National Rural Health Association CEO Alan Morgan discusses his organization’s work on the national and global stages and shares his rural health predictions for 2020.

CMS seeks comment on proposed updates to the hierarchical condition categories (HCC) model and the use of encounter data for risk adjusting MA plan payments in the 2021 plan year.  The proposed changes to the risk adjustment methodology are intended to better predict the cost to care for Medicare Advantage enrollees based on their health status and other factors   Research has found that HCC risk scores vary between rural and urban providers.  Other proposed payment methodology changes for the 2021 plan year will be released at a later date in Part II of the Advance Notice. Read more here.

The Medicare Disproportionate Share Hospital (DSH) payment adjustment is intended to compensate those hospitals serving a disproportionate number of low-income patients. Begun in 1986, the program was amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to impose a 12% cap on the payment, with exception for large hospitals and Rural Referral Centers. This policy brief from the RUPRI Center for Rural Health Policy Analysis describes the number and location of urban and rural hospitals affected by that cap. Read more here.

On December 30, 2020, the Rural Health Research Gateway released two policy briefs from the University of Minnesota Rural Health Research Center.  The first presents findings from an online survey of Rural Health Clinics describing clinic data and characteristics related to healthcare access.  A second brief examines access issues for rural Medicare beneficiaries seeking care from specialty providers. Read more here.

A paper from the Rural and Underserved Health Research Center explores the decline in the percentage of family physicians providing endoscopic services overall and in urban and rural areas. This has implications on the availability of colonoscopies, endoscopies, and flexible sigmoidoscopies in areas that lack specialists who perform such services. Read more here.

A paper from the Rural and Underserved Health Research Center shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination. Read more here.

Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper from the Rural and Underserved Health Research Center examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine. Read more here.

In the U.S., severe maternal morbidity and mortality (SMMM) is climbing—a reality that is especially challenging for rural communities, which face declining access to obstetric services. Using data for 2007-15 from the National Inpatient Sample, the University of Minnesota Rural Health Research Center analyzed SMMM during childbirth hospitalizations among rural and urban residents. Read more here.

In collaboration with the U.S Census Bureau, the National Center for Health Workforce Analysis provides a comprehensive view of the nurse workforce with data on demographics, educational attainment, licenses and certifications, and employment characteristics in all U.S. states.  The survey is the work of the Bureau of Health Workforce at the Health Resources and Services Administration (HRSA). Read more here.