Rural Health Information Hub Latest News

How Are Hospitals Investing in Community Development?

The new report Exploring Hospital Investments in Community Development provides the first in-depth, national analysis of nonprofit hospitals’ reported spending on community building activities, examining how this spending varies by geography and hospital characteristics. The report also includes a qualitative review of related activities undertaken by hospitals in Third District states (Delaware, Pennsylvania, New Jersey), highlighting areas of potential alignment with the community development field.

Social determinants of health — such as economic security, housing conditions, and neighborhood context — are increasingly recognized as having an even greater impact on health and well-being than clinical care. Although many hospitals and health-care systems are exploring opportunities to address these nonmedical determinants, before now, little was known about how much hospitals typically invest in community development–related activities or what types of partnerships and initiatives they pursue.

Exploring Hospital Investments in Community Development sheds new light on this topic by examining nonprofit hospitals’ spending on efforts to address the social and economic needs of patients and communities. The report finds that, in aggregate, nonprofit hospitals reported spending an average of $474 million on community building each year during the study period. This funding was primarily allocated toward workforce development, community services, and community health improvement advocacy efforts. Additionally, a qualitative review of hospitals’ reported activities identifies examples of interventions related to housing, economic development, food access, and more.

Read the full report: Exploring Hospital Investments in Community Development.

See the Data Appendix for hospital spending breakouts for states, metropolitan areas, and nonmetropolitan portions of states.

Appalachian Commission Extends Strategic Plan Through 2021

ARC develops a Strategic Plan every five years with community input from listening sessions, workshops, and other information from the Region. ARC’s current Strategic Plan Envision Appalachia: Community Conversations for ARC’s Strategic Plan technically expired when fiscal year 2020 ended at the end of September. Plans were in the making for a new strategic planning process earlier this year. However, noting challenges related to the COVID-19 crisis, the Commission unanimously voted to extend our strategic plan through fiscal year 2021.

Learn more about ARC’s investment priorities in relation to the extended strategic plan here.

The Present and Future of the Appalachian Gas Industry

Eighty-five percent of the growth in the United States natural gas production over the past decade has occurred in Northern to Central Appalachia. Additionally, petrochemical manufacturing, currently in development in the Region, is projected to attract between $16-20 billion in capital investment, and create more than 9,800 jobs directly and indirectly in Appalachia by 2025 noted The Appalachian Energy and Petrochemical Renaissance which was released by the Department of Energy earlier this year.

This week, Dr. Dean Foreman, Chief Economist for the American Petroleum Institute and an expert on domestic and global natural gas markets, briefed ARC staff on the current economic state and future growth potential for the Region’s significant shale gas resources. He noted that U.S. natural gas supply/demand fundamentals remain solid, with prospective market opportunity hinging largely on electricity generation, and that developing regional pipeline capacity enables Appalachian gas to reach diverse markets, thereby increasing demand and prices. Moreover, Dr. Foreman noted that natural gas demand and supply have held up relatively well through the COVID-19 pandemic, and with low prices are expected to support record 38.9% penetration of natural gas into U.S. electricity generation in 2020.

What’s an Opportunity Zone and How Can it Help Your Community?

The ARC hosted a 90-minute Learning Session led by Regional experts about how Appalachian communities can use Opportunity Zones to strengthen local communities. There are 737 distressed communities in Appalachia designed as Opportunity Zones where new investments may be eligible for preferential tax treatment.

The session included remarks from Donna Gambrell of Appalachia Community Capital (ACC) and Alex Flachsbart of Opportunity Alabama (OA), who were recognized recently by Forbes Magazine as visionaries for Opportunity Zones. Using ARC support, ACC is working directly with nearly 20 communities to get them ready for successful Opportunity Zone-driven investments and Opportunity Alabama is developing an Opportunity Zones-based funding and business development ecosystem across Alabama’s 37 Appalachian counties.

