measures to define rural for its grant programs.  Learn more details about eligibility for FORHP grants on the HRSA website.

 Yesterday, the U.S. Food and Drug Administration (FDA) announced that the makers of Narcan, an opioid overdose treatment, have the agency’s approval to make the drug widely available over the counter (OTC).  Narcan is the brand name of the drug naloxone, a fast-acting overdose reversal. Until now, availability varied by state – typically restricted to licensed health care providers, approved opioid overdose programs, and first responders. This is an important consideration for rural counties given that research shows that these areas are nearly three times more likely than metropolitan counties to be a low-dispensing county for naloxone.

 In 2021, the Centers for Disease Control and Prevention carved out $427 million in state funding to focus on combatting COVID-19 in rural communities as part of a multibillion-dollar national initiative to address COVID-19-related health disparities among at-risk and underserved populations. This case study by the FORHP-Supported Southwest Rural Health Research Center explores the circumstances around this emphasis on rural America by interviewing relevant decision-makers and key stakeholders.

A sweeping report from the Administration of Children and Families (ACF) delivers insight into the rural-specific barriers to the agency’s programs – e.g., for housing, early childhood, and family development, Healthy Marriage, and Responsible Fatherhood.  Some of these barriers are well known and understood, such as distance to services and negative perceptions of public assistance.  But through qualitative and quantitative data collection, ACF researchers find details of how factors such as race, digital access, and housing are realized in the rural context and hinder the effectiveness of human services.

 The Commonwealth Fund examines programs that send paramedics and other staff to peoples’ homes to stabilize their health and avoid the need for 911 calls down the line.  The report cites 129 programs in the U.S., with more than 40 of these in rural areas.