- Rural America a Focus for Bipartisan Health Caucus Formed in U.S. House
- Congenital Syphilis Rates Are Soaring, but Resources to Stem Infections Are Lacking
- Nighttime Harvests Protect Farmworkers From Extreme Heat, but Bring Other Risks
- Small-Town Fire Department Helps Fill Gaps in Postpartum Care
- For Rural Communities, Broadband Expansion Is No Single Thing
- Treating Rural America: The Last Doctor in Town
- FCC Seeks Further Comment on 5G Fund for Rural America
- How Will Rural Americans Fare During Medicaid Unwinding? Experts Fear They're on Their Own
- Primary Care Providers Can Play Key Role in Delivering Survivorship Care in Rural Areas
- Encouraging Rural Participation in Population-Based Total Cost of Care Models Request for Input (RFI)
- HHS Awards $45 Million in Grants to Expand Access to Care for People with Long COVID
- Northeastern Receives $17.5 Million from CDC to Launch Infectious Disease Prediction Center
- Just Two Doctors Serve This Small Alabama Town. What's Next When They Want to Retire?
- Rural Hospitals Are Closing Maternity Wards. People Are Seeking Options to Give Birth Closer to Home
- Native Americans, Alaska Natives See Big Spike in Suicide Rates
On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2020. Proposals that may be of interest to rural stakeholders include adding telehealth codes for bundled episodes of care in the treatment of opioid use disorders (OUDs); modifying the regulation on physician supervision of physician assistants (PAs) to give PAs greater flexibility; updating payment and/or codes for certain care management services; and implementing a new Medicare Part B benefit for OUD treatment services, including medication-assisted treatment (MAT), furnished by opioid treatment programs (OTPs). Comments are due on September 27, 2019. The full announcement can be accessed here.
On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) released proposed changes to the outpatient prospective payment system and the ambulatory payment system for the 2020 calendar year. The proposals on price transparency are highlighted with CMS proposing that all hospitals, including rural PPS hospitals and critical access hospitals (CAHs) make pricing information publicly available. Proposals also include reducing payment differences between certain sites of services, using the inpatient wage index values to address wage index disparities, and changing the generally applicable minimum required level of supervision from direct supervision to general supervision for hospital outpatient therapeutic services furnished by all hospitals and CAHs. Comments are due on September 27, 2019. The full announcement can be accessed here.
The Rural & Minority Health Research Center (RMHRC) is one of ten HRSA/FORHP-supported centers for research and policy analysis. In this series of policy briefs, the RMHRC provides data on social determinants of health (SDOH) for four minority groups living in rural areas: African American, Hispanic, American Indian/Alaska Native, and Asian and Pacific Islander. For each of these groups, researchers used several national data resources such as the U.S. Census to determine rates for educational attainment, poverty status, disability, veteran status, nativity, access to computers and broadband, and access to health care.
The reports can be accessed here.
As part of the transition to value-based care, Medicare Shared Savings Program Accountable Care Organizations (ACOs) have developed a number of strategies to reduce Medicare spending and improve quality of care. This report describes the strategies that selected ACOs have found successful in reducing spending and improving quality of care. These strategies involve working to increase cost awareness in ACO physicians, engaging beneficiaries to improve their own health, and managing beneficiaries with costly or complex care needs to improve their health outcomes. Other strategies that ACOs found successful involve reducing avoidable hospitalizations, controlling costs and improving quality in skilled nursing and home healthcare, addressing behavioral health needs and social determinants of health, and using technology to increase information sharing among providers. ACOs also report challenges in each of these areas and describe the ways they overcame them.
The Centers for Medicare & Medicaid Services (CMS) recently made changes to the Shared Savings Program. As CMS carries out this and other ACO programs and develops new alternative payment models, it should support the use of these strategies and other successful strategies that emerge. These strategies can apply not only to ACOs but also to other providers committed to transforming the healthcare system toward value.
The OIG recommend that CMS take the following actions to support efforts to reduce unnecessary spending and improve quality of care for patients: (1) review the impact of programmatic changes on ACOs’ ability to promote value-based care; (2) expand efforts to share information about strategies that reduce spending and improve quality among ACOs and more widely with the public; (3) adopt outcome-based measures and better align measures across programs; (4) assess and share information about ACOs’ use of the skilled nursing facility (SNF) 3-day rule waiver and apply these results when making changes to the Shared Savings Program or other programs; (5) identify and share information about strategies that integrate physical and behavioral health services and address social determinants of health; (6) identify and share information about strategies that encourage patients to share behavioral health data; and (7) prioritize ACO referrals of potential fraud, waste, and abuse. CMS concurred with all of our recommendations.
The full report can be found at oig.hhs.gov/oei/reports/oei-02-15-00451.asp.
U.S. Department of Health and Human Services
Office of Inspector General
The Flex Monitoring Team has released a new report on the community impact and benefit activities of Critical Access Hospitals (CAHs), rural non-CAHs, and urban hospitals. The report enables State Flex Programs and CAH administrators to compare the community impact and benefit profiles of CAHs nationally to the performance of CAHs in their state.
The report may be found in the link below. Pages 1–5 provide national data with key findings and pages 6–95 provide state-specific tables. Shortcut links to each state’s tables are on the bottom of page 5. The report can be accessed here.
