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.
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.
Findings Released on Rural-Urban Differences in Housing Cost Burden Across the U.S.
The University of Minnesota Rural Health Research Center examines rural-urban differences in housing affordability across Census regions, divisions, states, and counties, using data from the 2017-2021 American Community Survey.
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.
Partnership to Address Social Needs Across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals
This policy brief from the RUPRI Center for Rural Health Policy Analysis used survey data from the American Hospital Association to examine partnerships between hospitals and external organizations to address social needs.
National LGBTQ Survey Reveals Persistent Barriers to Care, Other Challenges
The findings of a new national survey conducted by The National Coalition for LGBTQ Health highlight significant barriers to care, a lack of provider training, and a rise in stigma and criminalization. The Coalition is releasing a digital report on these national survey findings during its 22nd National LGBTQ Health Awareness Week, themed “VITAL VIBRANT VOICES”. The Week runs from March 18 to March 22, 2024. Read the full report here: https://healthlgbtq.org/stateof/lgbtqhealth/
More than 1,000 clinical and service providers across the United States completed the survey and were asked to describe the state of LGBTQ health in one word. The top three submitted words were “lacking,” “poor,” and “inadequate,” which suggest a widening gap between the need for care and the available resources to provide care. Despite the critical need for greater allocation of resources to support LGBTQ health, healthcare providers continually report feeling unprepared to meet the needs of their LGBTQ clients and patients.
In addition to these findings, 80% of respondents exhibited confidence in using culturally appropriate terminology when communicating with LGBTQ patients, which fosters a more welcoming environment.
“Our survey exposes a stark reality: numerous healthcare providers, typically outside LGBTQ-specific health centers, still lack the necessary training to deliver basic LGBTQ care; let alone affirming care that is specific to transgender patients,” said Scott Bertani, lead for The National Coalition for LGBTQ Health. “This shortfall in education leads to provider uncertainty, which in turn leads to less meaningful patient engagement; and that has a true impact on both the physical and mental health outcomes for all our communities.”
The survey findings illustrate the need for a multi-pronged approach to address LGBTQ health:
- Increased funding for training healthcare providers in LGBTQ-specific care.
- Expansion of gender-affirming healthcare services.
- Stronger protections against discrimination in healthcare settings.
- Combating rising stigma and criminalization through education and advocacy.
The National Coalition for LGBTQ Health urges policymakers, healthcare providers, and LGBTQ advocacy groups to work collaboratively to create a more equitable and inclusive healthcare system for all.
For more information about the report or for interviews, contact Scott Bertani, The National Coalition for LGBTQ Health’s Director of Advocacy, at ScottB@HealthLGBT.org.
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:
- Texas: 45
- Kansas: 38
- Nebraska: 29
- Oklahoma: 22
- North Carolina: 19
- Georgia: 18
- 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.
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.
New Report Assesses Impact of CMS Quality Programs
The report from the Centers for Medicaid & Medicare Services (CMS) analyzes the performance of nearly 500 quality measures used in CMS’s quality and value-based incentive payment programs. It provides patients and families, clinicians, measure developers, federal partners, and researchers with updates on progress toward reducing disparities across the measure portfolios. For example, rural/urban disparities were most often detected in quality measures addressing Wellness and Prevention and Chronic Conditions; however, several measures of Person-Centered Care no longer show rural/urban disparities. Findings from focus groups underscore the need to develop measures that address bias in care delivery, deficits in cultural competence, and social drivers of health relative to unmet health needs, poor access, and low health literacy.