Rural Health Information Hub Latest News

Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts

Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage companies, and some say the only way to maintain services and protect patients is to end their contracts with the private insurers

Medicare Advantage plans pay hospitals lower rates than traditional Medicare, said Jason Merkley, CEO of Brookings Health System in South Dakota. Merkley worried the losses would spark staff layoffs and cuts to patient services. So last year, Brookings Health dropped all four contracts it had with major Medicare Advantage companies.

“I’ve had lots of discussions with CEOs and executive teams across the country in regard to that,” said Merkley, whose health system operates a hospital and clinics in the small city of Brookings and surrounding rural areas.

Merkley and other rural hospital operators in recent years have enumerated a long list of concerns about the publicly funded, privately run health plans. In addition to the reimbursement issue, their complaints include payment delays and a resistance to authorizing patient care.

But rural hospitals abandoning their Medicare Advantage contracts can leave local patients without nearby in-network providers or force them to scramble to switch coverage.

Medicare is the main federal health insurance program for people 65 or older. Participants can enroll in traditional, government-run Medicare or in a Medicare Advantage plan run by a private insurance company.

In 2024, 56% of urban Medicare recipients were enrolled in a private plan, according to a report by the Medicare Payment Advisory Commission, a federal agency that advises Congress. While just 47% of rural recipients enrolled in a private plan, Medicare Advantage has expanded more quickly in rural areas.

In recent years, average Medicare Advantage reimbursements to rural hospitals were about 90% of what traditional Medicare paid, according to a new report from the American Hospital Association. And traditional Medicare already pays hospitals much less than private plans, according to a recent study by Rand Corp., a research nonprofit.

Read more.

Apply Now for the 2026 Rural Health Innovation Program

The University of California Berkeley’s Rural Health Innovation (RHI) Program is accepting is now accepting applications for its next cohort of Rural Health Innovation Scholars. This program provides full-tuition scholarships for public health professionals living and working in rural communities to earn their Master of Public Health degree online. Scholars also receive a paid membership in the National Rural Health Association (NRHA).

Since its launch, the program has funded 81 professionals across 32 states, and we are excited to support another 25 scholars beginning in Spring 2026.

Scholars come from a variety of backgrounds, including healthcare, policy, and community leadership, and continue working in their rural communities while completing their degree. Participants will study alongside a diverse cohort of public health students while also engaging in a smaller group with a specialized rural health curriculum. This structure allows scholars to gain broad public health training while focusing on the unique challenges and opportunities in rural health.

The deadline to apply for the next cohort is August 3, 2025. For more information, visit UC Berkeley’s Rural Health Innovation Program.

Study Links Lack of Oral Health Care with Pregnancy Complications

A new study links a lack of oral health care with complications during pregnancy. The study, “Use of Oral Health Services Among Pregnant Women and Associations with Gestational Diabetes and Hypertensive Disorders of Pregnancy,” was recently featured in the Journal of the American Dental Association. The study found that fewer than 40% of women seek preventive oral health care during pregnancy. Women who did not receive preventive oral health care or visit a dentist or dental clinic for oral health problems during pregnancy had an increased risk of gestational diabetes and hypertensive disorders.

Click here to read the study.

Pennsylvania Launches New State Health Improvement Plan Dashboard

The Pennsylvania Department of Health Office of Operational Excellence has published the State Health Improvement Plan (SHIP) dashboard. The dashboard features trends related to overarching SHIP objectives as well as individual objectives organized by workgroup and goal. It includes a list of current strategies and activities being implemented by SHIP goal team members and member organizations.

Click here to view the dashboard.

With Few Dentists and Fluoride Under Siege, Rural America Risks New Surge of Tooth Decay

In the wooded highlands of northern Arkansas, where small towns have few dentists, water officials who serve more than 20,000 people have for more than a decade openly defied state law by refusing to add fluoride to the drinking water.