For more than 50 years, community health centers have delivered comprehensive, high-quality preventive and primary health care to patients regardless of their ability to pay. Today, there are nearly 1,400 HRSA-funded health centers, operating approximately 12,000 delivery sites, across our country. Health centers deliver care to the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and the nation’s veterans.
Learn more about the Health Center Program. Visit data.HRSA.gov for current and comprehensive data on health centers. Join HRSA on Twitter and Facebook during Health Center Week as we celebrate the work that health centers do.
On Tuesday, July 23, 2019, HRSA HIV/AIDS Bureau Associate Administrator Laura Cheever, MD, ScM, and HRSA Bureau of Primary Health Care Associate Administrator Jim Macrae, MA, MPP, met with public health leaders in South Carolina to discuss the Ending the HIV Epidemic: A Plan for America initiative and the progress being made in ending the HIV epidemic in the state. South Carolina is one of seven states with substantial rural HIV burden, with an HIV/AIDS incidence case rate of a little over eight for every 100k residents.
Through HRSA’s Ryan White HIV/AIDS Program and the HRSA-funded Health Center Program, the agency will play a leading role in helping to diagnose, treat, prevent, and respond to end the HIV epidemic.
July 25, 2019 – The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) awarded almost $42 million in funding to 49 Health Center Controlled Networks (HCCNs). These awards will enable the HCCNs to support 1,183 federally-funded health centers across all 50 states, the District of Columbia and Puerto Rico to expand the use of health information technology (health IT). Empowering patients and promoting data sharing through health IT is an element of President Trump’s vision for a healthcare system that delivers better value and better health for American patients.
“Health centers play a crucial role in providing their communities with access to high quality, affordable healthcare,” said HHS Secretary Alex Azar. “Investing in more advanced health IT will help put patients at the center and unleash the power of data, helping us get better value from the care delivered by health centers and delivering on President Trump’s vision for healthcare.”
On July 1, 2019, the Federal Office of Rural Health Policy (FORHP) announced that it will award approximately $2.2 million to 25 awardees for the 2019 Rural Health Network Development Planning Program (Network Planning). This is a one-year, community-driven program designed to assist in the planning and development of an integrated health care network at the local level. By emphasizing the role of networks, the program creates a platform for medical care providers, social service providers, and community organizations to coalesce key elements of a rural health care delivery system for the purpose of improving local capacity and coordination of care.
The Network Planning program will aid providers as they move from focusing on the volume of services to focusing on the value of services. For grantees, the award (of up to $100,000) provides an opportunity to implement new and innovative approaches towards a dynamic health care environment that may in turn serve as a model for other rural communities. The incoming cohort of Network Planning grantees have projects that focus on building, strengthening, and formalizing integrated health care networks and systems, developing training cooperatives, conducting community health needs assessments, increasing service capacity, addressing behavioral and mental health conditions, and addressing the rural opioid epidemic.
Historically, previously awarded grantees have been successful in leveraging finances by using FORHP grants to sustain their efforts; they have been able to combine federal funds with local and foundation dollars to support the continuation and development of health care services in rural areas. Organizations have also demonstrated the ability to achieve innovative expansion and replication of their funded projects to successfully serve additional populations and regions, providing support to other rural communities with similar healthcare needs.
As FORHP continues to focus on showcasing program outcomes, the identification and dissemination of rural evidence-based models maintains as a priority. The Rural Community Health Gateway, located on The Rural Health Information Hub (RHIhub) consists of a number of resources, including successful program models and evidence-based toolkits.
If you have any questions about the program, please contact Jillian Causey: JCausey@hrsa.gov or 301-443-1493.
The Federal Office of Rural Health Policy is pleased to announce approximately $6.3 million in grant awards to 32 rural communities across 19 states for the Small Health Care Provider Quality Improvement (Rural Quality) Program. Each award recipient will receive up to $200,000 per year for a three-year project period to improve to patient health outcomes through implementation of activities designed to address improvements to the quality and delivery of rural health care services in primary care settings. Organizations participating in the Rural Quality Program are required to utilize an evidence-based or promising practice quality improvement model, perform tests of change focused on improvement, and use health information technology (HIT) to collect and report data. The Incoming cohort of Rural Quality grantees include projects that focus on substance use disorders and chronic disease conditions, such as diabetes and cardiovascular disease, and propose goals to integrate metal/behavioral health and primary care, enhance chronic disease management, improve transitions of care, reduce preventable hospital and emergency department utilization and better engage patients and their caregivers. Several projects also align with national quality improvement initiatives such as value-based care and the accreditation and application of the patient centered medical home model. Historically, grantees have demonstrated success in leveraging finances by using FORHP grants to sustain their efforts; they have been able to combine federal funds with local and foundation dollars to support the continuation and development of health care services in rural areas. Organizations have innovatively expanded their programs to serve different populations and regions while ensuring alignment with the current health care landscape.
As FORHP continues to focus on showcasing program outcomes, the identification and dissemination of rural evidence-based models maintains as a priority. The Rural Community Health Gateway, located on The Rural Health Information Hub (RHIhub) consists of a number of resources, including successful program models and evidence-based toolkits. If you have any questions about the program, please contact Katherine Lloyd: Klloyd@hrsa.gov or 301-443-2933. Thank you for your continued support and dedication to rural health!