The Technical Resources, Assistance Center, and Information Exchange (TRACIE) is a site created by the Assistant Secretary for Preparedness and Response at the U.S. Department of Health & Human Services. In this report, TRACIE explains and provides data for pandemic challenges specific to rural populations and health care facilities. Find the report here. More information and resources for emergency preparation and response can be found on the TRACIE website.
The Future of Rural Value-Based Health Care and Surge Capacity
Healthcare service demands consequent to the COVID-19 pandemic have challenged preconceived rural value-based priorities such as inpatient-care reduction and just-in-time inventories. Thus, rural healthcare organizations may struggle with conflicting demands for surge-ready healthcare infrastructure and value-oriented business processes. This Rural Health Value commentary outlines questions for consideration about the future of rural value-based care and payment.
Link: https://ruralhealthvalue.org/files/Future%20of%20Rural%20VBC%20and%20Surge.pdf
Top resources on the Rural Health Value website:
- Value-Based Care Assessment – Assess capacity and capabilities to deliver value-based care. Receive an eight-category readiness report.
- Physician Engagement – Score current engagement and build effective relationships to create a shared vision for a successful future.
- Board and Community Engagement – Hold value-based care discussions as part of strategic planning and performance measurement.
- Social Determinants of Health – Learn and encourage rural leaders/care teams to address issues to improve their community’s health.
Contact information:
Keith J. Mueller, Ph.D., Co-Principal Investigator, keith-mueller@uiowa.edu
Rural Health Value helps create high performance rural health systems by building and offering an actionable knowledge base through research, practice, and collaboration. Visit www.ruralhealthvalue.org.
Developed with funding from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $250,000 with 0% financed with non-governmental sources. The contents are those of the authors(s) do not necessarily represent the official views of, nor an endorsement by HRSA, HHS or the U.S. Government.
Varying Trends In The Financial Viability Of US Rural Hospitals, 2011–17
Health Affairs
The financial viability of rural hospitals has been a matter of serious concern, with ongoing closures affecting rural residents’ access to medical services. We examined the financial viability of 1,004 US rural hospitals that had consistent rural status in 2011–17. The median overall profit margin improved for nonprofit critical access hospitals (from 2.5 percent to 3.2 percent) but declined for other hospitals (from 3.0 percent to 2.6 percent for nonprofit non–critical access hospitals, from 3.2 percent to 0.4 percent for for-profit critical access hospitals, and from 5.7 percent to 1.6 percent for for-profit non–critical access hospitals). Occupancy rate and charge markup were positively associated with overall margins: In 2017 hospitals with low versus high occupancy rates had median overall profit margins of 0.1 percent versus 4.7 percent, and hospitals with low versus high charge markups had median overall margins of 1.8 percent versus 3.5 percent. Rural hospital financial viability deteriorated in states that did not expand eligibility for Medicaid and was lower in the South. Rural hospitals that closed during the study period had a median overall profit margin of −3.2 percent in their final year before closure. Policy makers should compare the incremental cost of providing essential services between hospitals and other settings to balance access and efficiency.
Access the full article here.
New Brief: Engaging Critical Access Hospitals in Addressing Rural Substance Use
Substance use is a significant public health issue in rural communities. Despite this fact, substance use treatment services are limited in rural areas and residents suffer from significant barriers to care. Critical Access Hospitals (CAHs), frequently the hubs of local systems of care, can play an important role in addressing substance use disorders. To develop a coordinated response to community substance use issues, CAHs must identify and prioritize local needs, mobilize local resources and partnerships, build local capacity, and screen for substance use among their patients. These activities provide a foundation upon which CAHs and their community partners can address identified local needs by selecting and implementing initiatives to minimize the onset of substance use and related harms (prevention), treat substance use disorders, and help individuals reclaim their lives (recovery).
This brief makes the case for why CAHs should address substance use, provides a framework to support CAHs in doing so, describes examples of substance use activities undertaken by CAHs to substantiate the framework, and identifies resources that can be used by State Flex Programs to support CAHs in addressing this important public and population health problem.
The report may accessed here or on the Flex Monitoring Team website.
A National Transportation Research Nonprofit (TRIP): Challenges and Opportunities in Rural America
TRIP is a nonprofit organization researching and evaluating economic and technical data on surface transportation issues. For this report focused on rural America, TRIP examines deficiencies and identifies needed improvements. Read the report here.
The State of Senior Hunger in America: An Annual Report
Feeding America is a national nonprofit researching and responding to insufficient food resources. In this annual report, the organization provides rates of food insecurity among Americans age 60 or older, with data breakdowns by metropolitan and nonmetropolitan settings. Read the report here. A separate report examines food insecurity among adults aged 50-59.
Early Insights from the Accountable Health Community (AHC) Model
This Issue Brief summarizes the second annual meeting of the CMS Innovation Center AHC Model participants, where they had an opportunity to network and discuss challenges and strategies to address HRSNs. Highlighted in the brief are challenges and strategies in serving rural communities to address health-related social needs (HRSNs). Read more here.
Estimated Reduction in CAH Profitability from Loss of Cost‐Based Reimbursement for Swing Beds
This brief from the North Carolina Rural Health Research and Policy Analysis Center estimates the impact of potential loss of cost-based reimbursement for swing beds on profitability for Critical Access Hospitals (CAHs) and examines the characteristics of CAHs that would be most affected by such a change in reimbursement. Read more here.
Rural-Urban Residence and Mortality Among Three Cohorts of U.S. Adults
Researchers at the Maine Rural Health Research Center used data from the National Health Interview Survey and national death certificate data, finding that the risk of death at any point in time was 10% higher for rural residents as compared with urban residents. Read more here.
New Report: Community Impact and Benefit Activities of CAHs, Other Rural, and Urban Hospitals, 2018
The Flex Monitoring Team has released a new report on the community impact and benefit activities of Critical Access Hospitals (CAHs), rural non-CAHs, and urban hospitals. The report enables State Flex Programs and CAH administrators to compare the community impact and benefit profiles of CAHs nationally to the performance of CAHs in their state.
The report may be found in the link below. Pages 1-5 provide national data with key findings, and pages 6-95 provide state-specific tables. Shortcut links to each state’s tables are at the bottom of page 5.
The report may accessed here or on the Flex Monitoring Team website.