USDA Releases Report on Rural Broadband and Benefits of Next Generation Precision Agriculture

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Reliable, High-Speed Broadband e-Connectivity is Essential to Enhanced Agricultural Production

WASHINGTON, April 30, 2019 – Agriculture Secretary Sonny Perdue today unveiled a groundbreaking report, A Case for Rural Broadband: Insights on Rural Broadband Infrastructure and Next Generation Precision Agriculture Technologies (PDF, 2.5 MB). The report finds that deployment of both broadband e-Connectivity and Next Generation Precision Agriculture Technology on farms and ranches throughout the U.S. could result in at least $47 billion in national economic benefits every year.

“Broadband and Next Generation Precision Agriculture are critical components for creating vital access to world-class resources, tools and opportunity for America’s farmers, ranchers, foresters and producers,” Secretary Perdue said. “Under the leadership of President Trump, USDA is committed to doing our part to clear the way for nationwide broadband connectivity that will allow the next generation of precision agriculture technologies to thrive and expand.”

Download A Case for Rural Broadband: Insights on Rural Broadband Infrastructure and Next Generation Precision Agriculture Technologies (PDF, 2.5 MB). To see how Next Generation Precision Agriculture Technologies can work on farm and ranching operations, view the Connected Technologies infographic (PDF, 910 KB).

The report also finds that if broadband infrastructure and digital technologies at scale were available at a level that meets estimated producer demand, the U.S. economy could realize benefits equivalent to nearly 18 percent of total agriculture production. Of that 18 percent, more than one-third is dependent on broadband e-Connectivity, equivalent to at least $18 billion in annual economic benefits that only high-speed, reliable internet can provide.

For many years, USDA and the American agriculture industry have been actively researching the feasibility, usage and potential upside of Next Generation Precision Agriculture technologies. Until now though, the interdependency of these technologies and broadband e-Connectivity has not been evaluated. The report released today explores this symbiotic relationship and quantifies the potential economic benefit of broadband buildout and the complementary adoption of connected agriculture technologies. Going forward, the U.S. Department of Agriculture (USDA) will be engaged in multiple facets of infrastructure and technology deployment, including financing rural capital investments and supporting producers who are exploring which Next Generation Precision Agriculture Technologies are best suited to improve their operations and serve their customers.

In April 2017, President Trump established the Interagency Task Force on Agriculture and Rural Prosperity to identify legislative, regulatory and policy changes that could promote agriculture and prosperity in rural communities. In January 2018, Secretary Perdue presented the Task Force’s findings to President Trump. These findings included 31 recommendations to align the federal government with state, local and tribal governments to take advantage of opportunities that exist in rural America. The Report identified Achieving e-Connectivity in Rural America as a cornerstone recommendation. The Administration has been executing this priority call to action through the American Broadband Initiative (ABI) (PDF, 647 KB), which reflects rural broadband build-out as one of President Trump’s directives to the Federal government. A Case for Rural Broadband: Insights on Rural Broadband Infrastructure and Next Generation Precision Agriculture Technologies (PDF, 2.5 MB) opens the next chapter in the USDA’s response to this call to action.

To view the report in its entirety, please view the Report to the President of the United States from the Task Force on Agriculture and Rural Prosperity (PDF, 5.4 MB). In addition, to view the categories of the recommendations, please view the Rural Prosperity infographic (PDF, 190 KB).

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Pennsylvania Oral Health Surveillance Plan Announced

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The Pennsylvania Department of Health Oral Health Program is excited to announce the publication of the 2019-2024 Pennsylvania Oral Health Surveillance Plan.  The Oral Health Surveillance Plan provides a consistent source of reliable and valid information for use in the monitoring of oral health status and trends of the state and for developing, implementing, and evaluating programs to improve the oral health of Pennsylvanians.

Click here to view the plan.

Congressional Budget Office Releases Report on Single-Payer Health Care System

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Key Design Components and Considerations for Establishing a Single-Payer Health Care System

Congressional interest in substantially increasing the number of people who have health insurance has grown in recent years. Some Members of Congress have proposed establishing a single-payer health care system to achieve universal health insurance coverage. In this report, CBO describes the primary features of single-payer systems, as well as some of the key considerations for designing such a system in the United States.

Establishing a single-payer system would be a major undertaking that would involve substantial changes in the sources and extent of coverage, provider payment rates, and financing methods of health care in the United States. This report does not address all of the issues that the complex task of designing, implementing, and transitioning to a single-payer system would entail, nor does it analyze the budgetary effects of any specific bill or proposal.

This report describes the primary features of single-payer systems, and it discusses some of the design considerations and choices that policymakers will face in developing proposals for establishing such a system in the United States.

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Primary Care Clinician Participation in the CMS Quality Payment Program

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Clinton MacKinney, MD, MS; Fred Ullrich, BA; and Keith J. Mueller, PhD

Approximately 10 percent of primary care clinicians participate in Advanced Alternative Payment Models (A-APMs) and less than 30 percent of primary care clinicians participate in the Merit-Based Incentive Payment System. Metropolitan primary care clinicians are more likely to participate in A-APMs than non-metropolitan primary care clinicians.

