Internet Subscription in Rural Counties Low

Internet Subscription in Rural Counties Low.  In its recent release of American Community Survey (ACS) data, the U.S. Census Bureau reports that “nationally, 78 percent of households subscribe to the internet, but households in both rural and lower-income counties trail the national average by 13 points.” The ACS is a survey of American life, taken every five years to track trends on more than 40 social, economic, housing and demographic topics in every U.S. county.  Low internet subscription rates in rural areas hinder adoption of telehealth, which could improve quality of care while reducing cost.

New Projections for the Behavioral Health Workforce

New Projections for the Behavioral Health Workforce.  HRSA’s National Center for Health Workforce Analysis recently released its updates and projections for the nation’s behavioral health workforce from the year 2016 through 2030.   The report includes updated fact sheets and state-level projections on the supply and demand for eight occupations: addiction counselors, marriage and family therapists, mental health and school counselors, psychiatric technicians and psychiatric aides, psychiatric nurse practitioners and psychiatric physician assistants, psychiatrists, psychologists, and social workers.  There is a significant need for mental health services in rural America. According to the Results from the 2017 National Survey on Drug Use and Health, 19 percent of residents aged 18 or older in nonmetropolitan counties had Any Mental Illness (AMI) in 2017, approximately 6.8 million people. In addition, 4.9 percent, or nearly 1.7 million, of residents of nonmetropolitan counties experienced serious thoughts of suicide during the year. Visit the Rural Health Information Hub for programs, toolkits,  and other resources for behavioral health workforce in rural areas.

State health rankings

Hawaii is the healthiest U.S. state and Louisiana is the unhealthiest state, according to the United Health Foundation’s 2018 America’s Health Rankings report. The report also noted some concerning health trends, such as a “record-breaking prevalence of obesity and rising mortality rates,” and an increase in the United States’ premature death rate. (Source: Politico‘s “Pulse,” 12/12)

Recent Journal Articles Publishing Rural Health Research

Recent Journal Articles Publishing Rural Health Research.  Several articles written by the HRSA/FORHP-supported Rural Health Research Centers were recently published in peer-reviewed journals.  Among these are Patterns of Telehealth Use Among Rural Medicaid Beneficiaries and Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder.  While some journal articles offer free access, others may require a subscription or affiliation with a subscribing library.

The Rural Hospital and Health System Affiliation Landscape – A Brief Review

The Rural Hospital and Health System Affiliation Landscape – A Brief Review.  Rural hospitals that join health systems may find it challenging to balance local decision-making control and the requirements of larger, better-funded regional health systems.  This policy paper from the RUPRI Center for Rural Health Policy Analysis examines rural hospital motivations for joining health systems and examines different affiliation structures.

New Federal Report: Reforming America’s Healthcare System through Choice and Competition

New Federal Report: Reforming America’s Healthcare System through Choice and Competition.  The Department of Health and Human Services (HHS) in collaboration with the Departments of the Treasury and Labor and the Federal Trade Commission collaborated to develop this report, which identifies challenges to and recommendations for improving the health care system.  It describes the influence of state and federal laws, regulations, guidance, and polices on choice and competition in health care markets and identifies actions that states or the Federal Government could take to develop a better functioning health care market.  Rural relevant issues addressed include scope of practice, workforce mobility, and telehealth.

New Data on Suicide Mortality from the CDC

New Data on Suicide Mortality from the CDC.  Using data from the National Vital Statistics System (NVSS), the Centers for Disease Control and Prevention (CDC) recently released a report on rates of suicide in the United States from 1999 to 2017.  The data brief ranks suicide as the second leading cause of death for people aged 10-34 and the fourth leading cause for ages 35-54.  For the most recent year studied, the age-adjusted suicide rate for the most rural counties was nearly twice (1.8 times) the rate for the most urban counties.  In a separate data brief from the CDC, the NVSS showed there were 70,237 drug overdose deaths in 2017.  The surveillance system found that, among persons aged 15 and over, adults aged 25-54 had higher rates than other age groups.  West Virginia, Ohio and Pennsylvania were the three states with the highest observed age-adjusted overdose death rates in 2017; the four states with the lowest rates were Texas, North Dakota, South Dakota and Nebraska.

