Rural Health Information Hub Latest News

CMS Updates Mental Health and Substance Use Disorders (SUD) Content

The Centers for Medicare & Medicaid Services (CMS) has updated its Mental Health and Substance Use Disorders (SUD) content on The content updates are part of the CMS broader Behavior Health Strategy and will make it easier for users to access mental health and substance use disorder information.  Visit to see the new updates.

The CMS Behavioral Health Strategy translates our goals into a framework focused on outcomes and focuses on three key areas:

  • Substance Use Disorders Prevention, Treatment, and Recovery Services,
  • Ensuring Effective Pain Treatment and Management, and
  • Improving Mental Health Care and Services.

You can find more information on CMS’ Behavioral Health Strategy and our mission to ensure that high-quality behavioral health services and supports are accessible to the people we serve, by visiting

If you or someone you know is in crisis, call, text 988 or chat, 24 hours a day, 7 days a week. Call 911 if you’re in an immediate crisis.

Federal Administration Acts to Improve Access to Kidney Transplants

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced the Increasing Organ Transplant Access (IOTA) Model. The proposed model, which would be implemented by the CMS Innovation Center, aims to increase access to kidney transplants for all people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process to receive a kidney transplant, and increase the efficiency and capability of transplant hospitals selected to participate. This proposed model would improve the kidney transplant system and the collaborative efforts between CMS and the Health Resources and Services Administration (HRSA) to increase organ donation and improve clinical outcomes, system improvement, quality measurement, transparency, and regulatory oversight.

“The organ transplant industry, like every other part of society, is not immune to racial inequities,” said HHS Secretary Xavier Becerra. “Black Americans disproportionately struggle with life-threatening kidney disease, yet they receive a smaller percentage of kidney transplants. The Biden-Harris Administration is taking concrete steps to remove racial bias when calculating wait times and rooting out profiteering and inequity in the transplant process.”

Kidney transplantation is the best treatment for most individuals with ESRD, a condition that occurs when the kidneys are no longer able to function properly. People with ESRD who receive transplants have better outcomes than people who receive dialysis, improvements in quality of life, and are freed from lengthy and burdensome dialysis treatments. However, the scarcity of organs, particularly for kidney transplants, leads to increased patient mortality and a significant gap between demand and supply. Despite this scarcity, approximately 30% of donor kidneys go unused annually, highlighting gaps in procurement, distribution, and utilization. Prolonged waiting times, averaging three to five years or more, intensify patient suffering. With just over 28,000 kidney transplants performed in 2023 and more than 90,000 people on a waitlist during that same time, urgent measures are needed to improve the efficacy and efficiency of the system.

“Modernizing the organ transplantation system is a top priority for the Biden-Harris Administration,” said CMS Administrator Chiquita Brooks-LaSure. “Kidney transplantation helps people live healthier and longer lives because they no longer have to undergo dialysis. The Increasing Organ Transplant Access Model would be an important step forward in improving the kidney transplant process for everyone on a waitlist and those who have received a transplant.”

In the proposed model, participating transplant hospitals would be measured by increases in the number of transplants, increased organ acceptance rates, and post-transplant outcomes. The Increasing Organ Transplant Access Model would hold kidney transplant hospitals accountable for the care they provide. Hospitals eligible to be selected for the proposed model are non-pediatric facilities that conduct a minimum of 11 transplants each during a three-year baseline period. Out of the 257 transplant hospitals in the country, an estimated 90 would be required to participate in the proposed six-year model beginning January 1, 2025.

To further improve equity and access, the model would offer additional performance incentives to participating transplant hospitals to improve equity in the transplant process. The proposed model would require participating transplant hospitals to establish health equity plans to identify gaps in access among populations in their communities and develop strategies to address these gaps. For example, participants could establish programs to educate and support potential living donors from underserved communities or to provide transportation assistance to patients on a waitlist. Participating transplant hospitals would also have the flexibility to address barriers related to social drivers of health, such as food insecurity and out-of-pocket prescription drug costs.

The proposed mandatory model would align with the HHS Organ Transplant Affinity Group’s strategy to coordinate a series of initiatives to increase transplantation access through payment, quality, and regulatory efforts. This model would be complementary to existing and future regulatory efforts for Organ Procurement Organizations, nephrologists, and dialysis facilities to improve the overall transplant system for people with ESRD. In March 2023, HRSA launched its OPTN Modernization Initiative to strengthen accountability and the performance of the nation’s organ transplant system by focusing on improving the OPTN’s governance, technology, and operations. Across the nearly 40-year history of the OPTN, all functions of the OPTN were managed by a single vendor rather than multiple contracts based on technical expertise in areas like IT or operations. HRSA is also taking transformational steps to modernize the critical organ matching technology while increasing transparency and accountability by issuing new data reporting requirements to better address pre-waitlist and organ procurement practices, which will help address inequities in the transplant waitlist process by reducing racial and ethnic variation both in patient referrals and in organ procurement.

