Rural Health Information Hub Latest News

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.

HRSA Modernizes Nation’s Organ Transplant System, Ends Current Contract Monopoly

The Health Resources and Services Administration (HRSA) at the Department of Health and Hunan Services (HHS) announced the first ever multi-vendor contract awards to modernize the nation’s organ transplant system to improve transparency, performance, governance, and efficiency of the organ donation and transplantation system for the more than 100,000 people on the organ transplant waitlist.

The Organ Procurement and Transplantation Network (OPTN) has long faced critiques about lack of transparency, potential for conflicts of interest, IT reliability issues and other structural challenges. As part of the Administration’s transformation of the OPTN, for the first time in 40 years, multiple contractors will provide their expertise and proven experience to improve the national organ transplant system. This transition from a single vendor to multiple vendors to support OPTN operations is a critical step in advancing innovation in the transplant system to better serve patients and their families and implements the bipartisan Securing the U.S. Organ Procurement and Transplantation Network Act signed by the President in September 2023.

“With the life of more than 100,000 Americans at stake, no organ donated for transplantation should go to waste,” said HHS Secretary Xavier Becerra. “For too long, our organ transplant system has fallen short, mired in monopoly. The Biden-Harris Administration has reformed OPTN to require accountability in the operation of organ procurement that our transplant patients and their families demand.”

“One person is added to the waitlist every 10 minutes. Each one relies on and deserves the best care possible,” said HRSA Administrator Carole Johnson. “Today’s action marks a significant advancement in the Biden-Harris Administration’s commitment to doing what it takes to make sure the nation’s organ matching system works for patients, donors, and the families who depend on the OPTN for that life-saving call.”

HRSA is announcing multiple OPTN modernization awards to support critical actions, including:

  1. Improving Patient Safety – Arbor Research Collaborative for Health will provide support on patient safety and the policy compliance systems and processes overseen by the OPTN Board of Directors and the Membership and Professional Standards Committee to improve oversight of the multiple entities in the OPTN.
  2. Supporting OPTN IT Modernization – General Dynamic Information Technology (GDIT) will focus on the opportunities to improve the OPTN organ matching IT system and inform HRSA’s Next Generation IT procurement and development work.
  3. Increasing Transparency and Public Engagement in OPTN Policy Development – Maximus Federal will advance opportunities to improve public visibility and engagement in the OPTN policy making process, including improving transparency around OPTN policy making committees’ deliberations and actions.
  4. Strengthening Patient-Centered Communications – Deloitte will focus on improvements in communications from the OPTN, within the OPTN and, importantly, with patients and families.
  5. Improving OPTN Financial Management – Guidehouse Digital will address improvements for OPTN’s budget development and management systems and processes.

In August 2024, HRSA announced that the OPTN Board of Directors—the governing board that develops national organ allocation policy—is now separately incorporated and independent from the Board of longtime OPTN contractor, the United Network for Organ Sharing (UNOS). HRSA awarded an OPTN Board Support contract to a new vendor, American Institutes for Research, to support the newly incorporated OPTN Board of Directors.

HRSA launched the OPTN Modernization Initiative in March 2023, including making proposals to reform the decades old OPTN statute and increase funding for the program to better serve patients and families. Within a year, HRSA worked closely with bipartisan leaders in Congress to secure passage of the Securing the U.S. OPTN Act and substantially boost funding to support modernization efforts. Today’s awards represent a key step forward in this work.

White House Unveils Sweeping Health Care Safety Efforts: 8 Notes

From Becker’s Clinical Leadership

The Agency for Healthcare Research and Quality, a division of HHS, has partnered with other federal agencies and health systems to create a national safety alliance as part of broader commitments from the federal government to reduce preventable harm and improve care quality industrywide.

The alliance was among efforts shared at the White House Sept. 17 during a forum on patient safety hosted by the President’s Council of Advisors on Science and Technology — a working group of more than two dozen thought leaders in the academic, government and private sectors. AHRQ first shared the concept of a national safety alliance in 2023, with more details emerging at the forum.

Eight things to know:

  1. The National Action Alliance for Patient and Workforce Safety is a collective of federal agencies, heath systems, medical associations, policymakers and patient groups that will work together to apply evidence-based harm reduction strategies across all populations and settings, according to an AHRQ overview. The first area of focus will be hospital care settings.
  2. The alliance will rely on a total-systems approach to safety improvement and align with the  National Action Plan to Advance Patient Safety, which aims to reduce preventable harm by 50% by 2026. Participating systems will conduct a baseline safety assessment to identify priority areas for improvement. Through the alliance, they’ll have access to implementation support, funding opportunities and other resources to support improvement efforts.
  3. On Nov. 1, the alliance will release an initial version of a dashboard to monitor the nation’s progress toward eliminating preventable patient and workplace harms across all settings.
  4. As part of the federal government’s broader efforts to improve safety in healthcare, the CDC has also released new guidance to support hospitals in reducing diagnostic errors — which are responsible for nearly 800,000 deaths per year. The CDC will also develop new measures to advance recognition and treatment of sepsis.
  5. The White House also secured commitments from 22 national and regional organizations to promote a “whole-of-society approach” to healthcare safety. For example, Press Ganey has committed to building an AI-backed analytics dashboard next year that will integrate key safety data points on patient outcomes, the workforce, safety culture and more. The Association of American Medical Colleges also plans to share a revised set of education competencies that focus on safety and quality improvement skills for physicians.
  6. In addition, the White House said 16 systems have committed to safety improvement actions. Together, these systems provide healthcare to more than 30 million patients and employ hundreds of thousands of workers
  7. In another initiative, the Veterans Health Administration, a component of the Department of Veterans Affairs, will roll out a new national program next year to prevent falls across care settings. All VA health system leaders will also sign a safety culture commitment by mid-2025.
  8. The patient safety alliance’s launch comes a little over a month after CMS added seven new measures to its hospital inpatient quality reporting program as part of its Hospital Inpatient Prospective Payment System final rule released Aug. 1. The patient safety measure will take effect in 2025. The patient safety structural measures assess whether hospitals have a structure and culture that prioritize safety through five domains: leadership committed to eliminating preventable harm; strategic planning and organizational policy; a culture of safety and learning; accountability and transparency; and patient and family engagement, according to a CMS final rule.

