Report to Congress from the Medicare Payment Advisory Commission Evaluating FFS Payments

A report to Congress from the Medicare Payment Advisory Commission (MedPAC) evaluates Medicare’s fee-for-service payments to providers, the Medicare Advantage and the Part D Prescription Drug Program, special needs plans for beneficiaries who are dually eligible for Medicare and Medicaid, and the new Rural Emergency Hospital provider designation.

Read the full report here.

Commission Reports to Congress on Medicaid and CHIP

Also known as MACPAC, the non-partisan Medicaid and CHIP Payment Advisory Commission conducts analysis and makes recommendations to Congress about policies affecting Medicaid and the Children’s Health Insurance Program (CHIP).  In the first of two reports required for 2024, MACPAC focuses on ways to increase Medicaid beneficiaries’ participation in policymaking, how to make the denials and appeals process in Medicaid Managed Care more transparent, and provides analysis of allotments to states for Medicaid Disproportionate Share Hospitals.

Read the full report here.

Racial/Ethnic Differences in Experiences of Intimate Partner Violence and Postpartum Abuse Screening Among Rural US Residents who Gave Birth 2016-2020

The University of Minnesota describes rates of self-reported intimate partner violence among rural residents before or during pregnancy, and the frequency by which different racial or ethnic groups are not screened for abuse after giving birth. Uses 2016-2020 data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based surveillance survey. Features statistics with breakdowns by race or ethnicity.

Read the full report here.

Prevent or Treat: Availability of Diabetes Self-Management Education and Dialysis in High Need Rural Counties

Researchers from the Rural and Minority Health Research Center assess the availability of in-county diabetes self-management education and dialysis across rural and urban counties.  Among the findings: at least one site for kidney dialysis services is available in 59.2 percent of all counties across the U.S., but present in only 31.1 percent of noncore rural counties.

Read the full report here.

418 Rural Hospitals at Risk of Closure; Breakdown by State

From Becker’s CFO Report

There are about 418 rural hospitals at risk of closure, according to a new report from Chartis, a healthcare advisory services firm.

The organization analyzed 16 vulnerability indicators and found nine were statistically significant in predicting hospital closures, including: case mix index, Medicaid expansion, average daily census swing, occupancy, government control status and years of negative operating margin. The hospital’s average length of stay and change in net patient revenue also factored into its risk of closure.

States in the Southeast region of the country had the highest percentage of rural hospitals at risk of closure, followed by the Great Plains. The states with the most hospitals vulnerable to closures include:

  1. Texas: 45
  2. Kansas: 38
  3. Nebraska: 29
  4. Oklahoma: 22
  5. North Carolina: 19
  6. Georgia: 18
  7. Mississippi: 18

The percentage of rural hospitals at risk of closure by state is as follows:

More than 41% of hospitals
Florida
Tennessee
Nebraska

31% to 40%
Utah
South Dakota
Kansas
Oklahoma
Alabama
North Carolina
South Carolina

26% to 30%
Wyoming
Texas
Louisiana
Arkansas
Mississippi
Georgia

21% to 25%
Missouri
Illinois

16% to 20%
Wisconsin
New York
Massachusetts
Hawaii

10% to 15%
California
Idaho
North Dakota
New Mexico
Indiana
Pennsylvania
Virginia

0% to 9%
Oregon
Montana
Arizona
Alaska
Colorado
Minnesota
Iowa
Michigan
Ohio
Kentucky
West Virginia
Maryland
Rhode Island
Delaware
Connecticut
New Hampshire
Maine
Vermont
Nevada
Washington
New Jersey

New Research Results: Colon Cancer Rates Higher in Rural Areas

For health care professionals, it’s maddening. The technology needed to stop colorectal cancer before it turns deadly has never been better.

Yet in 2024, the American Cancer Society expects it to cause 106,590 new cases and 53,010 deaths. In Pennsylvania, about 34% of those diagnosed with colorectal cancer die from the disease. Though rates have decreased overall, they’re increasing among adults younger than 55.

And in a time when information can circle the globe in nanoseconds, barriers like geography still get between doctors and patients.

Health care professionals are finding higher rates of advanced colorectal cancer in rural areas compared with urban centers, said Dr. Karen Kim, dean of Penn State College of Medicine and Dorothy Foehr Huck and J. Lloyd Huck Chair in Rural Health Research. Also, mortality rates related to the disease are higher in less populated areas “largely because people there tend to be diagnosed in the later stages,” she said.

As a clinician, Kim knows the heartbreak and frustration firsthand. With multiple choices for colorectal cancer screening available, she explained, medical science can stop and prevent this fatal disease. But barriers get between her and some of her patients who need it most.

“Unlike some cancers where we think about early detection, with colon cancer it’s really about finding premalignant lesions before they even become cancer,” she said. “It’s so difficult as a gastroenterologist to continue to watch people die from this preventable disease.”

Kim discussed why people in less populated areas are seeing colon cancer more often than people living in cities, and what you can do to help protect your own health.

Read more.

Report Released on Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022

This policy brief from the RUPRI Center for Rural Health Policy Analysis describes differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.

Read the policy brief here.

New Report: Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022

This new policy brief describes differences in unsubsidized and net-of-subsidy premiums between nonmetropolitan and metropolitan counties in plan design and availability in 2022. Consistent with previous reports of health insurance marketplace (HIM) activity, we report enrollment-weighted plan selection by metal level and premiums paid by number of issuers and by Medicaid expansion status.

Authors: Abigail Barker, PhD; Ayushi Shrivastava, MPH; Eliot Jost, MBA, MPH; Timothy McBride, PhD; Keith Mueller, PhD

Read the full report.