The seminar, which included formal presentations and a fireside chat, identified these key steps for successfully implementing Opportunity Zone investment strategies:

  1. Organize a local ecosystem
  2. Identify community assets and needs
  3. Prioritize properties and projects
  4. Help facilitate connections

Learn more about Opportunity Zones in Appalachia and view the session here.

Trump Administration Finalizes Rule Requiring Health Insurers to Disclose Price and Cost-Sharing Information

The U.S. Departments of Health and Human Services, Labor, and Treasury finalized their tri-agency final rule on healthcare price transparency to further advance the Administration’s commitment to create a healthcare system that is patient and consumer centric. You can learn more about the final rule and the Administration’s transparency efforts by following the links below:

Resource Guide – Promoting Rural Prosperity in America

Building on the foundational work of the Task Force, the White House released a rural prosperity resource guide for State, local, and Tribal leaders. The resource guide – Promoting Rural Prosperity in America – demonstrates the Administration’s historic investment in and support for rural America and outlines key programs across the Federal government to support rural prosperity and resiliency.

You can also find a helpful guide from the White House Office of Intergovernmental Affairs on disaster recovery and resilience here.

Trump Administration Acts to Ensure Coverage of Life-Saving COVID-19 Vaccines & Therapeutics

Trump Administration Acts to Ensure Coverage of Life-Saving COVID-19 Vaccines & Therapeutics

The Centers for Medicare & Medicaid Services (CMS) is taking steps to ensure all Americans, including the nation’s seniors, have access to the coronavirus disease 2019 (COVID-19) vaccine at no cost when it becomes available. Today, the agency released a comprehensive plan with proactive measures to remove regulatory barriers and ensure consistent coverage and payment for the administration of an eventual vaccine for millions of Americans. CMS released a set of toolkits for providers, states and insurers to help the health care system prepare to swiftly administer the vaccine once it is available.  These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate reimbursement for administering the vaccine in Medicare, while making it clear to private insurers and Medicaid programs their responsibility to cover the vaccine at no charge to beneficiaries. In addition, CMS is taking action to increase reimbursement for any new COVID-19 treatments that are approved or authorized by the FDA.

Full press release

Free VA-Approved Health Care and COVID-19 Training Available

The Veterans Health Administration Employee Education System (EES) is a program office of the Department of Veterans Affairs.  They provide timely, reliable and essential educational offerings to VA employees and community providers in a variety of easily accessible and cutting-edge formats, much of which offer continuing education credits.

A host of materials have been developed that describe the free training that the VA provides to the public, including:

  • A catalog of our current TRAIN educational offerings, which is updated monthly.
    • These programs can be accessed anytime through VHA TRAIN
  • A subscriber page where learners can sign up by health care topic to get email announcements when courses on a specific topic are added
  • VHA TRAIN data sheet, which is a single page PDF of key TRAIN information and can be distributed digitally or printed for local use

The agency has created a COVID-19 training website where any learner can take free COVID-19 specific training. Materials on the site are all available through publicly accessible devices, such as personal cell phones and tablets so they can be taken anytime, anywhere. Here is a data sheet that describes its capabilities.

COVID-19 and Its Impact on Intimate Partner Violence

From the Penn State Center for Health Care and Policy Research

Each year in the United States, nearly 12 million people are the victims of some form of intimate partner violence (IPV) or domestic abuse. Under normal circumstances, IPV is an incredibly difficult public health and socio-judicial issue to address – by nature IPV is “behind closed doors,” and thus, stigma, shame and embarrassment, as well as concerns over safety and privacy, often prohibits individuals experiencing abuse from seeking help . The COVID-19 pandemic has only served to exacerbate this issue by not only increasing the incidence of IPV, but also by adding new challenges and complexities to how services for both victims and their abusers are delivered. In this post, we explore the immediate impact of COVID-19 on IPV rates, the way the pandemic has altered, and in some cases decreased access to, services for victims and perpetrators, and the potential long term implications COVID-19 has on future IPV trends.