New Release: State of Oral Health Equity in America 2024

The CareQuest Institute for Oral Health just released key findings from their annual survey, “State of Oral Health Equity in America” and includes perceptions, attitudes, and experiences with oral health from more than 9,000 adults in the United States. Among other findings, the survey found that “adults with less than a high school education were nine times more likely to report seeking dental care through an emergency department than those with a postgraduate or professional degree.” A comprehensive report with additional findings will be released soon.

Click here to learn more.

New Rural Hospital Workforce Toolkit Published

The Flex Monitoring Team (FMT) has released a new product, the Workforce Toolkit to Support Critical Access Hospitals and Rural Providers. This toolkit provides background on health care workforce challenges in the U.S., describes common workforce challenges faced by Critical Access Hospitals (CAHs), and provides examples and links to external resources that CAHs may use to address their own workforce needs and enhance recruitment and retention.

The toolkit includes five modules, which each discuss key workforce challenges and resources by topic. These include an introductory module that summarizes broad challenges in the rural health care workforce as well as modules on organizational culture and leadership, leveraging partnerships, emergency medical services workforce, and administrative and support staff workforce.

ARC Awards Nearly $11.5 Million to Support Appalachians in Recovery from Substance Use Disorder

The Appalachian Regional Commission (ARC) awarded nearly $11.5 million to 39 projects through its Investments Supporting Partnerships in Recovery Ecosystems (INSPIRE) Initiative, which aims to address the impact of substance use disorder (SUD) in Appalachia with investments in projects that create or expand services in the recovery ecosystem leading to workforce entry and re-entry.

ARC’s 2024 INSPIRE grantees will strengthen the SUD recovery ecosystem in 127 counties in nine Appalachian states—Kentucky, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia—by expanding recovery-focused partnerships, peer support and other wraparound services, and skills and workforce training programs that help prepare individuals in recovery for meaningful job opportunities.

“Substance use disorder is a region-wide epidemic that impacts Appalachian families and community workforces,” said ARC Federal Co-Chair Gayle Manchin. “I commend our 2024 INSPIRE grantees for their dedication in helping Appalachians who have struggled with substance use disorder regain a sense of hope and purpose by enabling them to rejoin their communities, bolster workforce development, and make positive impacts on the region.”

“In order to truly address substance use disorder, we must create an environment that includes support for wrap-around services such as housing, job training, and counseling,” said ARC States’ Co-Chair Tennessee Governor Bill Lee. “INSPIRE funding helps make this possible by empowering organizations to make an impact across the Appalachian region. We are proud of Tennessee’s nine grantees who are focused on this important work.”

Federal Co-Chair Manchin made the award announcement with North Carolina Health and Human Services Secretary Kody H. Kinsley, grantees, and state partners during a press conference at the headquarters of Land of Sky Regional Council—INSPIRE grantee and local development district—in Asheville, North Carolina.

“Communities in the Appalachian region, especially rural towns, have borne the brunt of the disease of addiction,” said Secretary Kinsley. “We are grateful to our federal partners for tackling these disparities head-on by investing in behavioral health services and supports.”

With this award package, ARC has invested $53.6 million in 166 projects across all 13 Appalachian states since INSPIRE was established in April of 2021. Together, ARC’s INSPIRE investments will impact 360 Appalachian counties, improve over 3,000 businesses and help prepare nearly 16,200 individuals for new opportunities in the workforce.

New Data Reveals Reduction in SUD-related Deaths in Appalachia
SUD recovery-to-work initiatives may be starting to make an impact, according to a new ARC research report that examines trends in diseases of despair including overdose, suicide, and liver disease. From 2021 to 2022, the overall diseases of despair mortality rate decreased 4 percent in the Appalachian Region while remaining virtually unchanged in the rest of the United States. However, work remains to be done, as these rates—in both Appalachia and the rest of the country—remain much higher than the pre-pandemic figures of 2019.

ARC expects to issue a Notice of Solicitation for Applications (NOSA) for the next round of INSPIRE funding in early 2025.

Learn more about ARC’s INSPIRE Initiative and the newest INSPIRE grantees

2023 ACS 1-Year Estimates Released

The latest research brief highlights key findings from the 2023 American Community Survey (ACS) 1-Year Estimates. This report provides updates on Pennsylvania’s demographic, social, and economic trends, covering topics such as household income, housing, educational attainment, and internet access. Additionally, the brief discusses changes in housing burdens across different racial and ethnic groups.

Read more.