For its refusal, the Ozark Mountain Regional Public Water Authority has received hundreds of state fines amounting to about $130,000, which are stuffed in a cardboard box and left unpaid, said Andy Anderson, who is opposed to fluoridation and has led the water system for nearly two decades.

This Ozark region is among hundreds of rural American communities that face a one-two punch to oral health: a dire shortage of dentists and a lack of fluoridated drinking water, which is widely viewed among dentists as one of the most effective tools to prevent tooth decay. But as the anti-fluoride movement builds unprecedented momentum, it may turn out that the Ozarks were not behind the times after all.

“We will eventually win,” Anderson said. “We will be vindicated.”

Fluoride, a naturally occurring mineral, keeps teeth strong when added to drinking water, according to the Centers for Disease Control and Prevention and the American Dental Association. But the anti-fluoride movement has been energized since a government report last summer found a possible link between lower IQ in children and consuming amounts of fluoride that are higher than what is recommended in American drinking water. Dozens of communities have decided to stop fluoridating in recent months, and state officials in Florida and Texas have urged their water systems to do the same. Utah is poised to become the first state to ban it in tap water.

Health and Human Services Secretary Robert F. Kennedy Jr., who has long espoused fringe health theories, has called fluoride an “industrial waste” and “dangerous neurotoxin” and said the Trump administration will recommend it be removed from all public drinking water.

Read more.

Thriving PA Releases New Early Intervention Fact Sheet

Thriving PA released a new Infant and Toddler Early Intervention fact sheet, aimed at educating policymakers about the program as part of our advocacy for the 2025-26 budget cycle. The fact sheet notes services and benefits provided by EI and highlights state-specific data. In the 2022-23 school year, 48,199 children were served by the program in Pennsylvania.

Thriving PA supports, at minimum, the Administration’s proposed increase of $16.2 million for the Infant/Toddler Early Intervention program as part of a final FY 2025-26 budget package. The proposed increase would provide $10 million for a long-overdue rate increase for providers and serve an additional 3,000 children and their families. This increase is a first step in addressing the workforce shortage of Early Intervention providers. Additional support beyond the $16.2 million is recommended, as we estimate $49 million in new funding is needed this year to address increased costs to the program and the projected children served.

Free Autism Resources Available for Dental and Medical Offices

The ASERT Collaborative (Autism Services, Education, Resources and Training) is a statewide partnership that provides streamlined access to information for Pennsylvanians living with and impacted by autism.

The ASERT website hosts resources covering a wide range of topics for parents, self-advocates, professionals, and community members while also providing information on statewide events, support groups, and free online training opportunities. To request free ASERT brochures in English or Spanish for your office, email info@paautism.org.

Click here to view an informational flyer.
Click here to learn more about ASERT.

New Oral Health Brief Published: What Happens if Adult Medicaid Goes Away

The American Dental Association (ADA) released a new research brief, “What Happens if Adult Medicaid Dental Goes Away?” This resource outlines the cost implications of eliminating the adult dental Medicaid benefit.

If federal aid to state Medicaid programs is reduced, states will face considerable budgetary challenges to keep Medicaid beneficiaries enrolled and provided with the same level of services. This resource looks at the estimated costs due to emergency department visits for dental conditions, unmet periodontal needs among pregnant beneficiaries, and beneficiaries with diabetes and coronary artery disease.

Click here to view the resource.

The PBDA is hosting two webinars in anticipation of opening the second round of the Digital Connectivity Technology Program (DCTP). Each webinar will provide an overview of the program, review FAQs, and will implement breakout sessions focusing on libraries, non-profits, workforce, and education. Each breakout session will include an awardee from Round One of the program who will provide background on their project and will highlight the key elements that contributed to their success.

You can find additional details for each webinar, including registration, by clicking the links below. Please note that content covered at each session will be the same, however, questions and dialogue may differ. PBDA will be recording these sessions to post as resources on our website.