As part of the RAND Center of Excellence on Health System Performance, researchers from RAND Corporation, Penn State, UCLA, Stanford, and Harvard have taken a “deep dive” into 24 health systems and their affiliated physician organizations in four regions of the United States. For these studies, a health system is defined as having at least one hospital and at least one physician organization affiliated through shared ownership or a contractual relationship.

In brief:

• If you’ve seen one health system, you’ve seen one health system
• Integration is a multi-layered concept—structural, functional, and clinical—each of which may affect health system performance
• A single interoperable EHR—accessible to allaffiliated physicians—is considered the gold standard—but implementation is by no means universal
• Health systems are taking a highly individualized approach to care delivery redesign, with an emphasis on standardizing and increasing the efficiency of existing practices over disruptive innovation
• The pace at which value-based payment arrangements are being implemented by the government and commercial payers may be too slow to support transformation of care delivery
• Structural integration does not necessarily signal clinical integration

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Despite the success of Pennsylvania’s drug monitoring program against overprescribing, overall overdose deaths increased.

Yunfeng Shi, PhD, Assistant Professor of Health Policy and Administration at Penn State, recently was interviewed by PublicSource about Pennsylvania’s Prescription Drug Monitoring Program (PDMP). Launched in 2016, the program tracks prescriptions of controlled substances to prevent overprescribing. All providers authorized to prescribe controlled substances must register with the program and pharmacies and other dispensers must enter data by the end of the next business day to ensure the PDMP information is up-to-date. Failure to meet the provisions of the PDMP law could result in sanctions. Shi thinks the mandates are essential: “Studies have observed the reduction in opioid prescriptions when you have a PDMP that holds physicians legally accountable.”

Despite the success of Pennsylvania’s PDMP in curtailing overprescribing, effectively decreasing chances for patients to become addicted to opioids and other substances, its success against the opioid epidemic is limited as overall overdose deaths increased in 2020 (note that the convergence of the COVID-19 pandemic and opioid epidemic proved uniquely challenging). According to Shi, “PDMPs are a program to reduce unnecessary opioid prescriptions” but “alone can’t win the fight to reduce opioid-related deaths.” Jeff Hanley, executive director of the Commonwealth Prevention Alliance, echoed Shi, viewing prevention programs as a “long-term solution that would be more effective in the future once we had the kinks worked out.”

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Resources to help your state Flex Program implement research and best practices.

 

Read the Brief: Rural Initiatives Addressing Community Social Needs

The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center (The Center), is excited to share with you resources that support the “Rural Initiatives Addressing Community Social Needs” brief provided by the Flex Monitoring Team.

The brief follows two Critical Access Hospital (CAH)-based initiatives out of Staples, Minnesota, and St. Johnsbury, Vermont. Included in this e-mail are links to TASC resources that can support your ongoing efforts for CAH initiatives in your state.

 

VIDEO: Population Health for Rural Hospitals: What the experts are saying

Hear from rural health care experts as they identify key initiatives that leaders and providers should take to develop a local infrastructure further to best deliver and manage population health in the future.

 

Building Trust in Collaborative Partnerships

Collaboration is one of the keys to sustainability in our changing health care environment. This webinar, along with the accompanying worksheet, is designed to help rural health network leaders improve their skills and build capacity for meaningful and impactful collaborations.

 

Population Health Learning Collab

TASC partnered with multiple subject matter experts to facilitate discussions and provide education through a web-based learning collaborative for Flex Program personnel to gain knowledge about population health and how Flex Programs can help support CAHs, rural health clinics, and rural communities in through population health initiatives.

 

Put Data to Use in Your Communities

Learn how to effectively conduct population health analytics with access to a web-based database for acquiring health data specific to your location. This tool also consists of educational modules offering step-by-step instructions of common population health analytical procedures.

 

Population Health Readiness Assessment

The goal of this assessment is to connect users with tools and resources targeted towards their rural health organizations’ unique strengths and needs for transitioning towards population health through each milestone of Getting Motivated, Getting Informed and Getting Going.

 

Rural Food Access Toolkit

This toolkit compiles evidence-based and promising models and resources to support organizations implementing food access programs in rural communities across the United States.

 

Rural Mental Health Toolkit

The toolkit compiles evidence-based and promising models and resources to support organizations implementing mental health programs in rural communities across the United States, with a primary focus on adult mental health.

Researchers at the  North Carolina Rural Health Research and Policy Analysis Center describe the effects of current Medicare payment standardization methods on the perceived cost of Critical Access Hospital swing bed care as it relates to the Medicare Spending per Beneficiary measure.

This paper from the WWAMI Rural Health Research Center explores regional, rural-urban, and intra-rural differences in the general surgeon workforce.

The Congressional Research Service (CRS) provides objective policy and legal analysis to committees and members of the U.S. House and Senate.  This report describes the availability of broadband internet by state and across urban, rural, and tribal areas.

Select key findings
Data from the National Vital Statistics System, Mortality

• From 1999 through 2019, the rate of drug overdose deaths increased from 6.4 per 100,000 to 22.0 in urban counties and from 4.0 to 19.6 in rural counties.
• In 2019, rates in rural counties were higher than in urban counties in California, Connecticut, North Carolina, Vermont, and Virginia.

Keywords

opioids, methamphetamine, National Vital Statistics System, Mortality (NVSS–M)

 

For more information, visit the full report

Full Report in HTML > 

Full Report in PDF >

 

From 2016-2019, the age-adjusted drug overdose death rates were higher in urban counties than in rural counties.

 

Suggested Citation:

Hedegaard H, Spencer MR. Urban–rural differences in drug overdose death rates, 1999–2019. NCHS Data Brief, no 403. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi.org/10.15620/cdc:102891.

 

Ways to Access Other NCHS Products and the National Vital Statistics System:

NVSS home page

Other NCHS products and publications

Visual Abstract Gallery