Stroudwater partnered with the National Rural Health Association and the National Organization of State Offices of Rural Health to create the third annual Rural Provider Compensation Survey to analyze provider compensation. This year’s report highlights the significant variation in provider pay among rural organizations and emphasizes the urgent need for rural health care to align provider compensation with the organization’s goals and ensure compliance with fair market value.

Read the report here.

A team at the Penn State Cancer Institute examined cancer registry data from 2017 through 2021 and reported that adults over 50 living in a 15-county area of South Central Pennsylvania were 57% more likely to be diagnosed with melanoma, the deadliest form of skin cancer, than residents in the rest of Pennsylvania.

Charlene Lam, MD, associate professor of dermatology at Penn State Health and a co-author of the study, noted that the affected region includes both rural and urban counties. She explained that the elevated risk is not limited to people in remote locations or those who spend long hours outdoors.

The full article is available.

The Flex Monitoring Team (FMT) is excited to release a new product, Facilitators of Strong Quality and Financial Outcomes in Critical Access Hospitals (CAHs). This brief builds on the prior quantitative analysis described in the companion brief, Characteristics of Critical Access Hospitals with High Financial and Quality Metrics, to explore how high-performing CAHs attain excellence in both quality and finance.

Through interviews with leaders at ten CAHs identified as top performers across key financial and quality benchmarks, this brief identifies leadership strategies, organizational practices, and external supports that contribute to success in both domains. Respondents highlighted traits such as active executive leadership, a strong patient/community focus, and transparent communication. Board engagement, participation in Accountable Care Organizations (ACOs), and service expansion were also commonly cited as drivers of success. These findings offer practical insights for CAH leaders, State Flex Programs, and other rural health stakeholders aiming to support organizational improvement in both financial and quality outcomes.

With historic investments in career and technical education, vo-tech, and apprenticeships, Pennsylvania is ensuring that students have the freedom to chart their own course and the opportunity to succeed.

Pennsylvania earned the top spot among all 50 states in a national study of how schools across the country are preparing middle school students for careers. The Pennsylvania Department of Education (PDE) joined a coalition of teams from Arizona, Kentucky, Washington, and Arkansas to accelerate efforts nationwide to prepare students for success beyond high school. The coalition formed from the “Extending the Runway” report that ranked Pennsylvania with the highest possible score for middle school career exploration. Through the coalition, Pennsylvania is continuing to lead the way by working with Pennsylvania schools on a new career-readiness program that will put students in an advisory role, focus on hands-on learning experiences, and leverage community partnerships.

Click here to learn more.

With the deactivation of data.census.gov, many data users may wonder if it is possible to still access critical data from the Census Bureau’s programs and surveys. Luckily, many resources remain that provide continuity of data access for your work.

• PA State Data Center (pasdc.hbg.psu.edu)

We maintain access to the Census Bureau’s API during the shutdown and are able to obtain data from Decennial Censuses, Population Estimates Program, and American Community Survey, among others.

• Census Reporter (censusreporter.org/)

An accessible, easy-to-use site similar to the experience of using data.census.gov. Great documentation on the site’s landing page related to “Using this site” will help you get started. Note that only the latest year of ACS (2023 1-Year and 2019-2023 5-Year) data are available.

• IPUMS (ipums.org/)

A collection of census and survey data where users submit custom data requests (“extracts”) to the IPUMS database to retrieve data in a variety of formats. For most data.census.gov users, we recommend using NHGIS, which includes most census programs and surveys including the most recent ACS.

Updates from the U.S. Census Bureau

A recent report from the U.S. Census Bureau highlighted the nation’s centenarian population, or individuals aged 100 years and older. Nationally, there were 80,139 (2.42 per 10,000) centenarians in 2020, up from 53,364 (1.73 per 10,000) in 2010. The nation’s centenarian population had a net gain of 26,775 and percentage increase of 50.2%. Click here to view interactive map.

Pennsylvania’s own centenarian population followed the nation’s trajectory. The commonwealth had 3,931 (3.02 per 10,000) centenarians in 2020, up from 2,510 (1.98 per 10,000) in 2010. The commonwealth’s centenarian population had a net gain of 1,421 and a percentage increase of 56.6%. Read more here.

