The NORC Walsh Center for Rural Health Analysis is pleased to share the final report and a series of practice briefs from the Exploring Strategies to Improve Health and Equity in Rural Communities project. These documents are the result of a one-year formative research project exploring rural strengths, cross-sector partners, cultural and historical assets, and opportunities for action to improve health and equity in rural communities. We welcome and would appreciate wide dissemination of these materials through your networks and established dissemination channels. Please let us know if we can support you in doing so.

 

All materials and a brief description of the project can be found on the Exploring Strategies to Improve Health and Equity in Rural Communities project webpage. The following links will take you to each report directly:

• Final Report: “Exploring Strategies to Improve Health and Equity in Rural Communities”
• Practice Brief #1: “Leveraging Culture and History to Improve Health and Equity in Rural Communities”
• Practice Brief #2: “Supporting Change Agents across Sectors to Improve Health and Equity in Rural Communities”
• Practice Brief #3: “Recommendations for Philanthropies and Government Agencies to Improve Health and Equity in Rural Communities”

New Reports and Recommendations for Rural Health Policy.  Two new briefs from the National Advisory Committee on Rural Health and Human Services are now viewable online.  During its September 2018 meeting in Charlotte, North Carolina, the Committee took an in-depth look at two pertinent topics: chronic obstructive pulmonary disease (COPD) and oral health care services. The Committee examined the factors and impacts of these conditions in rural areas and sent its findings and recommendations to the Secretary of the U.S. Department of Health and Human Services.

The RUPRI Rural Health Panel, through the support of the Federal Office of Rural Health Policy (FORHP) in the Department of Health and Human Services, has released a new Policy Brief, Assessing the Unintended Consequences of Health Policy on Rural Populations and Places.

The purpose of this paper is to illuminate the unintended consequences of health policy so that past is not prologue to future. The Panel explores a series of health policies that have affected, or had the potential to affect, rural people, places, and/or providers in ways counteractive to policy intent. Two realities drive the need for this analysis: 1) Rural health care systems are living with the legacy of policies having unintended consequences because the full impact of such policies on rural stakeholders was neither predicted nor understood; and (2) Policymakers have recognized the need to apply a rural lens to new and ongoing programs and policies to inform the pathways by which equitable rural health status and health care can be achieved, as articulated by the Centers for Medicare & Medicaid Services (CMS) Rural Health Council in its first explicit Rural Health Strategy. The Panel concludes with a framework for health policy evaluation that considers potential and unintended rural impacts.

A new report from our intern, Craig Yetter, uses microdata from the U.S. Community Survey to identify trends in domestic out-migration from Pennsylvania by age. Major trends identified include that nearly half of out-migrants were age 18 to 34 and that out-migrants age 65 and over moved to Florida in much greater percentages than other cohorts.

Click here to read more.

The Pennsylvania Department of Health (DOH), Bureau of Epidemiology has issued the 2017 Annual HIV Surveillance Summary Report. DOH is also working towards launching a virtual command center to address the increase of Hepatitis A. They will be working with various departments within DOH to take a three-pronged approach of looking at homelessness, drug users, and men who have sex with men (MSM), a model that is being successfully used in regions of Philadelphia.

On December 28, 2018, the U.S. Department of Health and Human Services released a draft report from the HHS Pain Management Best Practices Inter-Agency Task Force. Section 101 of the Comprehensive Addiction and Recovery Act of 2016 (CARA) (P.L. 114-198) authorized the Secretary of HHS, in cooperation with the Secretary of Veterans Affairs and the Secretary of Defense, to convene the Pain Management Best Practices Inter-Agency Task Force.

The Task Force is charged with providing advice and recommendations to relevant federal agencies and the general public for the development of best practices for managing chronic and acute pain and a strategy for disseminating such best practices.  The Task Force includes representatives from both federal and non-federal entities who represent diverse disciplines and views.

The Task Force held public meetings May 30 and May 31, 2018, and on September 25 and 26, 2018, voted on a list of proposed updates and recommendations. Those draft recommendations will be published in a draft report in the Federal Register on Monday, Dec. 31, 2018. (It will be available for public view via online public displayTODAY, Dec. 28.) The public will have 90 days to submit comments. Details on submitting comments are outlined on the HHS website and in the Federal Register’s posting. Once the 90-day public comment period concludes, the Task Force will consider comments received and publish a report with final recommendations.

Pennsylvania’s population grew to an estimated 12,807,060 persons according to the 2018 Nation & State Population Estimates. Clickhere to read how Pennsylvania’s total population has changed since 2010 and how it compares to other states’ populations.

New from Rural Health Value:

The Rural Health Value team recently released a new Rural Innovation Profile focused on how a rural Medicaid coordinated care organization reinvests the money it earns through achieving improvement targets to strengthen local capacity for organizations to work together and improve population health.

Please share this resource as makes sense for your networks and stakeholders:

Predictive Analytics Shape Care Processes – Community Care Partnership of Maine, a collaboration of nine federally qualified health centers and three community hospital systems, uses predictive analytics software to identify patients with the highest risk and plan interventions to support care management. (November 2018)

Link:  Predictive Analytics Shape Care Processes

Top resources on the Rural Health Value website:

• Value-Based Care Assessment – Assess capacity and capabilities to deliver value-based care. Receive an eight category readiness report.
• Physician Engagement – Score current engagement and build effective relationships to create a shared vision for a successful future.
• Board and Community Engagement – Hold value-based care discussions as part of strategic planning and performance measurement.
• Social Determinants of Health – Learn and encourage rural leaders/care teams to address issues to improve their community’s health.

Recent Journal Articles Publishing Rural Health Research.  Several articles written by the HRSA/FORHP-supported Rural Health Research Centers were recently published in peer-reviewed journals.  Among these are Patterns of Telehealth Use Among Rural Medicaid Beneficiaries and Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder.  While some journal articles offer free access, others may require a subscription or affiliation with a subscribing library.

The Rural Hospital and Health System Affiliation Landscape – A Brief Review.  Rural hospitals that join health systems may find it challenging to balance local decision-making control and the requirements of larger, better-funded regional health systems.  This policy paper from the RUPRI Center for Rural Health Policy Analysis examines rural hospital motivations for joining health systems and examines different affiliation structures.