Click to download a copy: Primary Care Clinician Participation in the CMS Quality Payment Program

Differences in Care Processes Between Community-Entry Versus Post-acute Home Health for Rural Medicare Beneficiaries

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Medicare beneficiaries may be admitted to home health following an inpatient stay (post-acute) or directly from the community (community-entry). An analysis of Medicare data for rural, fee-for-service Medicare beneficiaries who utilized home health from 2011 to 2013 found significant differences in care processes between community-entry and post-acute home health. Compared to post-acute home health episodes, community-entry home health episodes on average were longer; less likely to include physical, occupational, and speech therapy visits; more likely to include medical social work visits; and less likely to be initiated on the physician-ordered start date or within two days of referral. Results suggest community-entry and post-acute home health are serving different needs for rural Medicare beneficiaries, which provides preliminary support for distinguishing between the two types of episodes in payment policy reform.

ONC Brief on Electronic Capabilities of Hospitals

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The Office of the National Coordinator (ONC) reports that nearly all hospitals provided patients with the ability to electronically view and download their personal information in 2017.  However, Critical Access Hospitals (CAHs) and small rural hospitals were less likely than larger and urban hospitals to be able to transmit that data and to have view, download, and transmit (VDT) capabilities.  Under the Promoting Interoperability Program (PI), hospitals are required to use electronic health records technology.  Another aspect of the program is to promote patients’ ability to view and download their personal health information.  The cost of electronic health record systems and limited access to broadband are two of the barriers to electronic capabilities in rural health care settings. See the Policy Updates section below for requests for comment on recent proposals on electronic health information networks.

ARC on the State of Health Disparities in Appalachia

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The Appalachian Regional Commission (ARC) is a federal agency created by Congress to partner with state and local governments and promote economic development for the region.  This month, the ARC released three separate issue briefs on health disparities in the 13 states of the region – Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia.  The briefs describe the factors unique to the region that contribute to disparities related to obesity, opioid misuse, and smoking, and provide recommendations and practical strategies for communities.

 

Nonmetro Counties Gain Population for Second Straight Year

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From the Daily Yonder…

By Tim Marema

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Rural America’s population grew by 0.1 percent from 20017 to 2018. The growth was small and clustered near metropolitan areas. But it reverses the trend of population loss that occurred from 2011 to 2016.

The size of the non-metropolitan population crept up for the second year in a row in 2018, adding about 37,000 residents to reach 46.1 million.

That’s a gain of about 0.1 percent, according to a report from demographer Kenneth M. Johnson at the University of New Hampshire’s Carsey School of Public Policy.  The rate of growth is roughly the same as the growth rate from 2016 to 2017, when non-metropolitan counties added 33,000 residents.

The overall U.S. population grew by about 0.6 percent over the last year.

While the gains for non-metropolitan America were scant, they continue to reverse the historic drop in non-metropolitan population that occurred from 2011-16.

The map shows which counties gained or lost population from 2017 to 2018. County-level data is available  a map. Or see the map in a new, full-sized window.

About half of America’s 2,000 or so non-metropolitan counties gained population, while about three quarters of metropolitan counties did.

Rural America’s net growth came from rural counties that are adjacent to metropolitan areas, Johnson said in his report. Those counties gained 46,000 residents, while non-metro counties that don’t touch a metro area lost 9,000 residents.

Johnson said non-metro counties grew from a combination of migration (more people moving into a county than leaving it) and natural increase (more births than deaths). The rate of natural increase is dwindling, Johnson said.

Growth rates in non-metropolitan American varied by region. “The fastest growing counties have recreational and scenic amenities that attract migrants including retirees from elsewhere in the United States,” according to the report. In contrast, farm counties had more people leave than move into the counties.

The Census Bureau, which released the 2018 population estimates Wednesday (April 18, 2019), noted that the South and West tended to have the fastest numerical growth in counties.

How this story defines rural: This story uses the Office of Management and Budget metropolitan statistical area system to define rural. Rural counties are defined as those that are not in a metropolitan statistical area or MSA. In this story, rural is synonymous with non-metropolitan. There are numerous ways to define rural. You can learn more (much more!) from the USDA Economic Research Research and the U.S. Census. 

NIH Funds Study in Four States to Reduce Opioid Related Deaths by 40 Percent Over Three Years

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The National Institutes of Health has selected four research sites for the HEALing Communities Study in states hard hit by the opioid crisis. This ambitious study aims to reduce overdose deaths by 40 percent over three years in selected communities by testing a set of proven prevention and treatment interventions.  More than $350 million will support this multi-year study.  Applications included the involvement of community resources such as police departments, faith-based organizations, and schools, with a focus on rural communities and strong partnerships with state and local governments.

Medicare Advantage Enrollment Update 2018

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Medicare Advantage Enrollment Update 2018

Onyinye Oyeka, MPH; Fred Ullrich, BA; and Keith Mueller, PhD

The RUPRI Center’s annual analysis of Medicare Advantage (MA) enrollment shows that there are 2.6 million nonmetropolitan beneficiaries (24.6 percent of eligible nonmetropolitan beneficiaries) enrolled in an MA plan. The number of nonmetropolitan beneficiaries enrolled in an MA plan increased by 9.5 percent from 2017 to 2018. Nonmetropolitan MA enrollment remains significantly lower than metropolitan enrollment (24.6 percent v. 36.4 percent), but in 2017 the nonmetropolitan rate of growth in MA plan enrollment was higher than the rate of growth in metropolitan areas (4.7 v. 2.0 percent).

Among MA plans, nonmetropolitan enrollment in private fee-for-service MA plans declined sharply between 2009 and 2018, while nonmetropolitan enrollment in health maintenance organizations (HMOs) and local preferred provider organizations (PPOs) saw significant increases.

Click to download a copy: Medicare Advantage Enrollment Update 2018