New Release: State of Oral Health Equity in America 2024

The CareQuest Institute for Oral Health just released key findings from their annual survey, “State of Oral Health Equity in America” and includes perceptions, attitudes, and experiences with oral health from more than 9,000 adults in the United States. Among other findings, the survey found that “adults with less than a high school education were nine times more likely to report seeking dental care through an emergency department than those with a postgraduate or professional degree.” A comprehensive report with additional findings will be released soon.

Click here to learn more.

New Rural Hospital Workforce Toolkit Published

The Flex Monitoring Team (FMT) has released a new product, the Workforce Toolkit to Support Critical Access Hospitals and Rural Providers. This toolkit provides background on health care workforce challenges in the U.S., describes common workforce challenges faced by Critical Access Hospitals (CAHs), and provides examples and links to external resources that CAHs may use to address their own workforce needs and enhance recruitment and retention.

The toolkit includes five modules, which each discuss key workforce challenges and resources by topic. These include an introductory module that summarizes broad challenges in the rural health care workforce as well as modules on organizational culture and leadership, leveraging partnerships, emergency medical services workforce, and administrative and support staff workforce.

2023 ACS 1-Year Estimates Released

The latest research brief highlights key findings from the 2023 American Community Survey (ACS) 1-Year Estimates. This report provides updates on Pennsylvania’s demographic, social, and economic trends, covering topics such as household income, housing, educational attainment, and internet access. Additionally, the brief discusses changes in housing burdens across different racial and ethnic groups.

Read more.

Just Published! Trauma-Informed Care: The Role of Dental Hygienists

Children and adults with a trauma history are more likely to have poor oral health and increased dental care-related fear and anxiety.

An article from the CareQuest Institute for Oral Health was recently published in the Journal of Dental Hygiene. “Trauma-Informed Care in Oral Health Care: The Role of Dental Hygienists,” examines the critical role of dental hygienists to ensure patients feel heard and make them feel comfortable enough to return for regular dental care.

Click here to read the article.

New Report Released: Financial Performance of Rural and Urban Hospitals in Medicare Shared Savings Program

Financial Performance of Rural and Urban Hospitals in the Medicare Shared Savings Program

Huang Huang, PhD; Xi Zhu, PhD; Fred Ullrich, BA; A. Clinton MacKinney, MD, MS; Keith Mueller, PhD

This brief presents financial performance trends of hospitals who participated in Medicare’s Shared Savings Program (SSP) from 2011 to 2018. Trends in six financial outcomes are compared between SSP and non-SSP hospitals over time and between rural and urban hospitals.

Key Findings:

  • Hospitals participating in the SSP had, on average, higher outpatient revenue, higher inpatient revenue, higher net patient revenue, higher operating margins, lower inpatient revenue share, and higher Medicare revenue share at the baseline year 2011 and throughout the study period.
  • Compared to their respective non-SSP counterparts, rural SSP hospitals experienced a higher percentage increase in outpatient revenue than urban SSP hospitals.
  • Rural hospitals participating in SSP experienced higher increases in inpatient revenue and net patient revenue than rural hospitals not participating in SSP. In contrast, urban hospitals participating in SSP experienced lower increases in these measures than urban hospitals not participating in SSP.

Access the report here.

Additional Report:

Contact Information:

Keith J. Mueller, PhD; keith-mueller@uiowa.edu
Director, RUPRI Center for Rural Health Policy Analysis
University of Iowa College of Public Health
Office: 1.319.384.3832

New Report: Perspectives on Opioid Use Disorder Treatment Access and Engagement from Rural Family Members and People in Treatment

The Center for Rural Addiction at the University of Vermont conducted interviews with 20 family members in rural Vermont to detail facilitators and barriers to using either medications for opioid use disorder (MOUD) or illicit opioids. The report highlighted some of the unmet needs that were discussed by family members of people in treatment. The University of Vermont Center on Rural Addiction is one of three Rural Centers of Excellence on Substance Use Disorders supported by the Federal Office of Rural Health Policy (FORHP).

57% of Rural Hospitals Lack Maternity Care: 19 States with the Biggest Gaps

From Becker’s Hospital Review

In the past five years, over 100 rural hospitals have stopped delivering babies, contributing to the 57% of rural U.S. hospitals that lack labor and delivery services.

This finding comes from the Center for Healthcare Quality and Payment Reform. Its July report details the number of rural hospitals by state that lack maternity care services, those that do offer such services, the financial losses incurred from maternity care and the travel time to the nearest hospital providing OB services.

“Over 80% of pregnancy-related deaths are preventable with appropriate prenatal, labor & delivery, and post-partum care,” the CHQPR report notes. “Although improvements in maternity care are needed in all parts of the country to reduce mortality rates, one of the greatest challenges is in rural areas, because most rural hospitals are no longer providing maternity care at all.”

Of the 978 rural hospitals that offer labor & delivery services, almost 40% lost money on patient services overall in 2022 through 2023, meaning their ability to continue delivering maternity care is at risk.

Below are the 19 states with the highest percentage of rural hospitals lacking OB or maternity care. In each of these states, the percentage of rural hospitals without OB care exceeds the U.S. average of 57%. There are ties below, resulting in 19 states with 12 rankings for the greatest proportion of hospitals without OB care.

Readers can find CHQPR’s report on maternity care deserts among rural hospitals in full here.

1. Florida 
Total rural hospitals: 22
Number without OB services: 20
Percentage without OB services: 91%

2. North Dakota 
Total rural hospitals: 39
Number without OB services: 31
Percentage without OB services: 79%

3. Louisiana
Total rural hospitals: 56
Number without OB services: 42
Percentage without OB services: 75%

4. Illinois
Total rural hospitals: 74
Number without OB services: 55
Percentage without OB services: 74%

West Virginia
Total rural hospitals: 31
Number without OB services: 23
Percentage without OB services: 74%

5. Nevada
Total rural hospitals: 14
Number without OB services: 10
Percentage without OB services: 71%

6. Virginia
Total rural hospitals: 30
Number without OB services: 21
Percentage without OB services: 70%

7. Alabama
Total rural hospitals: 52
Number without OB services: 36
Percentage without OB services: 69%

Oklahoma
Total rural hospitals: 81
Number without OB services: 56
Percentage without OB services: 69%

8. Mississippi
Total rural hospitals: 72
Number without OB services: 49
Percentage without OB services: 68%

9. Arkansas
Total rural hospitals: 50
Number without OB services: 32
Percentage without OB services: 64%

Georgia
Total rural hospitals: 72
Number without OB services: 46
Percentage without OB services: 64%

Montana
Total rural hospitals: 55
Number without OB services: 35
Percentage without OB services: 64%

10. South Dakota 
Total rural hospitals: 49
Number without OB services: 31
Percentage without OB services: 63%

Pennsylvania
Total rural hospitals: 43
Number without OB services: 27
Percentage without OB services: 63%

11. Iowa
Total rural hospitals: 94
Number without OB services: 58
Percentage without OB services: 62%

12. Texas
Total rural hospitals: 164
Number without OB services: 97
Percentage without OB services: 59%

Kansas
Total rural hospitals: 100
Number without OB services: 59
Percentage without OB services: 59%

California 
Total rural hospitals: 58
Number without OB services: 34
Percentage without OB services: 59%