Planning for the 25th census in U.S. history is underway. The Bureau released the first version of the 2030 Census Operational Plan, along with an interactive tool for exploring it. PaSDC will continue to coordinate involvement in decennial planning efforts. Two of the earliest and most critical programs include:

• LUCA: Local Update of Census Addresses

The LUCA program allows tribal, state, and local governments to review and suggest updates to the Census Address List to help ensure a complete and accurate count. Participating governments can compare Census address counts with their own records, submit additions or corrections, and receive feedback, with an option to appeal. For 2030, LUCA will be fully digital and offer earlier access to address data, improved online tools, and a longer review period to support more thorough and data-driven participation. Read more here.

• BBSP: Block Boundary Suggestion Project

As part of the upcoming 2030 Census preparation, Phase 1 of the Block Boundary Suggestion Project will give states the opportunity to recommend both traditional and non-standard geographic features to be used as census tabulation block boundaries.

States will receive guidance and training in early 2026 and will later verify their boundary suggestions. In addition, states will be able to review and update legal boundaries through coordination with the annual BAS program, with final verification of all suggestions planned for early 2027. Read more here.

Seven in ten adults living in rural Pennsylvania (69%) indicated they have experienced symptoms of depression or have been concerned about a family member or friend dealing with depression during the past year. This is among the findings of a new poll of 508 rural Pennsylvania residents conducted by Russell Research on behalf of the mental health nonprofit RuralMinds.

The poll, fielded during August 2025, also showed that three in four rural Pennsylvanians (76%) are aware of talk therapy as a depression treatment or intervention, and more than two-thirds (68%) are aware of pharmacological treatments. However, significantly less are aware of additional therapies. For example, only 17% indicated being aware of digital therapeutics and 11% knew of Eye Movement Desensitization and Reprocessing (EMDR) therapy.

Seven in ten rural Pennsylvanians (71%) responded that they would be comfortable talking about mental health challenges with a mental health professional or counselor. And more than one-half of rural Pennsylvanians (55%) would be comfortable talking about mental health challenges with a close family member. However, only two in five rural Pennsylvanians (39%) would be comfortable talking about mental health challenges with a trusted coworker or friend.

“Depression is a significant challenge for people living in rural areas,” said Robert E. Nelson, MD, Co-Owner DGR Behavioral Health, LLC and Medical Director at Caron Counseling Center in Wyomissing, PA.“Additionally, the factors leading to depression can be different for those living outside urban and suburban communities.”

“For example, some of my rural patients are reluctant to seek help until the situation is much more severe than necessary. This is often because of the stigma associated with mental health issues that makes it more difficult for people to even admit they are suffering.”

Established in 2021, Rural Minds is the only national 501(c)(3) nonprofit focused on advocating for rural mental health equity, promoting mental wellness, and providing information and resources to confront rural mental health challenges and the stigma that surrounds mental illness. The organization serves the 46 million people living in farming, ranching, and agriculture communities, small towns, and isolated areas in the country across rural America.

“Common barriers to mental health treatment for residents of rural areas include the lack of confidentiality in small communities, fewer providers and greater distance to access mental health services. In addition,many rural residents are either uninsured or underinsured,” said Jeff Winton, founder and chairman of Rural Minds. “Much of the data from this poll in Pennsylvania are in keeping with many other rural communities across the country.”

Established in 2021, Rural Minds is the only national 501(c)(3) nonprofit focused on advocating for rural mental health equity, promoting mental wellness, and providing information and resources to confront rural mental health challenges and the stigma that surrounds mental illness. The organization serves the 46 million people living in farming, ranching, and agriculture communities, small towns, and isolated areas in the country across rural America. For additional information from the poll, or to schedule an interview with Dr. Nelson or Jeff Winton contact Adriel McMahan, adriel@ruralminds.org.

The poll was sponsored through a grant from Otsuka Precision Health.

From Becker’s Hospital Review

Twenty-seven labor and delivery units at rural hospitals have shuttered in 2025, up from 21 in 2024, according to a new report from the Center for Healthcare Quality and Payment Reform.

