This is the third in a series of reports based on surveys conducted by NPR, the Harvard T.H. Chan School of Public Health, and the Robert Wood Johnson Foundation. With a significant section on rural households, the report finds that many challenges cascading from the pandemic are due to long-standing inequities.
New Research on Child Health
A new report from the Federal Interagency Forum on Child and Family Statistics compares 41 indicators of well-being in children by the type of community they live in. (These are metropolitan, nonmetropolitan, micropolitan, or rural, according to the Office of Management and Budget.) The brief finds that infant mortality rates were highest in rural counties (6.8 per 1,000). During the same time, the mortality rate for Hispanic and American Indian or Alaska Native, non-Hispanic infants was also higher for those living in rural counties than those living in micropolitan and metropolitan counties. Separately, the Centers for Disease Control and Prevention released Mental Health Treatment Among Children Aged 5-17 years, 2019, finding that as the level of urbanization decreased, the percentage of children who had taken medication for their mental health increased.
Brief on Internet Access in Pennsylvania Released
Comments Requested: The Role of Telehealth in Improving Quality and Access to Care – October 9
The Physician-Focused Payment Model Technical Advisory Committee requests public input on the role that telehealth can play in new physician payment models. This committee reviews and recommends payment models proposed by the public to the Secretary of Health and Human Services, and they have posed several questions in this RFI to improve their understanding of how telehealth is used in value-based care and how it can be improved. Find more information here. Email comments to PTAC@HHS.gov.
Urban Hospitals with a High Percentage of Inpatient Days for Rural Patients
This study from the North Carolina Rural Health Research and Policy Analysis Center evaluated differences in urban hospitals with high and low percentages of rural inpatient days using several indicators. These indicators fall into five broad categories: Medicare payer mix, size, profitability, distance to the next closest hospital, and wage index. Read more here.
New Report on Post-Acute Care in Rural America
This week, the National Rural Health Resource Center released findings from their May 2020 Virtual Summit, which focused on the issues, challenges, and strategies related to the integration of acute and post-acute care in rural areas. The report covers the current state of rural post-acute care, including the impact of COVID-19, and explores strategies and tactics to address key issues, such as payment, workforce, and community care coordination. Read more here.
Census Report on Income and Poverty in the United States, 2019
The report from the U.S. Census Bureau presents data based on information collected every month in the Current Population Survey (CPS). Findings show a median household income of $68,703 in 2019, with a 1.3 percent decline in the official poverty rate. Read more here.
SAMHSA: National Survey on Drug Use and Health
In its annual report, the Substance Abuse and Mental Health Services Administration (SAMHSA) presents data on the use of illicit drugs, alcohol, and tobacco, as well as trends in mental health and access to treatment. Statistics cover a range of demographic and geographic characteristics, including comparison of urban and rural. Read more here.
CDC: Urban-Rural Differences in Suicide Rates, 2000-2018
The Centers for Disease Control and Prevention (CDC) used data from the National Vital Statistics System to find that suicide rates increased overall for urban and rural areas for the years studied, with the pace of increase greater for rural suicide rates. On Wednesday, the CDC’s National Center for Health Statistics released their findings from a survey on Mental Health Treatment Among Adults in 2019. Results show that overall, as the level of urbanization decreased, the percentage of adults who had taken medication for their mental health increased, and the percentage who had received counseling or therapy decreased. Read more here.
Rural Post-Acute Care Summit Report Released
The National Rural Health Resource Center (The Center), supported by the Federal Office of Rural Health Policy (FORHP), convened a virtual summit of key stakeholders to examine the current state of post-acute care (PAC) in rural America. The COVID-19 pandemic has brought PAC/long-term care (LTC) into the national spotlight, as a significant percentage of pandemic deaths in the U.S. are occurring in LTC and skilled nursing facilities (SNFs). Summit attendees explored issues, challenges, and strategies related to the integration of rural acute and PAC and considered how rural PAC can be successfully included in a population health and value-based payment future.
Focused Topics
Participants engaged in a wide-ranging discussion about current and often longstanding PAC-focused issues and challenges confronting health care organizations and communities across the rural U.S. In particular, the breakout sessions focused on four major topics, identifying both issues and potential strategies and tactical solutions to address those issues.
Identified Common PAC Challenges
- Impact of the shifting payment environment from traditional volume-driven fee-for-service and cost-based reimbursement methods to value-based payment arrangements
- Need to improve access to rural PAC and services
- Evolving role of technology, particularly the rapid expansion of telehealth in response to the COVID-19 pandemic
- PAC workforce challenges and opportunities
- Importance of addressing social determinants of health
This report provides a background on PAC, the Summit participants, process used at the Summit, comprehensive lists of identified strategies and tactics to address high priority rural PAC issues, a discussion on how state Flex Programs can help rural providers address PAC, and a collection of PAC best practices from the field.