The current kidney transplant process is complex and fragmented care and disparities contribute to the inequitable distribution of this life-saving treatment. Access to organ transplantation varies not only by geography but also by factors such as race, ethnicity, disability status, and socio-economic status. For example, according to the Scientific Registry of Transplant Recipients (SRTR) Annual Data Report, 32% of waitlisted individuals were African American in 2021, but only 13.5% of recipients of a transplant from a living donor were African American. White individuals made up 35.8% of the waitlist and 61.8% of transplant recipients from a living donor. The proposed Increasing Organ Transplant Access Model is designed to address these challenges by improving the overall quality of care for patients with ESRD and increasing the number of transplants performed.

“Requiring participation in the proposed Increasing Organ Transplant Access Model would be a promising opportunity to engage participating transplant hospitals and collaborators in the model in seeking to reduce fragmentation in kidney transplantation while improving care, access, and affordability,” said Liz Fowler, CMS Deputy Administrator and Director of the CMS Innovation Center. “If finalized, CMS will work with selected participating transplant hospitals and providers to provide technical assistance so they can succeed in the model, putting us on the path to using all available kidneys and ultimately improving the quality of life for hundreds of thousands of individuals and their families.”

CMS has proposed the Increasing Organ Transplant Access Model be a mandatory model to aim to achieve a sufficient and representative national sample of participating kidney transplant hospitals that represent diverse geographic locations, familiarity with designing care focused on quality, provider performance, and the patient experience, and success with increasing transplants. CMS is prepared and ready to partner together with transplant hospitals to be successful in their improvement efforts and will support them with additional resources and assistance. By focusing on the problem together, we will be on the path to using all available kidneys and ultimately improving the quality of life for hundreds of thousands of individuals and their families.

The proposed rule on the Increasing Organ Transplant Access Model can be accessed from the Federal Register at Standard provisions are included in the proposed rule that would be applicable to all Innovation Center model participants that begin participation in a model on or after January 1, 2025.

View a fact sheet on the Increasing Organ Transplant Access Model.

More information on the Increasing Organ Transplant Access Model is available on the model webpage.

Explore New Data on the Anchor Economy Dashboard

The Federal Reserve Bank of Philadelphia launched new data on the Anchor Economy Dashboard. You can now explore anchor institution economic impacts and reliance measures for the years 2004 and 2019 for all 524 U.S. regions.

In the coming weeks, they are releasing an accompanying research brief that delves deeper into the change in anchor institution reliance in the United States between 2004 and 2019. The brief will be posted to  their website and discussed at the upcoming 2024 Anchor Economy Conference in Philadelphia on May 15–16.

If you have any questions on the dashboard or this new data set, please feel free to get in touch Deborah Diamond at

New Brief Released: Medicare Advantage Plan Growth in Rural America: Availability of Supplement Benefits

The 2018 CHRONIC Care Act influenced the growth rate in MA plan enrollment by allowing plans to offer more options extending the types of benefits available to MA beneficiaries. The Act gave MA plans the flexibility to offer new supplemental benefits to address enrollees’ broader health and social needs. Now, in addition to traditional primarily health-related benefits, MA plans can offer expanded health-related benefits (e.g., in-home support services, therapeutic massage, caregiver support, home-based palliative care, and adult day health services) and special supplemental benefits for the chronically ill (SSBCI) such as food and produce, meals, transportation, and pest control.

MA plans providing any supplemental benefit were less commonly offered in noncore counties (87.2 percent of plans), followed by micropolitan counties (94.6 percent) and metropolitan counties (97.6 percent) in 2022. But only 10 to 20 percent of plans offered expanded supplemental benefits or SSBCI across all three geographies. Plans with traditional primarily health-related supplemental benefits most frequently included vision (97.6 percent), hearing (95.2 percent), fitness (94.6 percent), and dental services (93.6 percent). Significantly fewer plans offered expanded supplemental benefits and SSBCI that address beneficiaries’ broader health and social needs. Declining availability of all supplemental benefit types was seen as geography shifted from metropolitan to noncore counties.

Read the full report here.