Read More

New CMS Proposals Streamline Medicare Coverage, Payment, and Coding for Innovative New Technologies and Provide Beneficiaries with Diabetes Access to More Therapy Choices

Durable Medical Equipment (DME) proposed rule would reduce administrative burden for new innovative technologies

On October 27, CMS proposed new changes to Medicare Durable Medical Equipment, Prosthetics, Orthotic Devices, and Supplies (DMEPOS) coverage and payment policies. This rule would provide more choices for beneficiaries with diabetes, while streamlining the process for innovators in getting their technologies approved for coverage, payment, and coding by Medicare.

The proposed rule would expand the interpretation regarding when external infusion pumps are appropriate for use in the home and can be covered as DME under Medicare Part B, increasing access to drug infusion therapy services in the home. The proposed rule also drastically reduces administrative burdens – such as complicated government coverage, payment, and coding processes – that block innovators from getting their products to Medicare beneficiaries in a timely manner. This action aligns with President Trump’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors.

“With the policies outlined in this proposed rule, innovators have a much more predictable path to understanding the kinds of products that Medicare will pay for,” said CMS Administrator Seema Verma. “For manufacturers, bringing a new product to market will mean they can get a Medicare payment amount and billing code right off the bat, resulting in quicker access for Medicare beneficiaries to the latest technological advances and the most, cutting-edge devices available. It’s clearly a win-win for patients and innovators alike.”

Due to administrative constraints, the process for making Medicare benefit classifications, pricing determinations, and creating billing codes for DMEPOS used to routinely take up to 18 months to complete. Last year, CMS changed this process through sub-regulatory guidance to reduce that timeframe to six months in many cases, and is now proposing to establish a streamlined process for coding, coverage, and payment in regulation. Under this accelerated process, benefit classification and pricing decisions could happen on the same day the billing codes used for payment of new items take effect, which would facilitate seamless coverage and payment for new DMEPOS and services. If finalized, this proposed rule would allow innovators to bring their products to Medicare beneficiaries quicker giving them more choices and increased access to the latest, cutting-edge devices.

If finalized, this proposed rule will also expand Medicare coverage and payment for Continuous Glucose Monitors (CGMs) that provide critical information on blood glucose levels to help patients with diabetes manage their disease. Currently, CMS only covers therapeutic CGMs or those approved by the FDA for use in making diabetes treatment decisions, such as changing one’s diet or insulin dosage based solely on the readings of the CGM.

CMS is proposing to classify all CGMs (not just limited to therapeutic CGMs) as DME and establish payment amounts for these items and related supplies and accessories. CGMs that are not approved for use in making diabetes treatment decisions can be used to alert beneficiaries about potentially dangerous glucose levels while they sleep and that they should further test their glucose levels using a blood glucose monitor. With one in every three Medicare beneficiaries having diabetes, this proposal would give Medicare beneficiaries and their physicians a wider range of technology and devices to choose from in managing diabetes. This proposal will improve access to these medical technologies and empower patients to make the best health care decisions for themselves.

In addition, the proposed rule would expand classification of external infusion pumps under the DME benefit making home infusion of more drugs possible for beneficiaries. An external infusion pump is a medical device used to deliver fluids such as nutrients or medications into a patient’s body in a controlled manner. The proposal would expand classification of external infusion pumps as DME in cases where assistance from a skilled home infusion therapy supplier is necessary for safe infusion in the home, allowing beneficiaries more choices to get therapies at home instead of traveling to a health care facility.

Lastly, in the proposed rule, CMS proposes to continue to pay higher amounts to suppliers for DMEPOS items and services furnished in rural and non-contiguous areas to encourage suppliers to provide access and choices for beneficiaries living in those areas. CMS is making this proposal based on previous stakeholder feedback that indicate unique challenges and higher costs for providing for DMEPOS items for beneficiaries in rural and remote areas.

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