The first study, conducted by the RAND Corporation, highlights a range of indicators where rural residents fall below national measures. The study looks at consumer assessment data for both Medicaid FFS and Medicare Advantage populations and clinical measures for Medicare Advantage populations only. This is a limiting factor – it would be useful to have some indication of clinical inadequacies in all rural Medicare populations:

The second study examines a range of different health care access indicators in rural/urban America. Indicators include insurance coverage measures and assorted health service availability measures.

From Becker’s Hospital Review

In 2023, private industry employers reported 2.6 million nonfatal workplace injuries and illnesses, down 8.4% from 2022, the U.S. Bureau of Labor Statistics reported Nov. 8.

Nonfatal recordable workplace injuries and illnesses include cases with days away from work, job restriction or transfer, along with other recordable cases.

In 2023, total recordable injuries and illnesses decreased in the healthcare and social assistance sector to 562,500 cases, down from 665,300 in 2022. The rate of nonfatal injury or illness per 100 full-time workers was 3.6 last year, down from 4.5 the previous year.

If illnesses are removed, the healthcare and social services sector recorded 471,600 nonfatal injuries in 2023. This is up from 443,800 the previous year and higher than any other sector. By comparison, 334,700 nonfatal injuries were recorded in retail trade and 326,400 in manufacturing.

Some of the healthcare subsectors with the highest rates of nonfatal injury or illness per 100 full-time workers are:

• Ambulance services — 7.4
• Nursing care facilities (skilled nursing facilities) — 6.9
• Continuing care retirement communities and assisted living facilities for the elderly — 6.5
• Psychiatric and substance abuse hospitals — 6.3
• General medical and surgical hospitals — 5.1

Healthcare workers face physical demands and safety challenges in their jobs, including the potential to sustain injuries linked to violence. Various groups and organizations have taken steps to help ensure a safer work environment. For example, the American Hospital Association and the FBI recently partnered to mitigate targeted violence in healthcare settings.

Leadership of the University of Minnesota Rural Health Research Center Maternity Care Team provided a timely update on critical issues impacting maternal health in rural U.S. communities. The presentation described disparities in maternal health outcomes for rural populations, the growing scarcity of obstetric care, and the far-reaching consequences of obstetric unit closures. Additionally, the presentation delved into the reasons behind these closures and examined policy solutions aimed at improving access to maternal health care and advancing health equity.

Presenters:

Katy B. Kozhimannil, PhD, MPA, is a Distinguished McKnight Professor, University of Minnesota School of Public Health, and Co-Director of the University’s Rural Health Research Center. Her research contributes evidence for clinical and policy strategies advancing racial, gender, and geographic equity.

Julia D. Interrante, PhD, MPH, is a research fellow and statistical lead at the University of Minnesota Rural Health Research Center. Her work examines the impact of health policy on reproductive and maternal health care access and health outcomes.

The webinar can be accessed here.

Additional Resources of Interest

• Information for Rural Stakeholders About Access to Maternity and Obstetric Care: A Community-Relevant Synthesis of Research
• Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2010-2022

CMS published Re-imagining Rural Health: Themes, Concepts, and Next Steps from the CMS Innovation Center “Hackathon” Series. The report describes lessons learned from previous Innovation Center models focused on rural health and their application to recent model development, as well as potential future areas the Innovation Center might explore to support rural communities. It also highlights themes and insights from the CMS Innovation Center-hosted 2024 Rural Health Hackathon. The Hackathon series convened rural health providers, community organizations, industry and tech entrepreneurs, philanthropies, policy experts, and patients to generate creative and actionable solutions to address the varied challenges to delivering quality health care in rural communities. The top thematic areas highlighted a need for training, regulatory changes, and collaboration to help improve access to care and support transformation.

As a next step, CMS intends to issue a Request for Application to fill the ten open spaces for the Rural Community Hospital Demonstration. The demonstration was directed by Congress and requires a test of cost-based payment for Medicare inpatient services for rural hospitals with fewer than 51 beds that are ineligible for Critical Access Hospital status. The demonstration has been operated by CMS since 2004 and is scheduled to end on June 30, 2028. The paper also outlines some possible considerations for future Accountable Care Organization-focused and other models.

The Innovation Center is committed to advancing rural health. The Center looks forward to further utilizing input from the Hackathon and robust engagement with rural health groups to design new models and innovations to address challenges facing rural, Tribal, frontier, and geographically isolated areas. Additionally, where possible, the Center may change existing models to enable greater participation by rural providers.

• Read more: Re-imagining Rural Health: Themes, Concepts, and Next Steps from the CMS Innovation Center “Hackathon” Series.
• Learn more about the CMS Innovation Center Strategy Direction

The Rural Health Value team is pleased to share that we have launched a redesigned website and logo. While we have a new look – you will continue to find trusted resources that facilitate the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Please take a look! On the new website you will find two new resources.

• Rural Value-Based Care – The Payer Perspective, Rural Health Value Summit Report. The Rural Health Value team convened professionals and executives from national and regional health care payer organizations to share and explore insights, innovations, successes, and challenges in rural health value-based care (VBC) contracting. This report summarizes challenges and solutions followed by suggestions for rural health care organization leaders from the Summit participants.
• A one-page summary of CMS’s Transforming Episode Accountability Model (TEAM). TEAM is a mandatory, episode-based, alternative payment model, in which selected acute care hospitals will coordinate care for people with Traditional Medicare undergoing one of the surgical procedures included in the model and assume responsibility for the cost and quality of care from surgery through the first 30 days after the Medicare beneficiary leaves the hospital. Of the 741 hospitals identified for mandatory participation, 124 (16.7%) are in non-metro counties. More from CMS on TEAM.

This summary is part of Rural Health Value’s Catalog of Value-Based Initiatives for Rural Providers. The catalog summarizes rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI).

Rural Health Value facilitates the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Visit www.ruralhealthvalue.org or contact Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu.

Earlier this year, the U.S. Office of Management and Budget (OMB) published the results of its review of Statistical Policy Directive No. 15 (SPD 15) and issued updated standards for maintaining, collecting and presenting race and ethnicity data across federal agencies. The updated 2024 SPD 15 requires the use of a combined race and ethnicity question, the addition of a new “Middle Eastern or North African” minimum reporting category, and the collection of detailed race and ethnicity responses.

Since then, programs across the U.S. Census Bureau have been assessing how and when to implement the updated race and ethnicity standards set by OMB in the 2024 SPD 15. We expect race and ethnicity data that align with the revised standards will enhance the entire range of Census Bureau data products that describe the demographic makeup and socioeconomic characteristics of our country and our diverse communities.

Read more.

Written by: Donna M. Daily, Division Chief, American Community Survey Office and Karen Battle, Division Chief, Population Division