Wolf Administration Announces Comprehensive Tool to Help Individuals Identify Resources for Substance Use Disorder Treatment, Related Support Services


December 6, 2018

Wolf Administration Announces Comprehensive Tool to Help Individuals Identify Resources for Substance Use Disorder Treatment, Related Support Services 

Harrisburg, PA – The Wolf Administration today announced the launch of the Drug and Alcohol Referral Tool (DART), an online resource designed to help Pennsylvanians seeking substance use disorder treatment for themselves or a loved one find treatment options and other related services in their area. The tool is a centralized hub that consolidates available resources to assist people looking for services but are not sure where to begin.

“The Wolf Administration has been very focused on expanding resources for individuals with substance use disorder as we battle the opioid epidemic,” said Drug and Alcohol Programs Secretary Jen Smith. “A common concern that we have heard throughout the commonwealth is that individuals aren’t aware of the services and supports available to them. This web-based tool will allow individuals to have critical information on where to go and how to access the services they need.”

The DART tool provides resources based on a person’s age, county of residence, and veteran status, and can also list resources if a person is experiencing homelessness, has issues with transportation to treatment, or has legal concerns as well as programs that may be available depending on a person’s income. The tool does not evaluate eligibility for resources provided, but refers users to how they can obtain more information or assess their eligibility.

The tool is fully anonymous and can be translated into more than 100 languages.

“Substance use disorders often occur when a person experiences other medical and behavioral health concerns, and they may need additional resources to live a stable, healthy life in recovery,” said Human Services Secretary Teresa Miller. “Connecting people seeking treatment to comprehensive services that can help meet all of their needs from the start is critical as they work towards recovery.”

The DART tool can be accessed at

“Additionally, if an individual is need of a trained professional to assist them in finding substance use treatment or to learn more about programs, I encourage them to call Pennsylvania’s Get Help Now Hotline at 1-800-662-HELP. Regardless if an individual is insured, uninsured, or underinsured the hotline staff can connect you to the appropriate treatment resources you are seeking,” said Smith.

For more information on Pennsylvania’s response to the opioid crisis, visit

The Rural Hospital and Health System Affiliation Landscape – A Brief Review

Onyinye Oyeka, MPH; Fred Ullrich, BA; A. Clinton MacKinney, MD, MS; Joseph Lupica, JD; Keith Mueller, PhD

The shift from traditional fee-for-service to value-based payment requires major capital investment. Rural hospitals may be challenged by the volume-to-value transition because they may lack resources necessary to support new delivery models. As a result, many rural hospitals have considered affiliations with larger, better-funded regional health systems. However, rural hospital leaders often struggle to find the appropriate balance between local decision-making control and health system affiliation requirements. In this policy paper, we examine rural hospital and health system motivations for affiliation and present a non-exhaustive list of common affiliation structures with representative examples. Although hospital affiliation can take many forms, rural hospital leaders should develop a thoughtful strategy that weighs the benefits of affiliation versus independence.

Click to download a copy: The Rural Hospital and Health System Affiliation Landscape – A Brief Review

Comments Requested: Proposed Drug Pricing Changes for Medicare Advantage (MA) and Part D Plans

Comments Requested: Proposed Drug Pricing Changes for Medicare Advantage (MA) and Part D Plans – January 25.  CMS solicits public comments on potential Medicare policies intended to lower costs for beneficiaries and to provide MA and Part D plans with tools to lower the cost of prescription drugs.  Proposals include requiring Part D Explanation of Benefit statements to list drug pricing information, restricting Part D plans from prohibiting or penalizing a pharmacy from disclosing a lower cash price to an enrollee, and redefining the negotiated price paid to pharmacies.  Rural pharmacies report that payments from Part D plans are a major concern that affect their financial viability.