Authors:  Edmer Lazaro, DPT, MSHCA; Dan M. Shane, PhD; Fred Ullrich, BA; Keith Mueller, PhD

New Brief Released: Increasing Telehealth Use During the COVID-19 Public Health Emergency and Healthcare Disparities: An Updated Systematic Review

The COVID-19 public health emergency (PHE) led to a dramatic increase in telehealth use owing to relaxed policies to facilitate healthcare access, but early studies demonstrated variability in telehealth utilization patterns across demographic groups. COVID-19 disproportionately affected communities of color and the socially disadvantaged, highlighting existing disparities in access and quality of care in the U.S. health system.  In early 2023, an RTRC research team conducted a systematic review to summarize available evidence from early in the COVID-19 pandemic and concluded that most available evidence showed that telehealth did not reduce disparities in access to health care during the PHE. In December 2023, the prior systematic review was updated with contemporary data using the same search strategy and methods.

Of the 523 references in our updated search, 32 met final inclusion criteria for the study. Most studies were retrospective cohort studies using before-after methodology, and telehealth utilization was the most common study outcome. Compared to the initial search, more of the papers included in this search focused on total health care utilization (instead of telehealth-only utilization), but overall, conclusions were similar. Telehealth utilization, in aggregate, increased more slowly among disadvantaged groups, such as older, more rural, Black, and economically disadvantaged populations than in less disadvantaged populations over the course of the PHE.

Please click here to read the brief.

Pennsylvania Governor Shapiro Opens Application Window for $500,000 in PA Farm Bill Grants to Strengthen Agriculture Education, Healthy Foods in Schools

Pennsylvania Agriculture Secretary Russell Redding announced that Pennsylvania’s Farm-to-School Grant program is offering schools and childhood centers to apply for up to $15,000 for eligible projects. This program, funded by Governor Josh Shapiro’s budget, support healthy eating habits and future careers in agriculture. To date, more than $2.6 million has been awarded to 237 projects across 50 counties.

“These grants are an investment in our children’s health and their future,” said Secretary Redding. “Introducing kids to fresh, local food enriches the connection between families and local producers and imparts meaningful changes in the lives of our youth while strengthening their bond with their communities. Funded Farm-to School Grant programs enable students to learn about local farmers, make healthy choices, and explore exciting career opportunities.”

Eligible applicants include school districts, charter schools, private schools, or centers with pre-kindergarten through 8th grade that participates in the Federal Child Nutrition Program. Funded projects can involve partnering with local farmers to source fresh produce or building and improving school gardens, with the goal of incorporating hands-on educational activities about agriculture and encouraging healthy eating.

“The PA Farm Bill’s Farm to School grant has made it possible for hundreds of schools across the Commonwealth to enhance and strengthen their farm to school programs,” said Samantha Gibb, Senior Associate at The Food Trust and Coordinator for the PA Farm to School Network. “School food service professionals are able to procure local food to serve in school meals from farmers in their area for the first time – opening up valuable market opportunities for Pennsylvania growers. Educators are able to provide kids with hand-on experiences in school gardens, through in-classroom taste tests and taking kids on farm field trips.” The PA Farm to School Network stands ready with resources to support schools and farmers in their efforts to ensure kids are connected to and nourished by thriving and resilient community food systems.

“Access to nutritious food is a critical component of ensuring students can focus, learn, and achieve in school, and the Farm-to-School grants help make that access more readily available to learners across the Commonwealth,” said Secretary of Education Dr. Khalid N. Mumin. “This funding complements the Shapiro Administration’s commitment to keeping students healthy and fed through universal free breakfast while supporting Pennsylvania’s farmers and agriculture industry as a whole.”

Grant applications must be submitted online through the PA Department of Community and Economic Development Electronic Single Application. Applications are due by 4:00 p.m. on Friday, June 7, 2024.

Full grant guidelines are published in the April 27th edition of the PA Bulletin.

Visit our recently-launched Farm-to-School Network Dashboard, built in collaboration with Saint Joseph’s University, to learn about the programs that have already been implemented across the Commonwealth.

Find a map of previous Farm to School and other PA Farm Bill grant recipients in your area as well as details of initiatives to grow and sustain Pennsylvania agriculture at

USDA and EDA Update Resources in Joint Guide to Boost Economic Development in Rural Communities

U.S. Department of Agriculture (USDA) Rural Development Under Secretary Dr. Basil Gooden announced that USDA and the U.S. Economic Development Administration (EDA) updated resources in the joint guide originally released in 2022 to help rural communities build strategies to boost local economic development.

