- Rural Children Struggle to Access Hospital Services, Say Researchers
- Outlining the Intersection between Health Care and Missing and Murdered Indigenous People
- Biden-Harris Administration Announces Critical More Than $1.5 Billion State and Tribal Opioid Response Funding Opportunities
- RPHARM Program Fulfills Need for Rural Pharmacists
- Farmers Don't Do Mental Health
- A Pilot Program in Rural Vermont Hopes to Build a Blueprint for Substance Abuse Recovery
- Rural Telehealth Extension Reintroduced in Congress
- Students From Across the State Emphasized the Need for Mental Health Resources in Rural Alaska During a Conference
- The South Was the Center of Rural Population Growth Last Year
- How HHS SUD Confidentiality Regulations Will Impact Rural Providers
- VA Announces Expansion of "Close to Me" Cancer Program as Part of the Cancer Moonshot, Bringing Cancer Diagnosis and Treatment Closer to Thousands of Veterans
- Navajo Psychiatrist Bridges Gaps Between Native American Culture and Behavioral Health Care
- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Communities Face Primary Care Physician Shortage
Navigating Health Policy in an Election Year: Insights From a Health Policy Expert
On the April 2, 2024 episode of Managed Care Cast, we talked with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care® and a health policy professor at Penn State University. Topics discussed include President Biden’s recent prescription drug proposals, prior authorization practices, price transparency, and the potential impact of health policy on the upcoming election.
Listen to the Podcast here.
City-Country Mortality Gap Widens Amid Persistent Holes in Rural Health Care Access
In Matthew Roach’s two years as vital statistics manager for the Arizona Department of Health Services, and 10 years previously in its epidemiology program, he has witnessed a trend in mortality rates that has rural health experts worried.
As Roach tracked the health of Arizona residents, the gap between mortality rates of people living in rural areas and those of their urban peers was widening.
The health disparities between rural and urban Americans have long been documented, but a recent report from the Department of Agriculture’s Economic Research Service found the chasm has grown in recent decades. In their examination, USDA researchers found rural Americans from the ages of 25 to 54 die from natural causes, like chronic diseases and cancer, at wildly higher rates than the same age group living in urban areas. The analysis did not include external causes of death, such as suicide or accidental overdose.
The research analyzed Centers for Disease Control and Prevention death data from two three-year periods — 1999 through 2001 and 2017 through 2019. In 1999, the natural-cause mortality rate for people ages 25 to 54 in rural areas was only 6% higher than for city dwellers in the same age bracket. By 2019, the gap widened to 43%.
The researchers found the expanding gap was driven by rapid growth in the number of women living in rural places who succumb young to treatable or preventable diseases. In the most rural places, counties without an urban core population of 10,000 or more, women in this age group saw an 18% increase in natural-cause mortality rates during the study period, while their male peers experienced a 3% increase.
New Brief: Partnerships to Address Social Needs across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals
This policy brief used American Hospital Association (AHA) survey data to examine partnerships between hospitals and external organizations to address social needs. Hospitals were stratified by rurality (metropolitan or non-metropolitan) and type—prospective payment system (PPS) or critical access hospital (CAH) as well as by region, ownership status and accountable care organization (ACO) participation. We calculated a partnership score for all hospitals reflective of the number of types of partnerships and the number of ways that hospital partner to address social needs with scores ranging from 0 to 48. We also assessed what types of specific partnerships hospitals indicated. Key findings are noted below:
- The highest mean community partnership scores were seen in metropolitan PPS hospitals (24.0), followed by non-metropolitan PPS hospitals (20.4) and CAHs (16.8).
- Except for non-metropolitan PPS hospitals in the West, the Northeast had the highest mean partnerships across hospital types.
- Regardless of geography or type (CAH or PPS), non-profit hospitals and those participating in ACOs had higher mean partnership scores.
Most hospitals had partnerships with state and local agencies, though compared to other types of hospitals, a higher proportion of metropolitan PPS hospitals had partnerships with organizations that address specific social needs (e.g., food insecurity).
Authors: Whitney E. Zahnd, PhD; Khyathi Gadag, MHA; Kristin D. Wilson, PhD, MHA; Keith J. Mueller, PhD
Contact Information: Lead Author: Whitney Zahnd, PhD; whitney-zahnd@uiowa.edu
Senator Announces New Legislation to Expand Access to Maternal Care
U.S. Senator Maggie Hassan (D-NH) announced the introduction of her bipartisan Rural Obstetrics Readiness Act with Senators Susan Collins (R-ME), Katie Britt (R-AL), and Tina Smith (D-MN). The bill provides support for rural health care facilities to provide urgent obstetric care by helping to create training programs focused on obstetric emergencies, establish new federal grants to help these facilities buy specialized equipment for both training and patient care, and create a pilot program for rural facilities to get teleconsultations from maternal health experts to improve care. Please find the press release here. Please find NRHA’s Rural Maternal Health legislative priorities here.