The report found that since year-end 2020, 116 rural hospitals have ended deliveries or planned to do so by year-end 2025. Rural L&D units have closed in most states over the last five years, and in three states, at least one-quarter of rural hospitals with maternity services have ended deliveries. Only 41% of U.S. rural hospitals provide L&D services, with less than one-third offering them in 12 states.

The findings highlight a concerning trend, driven by limited alternative revenue streams or inadequate reimbursement, which suggests that more rural communities could be at risk of losing maternity care due to the financial uncertainties of offering the services..

In fact, more than 120 rural hospitals that offer L&D ran at a loss over the last two years, which put them at risk of closing their L&D units to ensure financial sustainability. Across nine states, at least one-quarter of rural hospitals offering maternity care face the same issue, the report said.

“Rural maternity care is in a state of crisis, and more women and babies in rural communities will die unnecessarily until the crisis is resolved,” the report said. “Federal and state government officials and private employers must take immediate action to ensure that all health insurance plans are paying adequately to support high-quality maternity care in every community.”

Becker’s has reported on 27 maternity care closures in 2025. Most recently, Minneapolis-based Allina Health said it would close its Faribault (Minn.) Birth Center Dec. 1. The health system will consolidate L&D services to its Owatonna (Minn.) Hospital as part of a new regional obstetric care model.

Allina Health’s consolidation also comes after Mayo Clinic moved to end its on-call labor and delivery at Owatonna Hospital, effective November 17.

The center’s report can be accessed here.

From Becker’s Hospital Review

Safety-net hospitals provided $11 billion in uncompensated care and another $11.4 billion in under-reimbursed care in 2023, according to a Nov. 6 report from America’s Essential Hospitals.

Four things to know:

1. Of the $11 billion in uncompensated care performed at AEH’s 383 member hospitals in 2023, 70% was charity care for uninsured patients. Twenty-two percent was non-Medicare bad debt expenses and 8% was charity care for patients with insurance who could not afford their medical bills.
2. AEH said Medicaid and Medicare often undervalue the care provided at safety-net hospitals, resulting in shortfalls between what the programs pay and a hospital’s cost of care. Of the $11.4 billion in under-reimbursed care, 86% resulted from Medicaid shortfalls (after disproportionate share hospital payments), 10% from Medicare shortfalls (after DSH payments), 3% from Medicare bad debt, and 1% from state or local indigent care programs.
3. Without Medicaid DSH and other Medicaid supplemental payments, essential hospital operating margins would have been -12.4% in 2023. After DSH and other government appropriations, essential hospitals had aggregate margins of -1.6%.
4. “This report shines a light on the severe financial challenges facing essential hospitals, which will be dramatically increased in the coming years with the unprecedented Medicaid cuts in H.R. 1,” AEH President and CEO Jennifer DeCubellis said in a November 6 news release.

Read the full report here.

The Annie E. Casey Foundation released its annual Supplemental Poverty Measure (SPM) data, along with a 10-year update examining economic opportunity among children and families in the U.S. for housing, health care, and child care, as well as the benefits of supports such as the picture of financial well-being than the outdated Official Poverty Measure (OPM) by accounting for modern expenses, regional differences in cost of living, and the impact of public assistance programs. It factors in expenses related to housing, health care, and child care, as well as the benefits of supports like the Earned Income Tax Credit, Child Tax Credit, SNAP, Social Security, Supplemental Security Income, and housing subsidies. This offers a broader view of how families are faring across the country while highlighting how public programs reduce child poverty and strengthen family stability.

Nationally, the SPM child poverty rate fell to a record low of 5% in 2021 when federal supports expanded during the COVID-19 pandemic, but rose to 13% in 2024 after those temporary measures expired. Without public assistance, the rate would nearly double at 25%, meaning 8.5 million more children would be living in poverty. Consistent with national trends, Pennsylvania’s child poverty rate dropped to 6.5% from 2019-2021, then climbed back up to nearly 11% in recent years.

These findings demonstrate how effective economic policies are at lifting families out of poverty, while underscoring the urgent need to sustain funding for essential programs. Poverty not only undermines children’s development and long-term well-being; it also costs the nation an estimated $1 trillion each year in lost productivity and higher health care spending. The SPM remains one of the clearest tools available to help families, communities, and policymakers understand the impact of public programs and the high cost of failing to maintain them.