Community Catalyst, the American Dental Association (ADA) Health Policy Institute, (HPI) and Families USA published an issue brief on the current landscape of dental coverage for Medicaid-enrolled adults. “Making the Case for Dental Coverage for Adults in All State Medicaid Programs” illustrates how comprehensive dental coverage is a major driver of access to dental care and improved oral health for Medicaid-enrolled adults. The authors discuss federal policy options to ensure that all states offer adequate adult dental coverage in Medicaid that could reduce cost barriers and improve access to dental care for adults across the United States.
GAO Examines Nurse Corps Loan Repayment Program
Until last year, the federal program that repays education loans for nurses required that they work only at non-profit facilities. The pandemic-related CARES Act eliminated that restriction in March 2020, allowing Nurse Corps members to serve at for-profit critical shortage facilities (CSFs). The Government Accountability Office (GAO) examined the change and determined that it’s too early to tell its effects. Officials at non-profit CSFs such as Critical Access Hospitals expressed concern that for-profit facilities can offer higher wages, resulting in fewer nurses willing to work at non-profit CSFs in rural and other underserved areas.
The report can be accessed here: GAO Examines Nurse Corps Loan Repayment Program.
Report: Rural Health Clinic Experiences from the COVID-19 Testing Program
The National Association of Rural Health Clinics (NARHC) published a report on the federal program that funded COVID-19 testing in rural areas. First launched in May 2020, the program sent a total of more than $225 million to eligible RHCs in almost every state. The report captures how the RHCs used the funds, the challenges they faced, and anecdotes of their experiences.
Access the report here: Rural Health Clinic Experiences from the COVID-19 Testing Program [pdf].
New Briefs! Geographic Access to Health Care for Rural Medicare Beneficiaries: An Update and National Look
Two companion studies by the WWAMI Rural Health Health Research Center, led by Eric Larson, PhD, find that rural residents travel farther for health care and often have more problems accessing care, including medical and surgical specialists, than their urban counterparts.
The first policy brief examined national utilization, generalist vs. specialty care visits, and travel time for various types of visits at national and Census Division levels for rural and urban Medicare beneficiaries in 2014. Generalist providers (generalist physicians, nurse practitioners and physician assistants) performed over 51.7% of all visits for rural beneficiaries (vs. 38.1% among urban beneficiaries). Rural beneficiaries also had slightly more visits per capita in 2014 than urban beneficiaries overall and within the same Census Division.
The second policy brief reports findings of a similar study conducted by the WWAMI RHRC using 1999 Medicare data from five states (AK, ID, NC, SC, WA). Findings showed that the number of visits by rural Medicare beneficiaries dropped from 9.6 visits per year in 1999 to 8.9 in 2014. The proportion of visits provided by generalist physicians to rural beneficiaries in the five states increased from 29.2% to 41.7% during the same period.
Beneficiaries from isolated small rural areas, especially Hispanic and Native American beneficiaries, experienced much longer travel times than other rural (and urban) beneficiaries. Over 25% of visits by beneficiaries from isolated small rural areas for serious conditions such as ischemic heart disease and cancer required one-way travel of more than 50 miles, taking more than one hour.
The results of both studies underscore the ongoing importance of generalist providers in rural health care and the continuing challenges of access to specialty care posed by the long distances and travel times faced by many rural residents. Read more
New Brief: Changes in Socioeconomic Mix and Health Outcomes in Rural Counties with Hospital Closures, 2005-2018
The Rural and Minority Health Research Center released a new brief that examines the trend of hospital closures between 2005 and 2018 across definitions of rurality. Social, economic, and health structure trends at the county level across the contiguous United States were the study’s focus. Rural counties with hospital closures that occurred between 2005 and 2018 experienced greater negative economic, health, and social outcomes than did micropolitan counties.
Click here to access the brief.
Oral Health Care for People with Special Health Care Needs
The Association of State and Territorial Dental Directors (ASTDD) released a report, Best Practice Approach: Oral Health Care of People with Special Health Care Needs (SHCN). This report describes a public health strategy and uses practice examples to illustrate successful implementation for providing care to these individuals who often have complex medical and behavioral issues that require specialized training and the right setting to provide this care.
The Digital Divide in Health Care
Research shows that communities of color, older adults, people with lower educational levels, and families of low-income are more likely to experience limited digital access. The Association of State and Territorial Health Officials (ASTHO) published a brief on how federal agencies and states are expanding digital access to improve digital equity and access to care through funding investments, unique partnerships and other innovative interventions. In addition, the ASTHO interview with Craig Settles, a broadband expert with more than 30 years of experience, explores ‘broadband redlining,’ how pervasive it can be, and why the solutions will need to be community-driven. The Health Resources and Services Administration’s National Organizations of State and Local Officials cooperative agreement provided support for these resources.
Medicare Covers a Lower Percentage of Outpatient Costs in Hospitals Located in Rural Areas
A new brief from the North Carolina Rural Health Research and Policy Analysis Center examines the difference in payments between rural and urban hospitals.
Click here to access the brief.
New Report: Oral Health Care of People with Special Health Care Needs
The Association of State and Territorial Dental Directors (ASTDD) released a report, “Best Practice Approach: Oral Health Care of People with Special Health Care Needs (SHCN).” People with SHCN often have complex medical and behavioral issues that require specialized training and appropriate settings to provide comprehensive oral health care. This report describes a public health strategy and uses practice examples to illustrate successful implementation.
NACo Brief on Nursing Homes and COVID-19
The National Association of Counties (NACo) presents a resource on federal guidance, policies, data, and local best practices for outbreaks in long-term care facilities. Read more here.