Both agencies made several key updates to ensure communities can access new webpages and resources.

The announcement reinforces USDA’s commitment to strengthening partnerships that ensure rural Americans have the most up-to-date resources to compete in a modern economy and to create economic growth that lasts for generations to come.

Read full stakeholder announcement.

Federal Administration Finalizes Policies to Increase Access to Health Coverage for DACA Recipients

The U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), finalized a rule that will expand access to health care for Deferred Action for Childhood Arrivals (DACA) recipients. Today’s rule ensures DACA recipients will no longer be excluded from eligibility to enroll in a Qualified Health Plan (QHP) through the Affordable Care Act (ACA) Health Insurance Marketplace, or for coverage through a Basic Health Program (BHP). CMS estimates that this rule could lead to 100,000 previously uninsured DACA recipients enrolling in health coverage through Marketplaces or a BHP.

“HHS is committed to making health coverage accessible for people DACA recipients – Dreamers – who have worked hard to live the American Dream. Dreamers are our neighbors and friends; they are students, teachers, social workers, doctors, and nurses. More importantly, they are fellow Americans,” said HHS Secretary Xavier Becerra. “More than one third of DACA recipients currently do not have health insurance, so making them eligible to enroll in coverage will improve their health and wellbeing, and help the overall economy.”

“The Biden-Harris Administration believes health care is a right, not a privilege, and that extends to DACA recipients who have built their lives in the United States,” said CMS Administrator Chiquita Brooks-LaSure. “Today’s rule reduces barriers for DACA recipients to obtain health care coverage and is a vital step toward making certain that it is available and accessible to all Americans.”

Individuals without health insurance are less likely to receive preventive or routine health screenings and may delay necessary medical care, incurring high costs and debts when they do seek care. DACA recipients are currently three times more likely to be uninsured than the general U.S. population. DACA recipients who qualify to enroll in a Marketplace plan may also qualify for advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSRs) to reduce the cost of their Marketplace coverage, depending on their income.

As a result of this rule, DACA recipients and other newly eligible individuals will qualify for a special enrollment period to select a health plan through the Marketplace during the 60 days following the rule’s November 1, 2024, effective date. This timing also corresponds with the 2025 Open Enrollment Period, which will help ensure that newly eligible individuals are able to seamlessly enroll in coverage. Those who apply for coverage in November 2024 can have their Marketplace coverage begin as early as December 1, 2024, if they meet all other eligibility requirements. DACA recipients and others who are eligible for a BHP can apply for and receive coverage as early as November 1, 2024.

CMS also made technical modifications to the definition of “lawfully present” used to determine eligibility for coverage through a Marketplace or a BHP to promote administrative efficiency, clarity, and transparency. These changes aim to ensure complete, accurate, and consistent eligibility determinations and verification processes for health coverage for these populations.

CMS is committed to providing high-quality education regarding implementation of this rule and technical assistance for the many interested parties who assist immigrant and other communities with health coverage enrollment.

All provisions of the final rule will be effective on November 1, 2024.

For more information on the final rule, see the fact sheet at

To view the final rule, visit the Federal Register.

Report Now Available: Disparities in Health Care in Medicare Advantage by Race, Ethnicity, and Sex

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) released the tenth edition of the Disparities in Health Care in Medicare Advantage by Race, Ethnicity, and Sex Report. This 2024 report provides a summary of the quality of health care received by people enrolled in Medicare Advantage across the United States, focusing on differences in patient experience and clinical care quality based on race, ethnicity, and sex in 2023.

Click here to review the report.

The 2024 report highlights a range of aspects regarding the quality of patient care. It includes seven measures of patient experience from the Medicare Advantage and Prescription Drug Plan Consumer Assessment of Healthcare Provider and Systems survey, along with 41 clinical care quality measures covering nine domains of care from the Health Effectiveness Data and Information Set. These measures were stratified by race and ethnicity, sex, and the combination of race and ethnicity within sex to highlight areas where disparities exist.

For more information and to explore other recent reports, research efforts, and data, please visit our Research & Data webpage.

New School Lunch Nutrition Standards Announced

The U.S. Department of Agriculture announced new nutrition standards that limit added sugars and sodium in children’s school meals. The change will gradually phase in added sugar limits for the school lunch and breakfast program and update total sugar limits for breakfast cereals and yogurt. Program operators are not required to make any changes to their menus as a result of this rulemaking until school year 2025-26 at the earliest. As diet directly affects oral health, limiting added sugars can improve the oral health of children and youth.

Click here for more information.