Congresswoman Announces New Bill to Addresses Rural Physician Shortages
Congresswoman Yadira Caraveo, M.D. (D-CO) announced a bill to expand healthcare accessibility in rural communities. The Rural Residency Planning and Development Act of 2024 (H.R. 7855), introduced by Rep. Caraveo (D-CO), and Rep. Carol Miller (R-WV), would authorize the Rural Residency Planning and Development program to continue building a strong pipeline of rural physicians for years to come. Nearly 20% of Americans live in rural areas, but only 10% of physicians practice in these communities. Among current medical residency programs, only two percent of training occurs in rural areas. To tackle this shortage, the Rural Residency Planning and Development program, housed under the Health Services and Resources Administration (HRSA), awards funding to support start-up costs to establish new rural residency programs. As of November 2023, award recipients have created 39 new accredited rural residency programs or rural track programs and enrolled 306 resident physicians training in rural clinical settings. Please find NRHA’s rural workforce legislative agenda here.
House Energy and Commerce Committee Expected to Hold Hearing on Telehealth Permanency
The House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) and Subcommittee on Health Chair Brett Guthrie (R-KY) announced a subcommittee hearing to discuss telehealth permanency that will occur on April 10, 2024 at 10:00 AM ET. The hearing will focus on the discussion of legislative proposals that will support patients’ access to telehealth services. Establishing permanency of telehealth in rural communities via telehealth provides opportunity for essential access to health services and can greatly impact health outcomes for rural constituents. Key legislative proposals that are going to be considered that have rural relevance include:
- H.R. 4189: CONNECT for Health Act of 2023 (Reps. Mike Thompson, David Schweikert, Doris Matsui)
- H.R. 7623: The Telehealth Modernization Act of 2024 (Reps. Earl “Buddy” Carter, Lisa Blunt Rochester, Gregory Steube, Terri Sewell, Miller-Meeks, Debbie Dingell, Jefferson Van Drew, and Joseph Morelle)
Please find the press release here. Livestream of the hearing can be accessed here. Please find NRHA’s Rural Telehealth legislative priorities here.
Learn About The Chickahominy T.R.U.T.H. (Trust, Research, Understand, Teach, and Heal) Project
The project is a community-academic partnership between the Virginia Chickahominy Indian Tribe and Virginia Commonwealth University. The research is designed to investigate perceived cancer risk in Charles City County, Virginia and develop culturally tailored cancer education and resources.
Community Impact and Benefit of Critical Access and other Rural Hospitals
Examines the economic and health care benefit of Critical Access Hospitals (CAHs) on rural communities. Looks at the services provided, the economic health of CAHs, and the effect this has on their communities broadly. Includes comparisons of community benefit and patient care services indicators provided by CAHs and other rural and urban hospitals. The Flex Monitoring Team is a FORHP-supported consortium of researchers who evaluate the impact of HRSA’s Medicare Rural Hospital Flexibility Program.
ONC Seeks Feedback on Federal IT Strategic Plan
Comment by May 28. The Office of the National Coordinator (ONC) for Health Information Technology (IT) seeks public input on their draft 2024-2030 Federal Health IT Strategic Plan, which was developed in collaboration with more than 25 federal organizations that regulate, purchase, develop, and use health IT. When finalized, this plan will serve as a roadmap for federal agencies to prioritize resources, align and coordinate efforts across agencies, signal priorities to the private sector, and benchmark and assess progress over time. It will also serve as a catalyst for alignment outside the federal government. Stakeholders must submit comments via the feedback form by May 28.
CISA Seeking Comments on New Covered Cyber Incidents for Covered Entities such as Critical Access Hospitals
Comment by June 4. On April 4, 2024, the Cybersecurity and Infrastructure Security Agency (CISA) will release its proposed rule to implement new reporting requirements outlined in the Cyber Incident Reporting for Critical Infrastructure Act of 2022 (CIRCIA). Through this proposed rule, the CISA is seeking public comment and input on policies requiring Covered Entities to report Covered Cyber Incidents and ransomware payments to CISA within 72 hours of occurrence of cyber-attack incident or 24 hours after the ransom payment has been made. The rule identifies 16 Critical Infrastructure Sectors, which includes the Healthcare and Public Health sector, as being at risk for a Covered Cyber Incident. As part of the Healthcare and Public Health sector, the rule includes a hospital with 100 beds or more, or a Critical Access Hospital as a Covered Entity. Covered Cyber Incidents experienced by a Covered Entity would be reportable regardless of which part of the organization suffered the impact. Other Covered Entities include Class II (moderate risk) and Class III ( high risk) devices as classified by the U.S. Food and Drug Administration and manufactures of drugs listed in Appendix A Essential Medicines Supply Chain and Manufacturing Resilience Assessment developed by the U.S. Department of Health and Human Services and the Administration for Strategic Preparedness and Response. In total, CISA estimates that over 300,000 entities from the 16 sectors would be covered by the Proposed Rule.