CDC Million Hearts® 2024 Hypertension Control Challenge is Now Open!

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Did you know… rural Americans are at greater risk for premature death from five leading causes, including heart disease?

Call for Applications: Million Hearts® 2024 Hypertension Control Challenge

 Million Hearts® is a national initiative to prevent 1 million heart attacks and strokes within 5 years. It focuses on implementing a small set of evidence-based priorities and targets that can improve cardiovascular health for all.

If you’re a rural healthcare professional, or represent a rural practice or health system with hypertension control rates of 80% or better, please consider applying for the “Challenge.” Moreover, colleagues with the Million Hearts program would welcome an opportunity to spotlight the success of a 2024 Hypertension Control Champion serving a rural community, as would we!

The Million Hearts® 2024 Hypertension Control Challenge recognizes and celebrates health care professionals, practices, and health systems that have achieved exceptional hypertension control rates of at least 80%. Practices and clinicians in the U.S. and its territories are eligible for possible recognition as a Champion. The submission deadline is April 5, 2024.

 Learn more about the Challenge rules and eligibility

Application form

Updated Value Based Care Assessment Tool Released

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he Rural Health Value team is pleased to announce the release of an updated version of our Value-Based Care (VBC) Assessment Tool. The structure of the assessment, including eight categories with capacities or best practices, remains the same; however, language has been updated in the capacity statements to add clarity and specificity. This online tool helps organizations assess readiness and supports strategic planning for the shift to value-based care and payment. The resulting report and additional tools can be used to help guide the development of action plans.

Value-Based Care Assessment Resources include:

Related resources on the Rural Health Value website:

Demonstrating Your Value: A Guide to Potential Value-based Care Partnerships for Rural Health Care Organizations– this Rural Health Value resource assists CAH leadership in demonstrating the value CAHs bring to networks, affiliations, payers, community-based organizations, or accountable care organizations.

Pennsylvania’s WellSpan Health and Evangelical Community Hospital Announce Definitive Agreement to Combine Health Systems

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WellSpan Health and Evangelical Community Hospital have entered into a definitive agreement to enhance community-based health care across the region. Pending regulatory approval, Evangelical Community Hospital will become WellSpan Evangelical Community Hospital on or about July 1, 2024. Their accompanying network of care serving the Central Susquehanna Valley will also join WellSpan, expanding the combined reach of the organizations across 12 counties in Central Pennsylvania and Northern Maryland.

A mutual commitment to reimagining healthcare through exceptional, innovative clinical care along with WellSpan’s successful approach to value and superior outcomes which are affordable and convenient serves as the cornerstone of the affiliation.

“We recognize the shared vision WellSpan has for community-based care, and we were deliberate in the decision to choose a partner who would ensure our patients continue to receive the high quality care they have come to expect from Evangelical Community Hospital,” said Kendra Aucker, president and CEO of Evangelical Community Hospital. “The industry is facing strong financial and workforce headwinds, and this integration will provide the best path forward, so we may continue to provide for the health and wellness needs of our communities well into the future.”

Serving the Central Susquehanna Valley, Evangelical Community Hospital is the only Centers for Medicare and Medicaid Services (CMS) 5-star rated hospital in the region. It employs 1,900 individuals and has more than 170 employed and non-employed physicians on staff at its hospital licensed to care for patients in its 131 licensed beds. The hospital provides a comprehensive array of services in both inpatient and outpatient settings and serves residents in Lycoming, Northumberland, Snyder, and Union counties.

The affiliation joins Evangelical with WellSpan’s integrated health care delivery system, which includes more than 21,000 team members, 2,000 employed providers, 220 locations, and eight award-winning hospitals, including the region’s largest behavioral health network and a Level 1 Trauma Center. WellSpan currently serves residents in Adams, Cumberland, Lancaster, Lebanon, Franklin, and York counties in Pennsylvania and Frederick and Washington counties in Maryland.

Combined, the organizations will serve more than 1.3 million patients across 12 counties.

Read more.

The Doctor Is Out: 6-County Swath of Northern Pennsylvania will Soon Have No Maternity Care

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From the Pittsburgh Post-Gazette

Pinned to the door of Stephanie Zuroski’s refrigerator is a curling black and white ultrasound image of her baby at 11 weeks, 1 day old.

The baby’s delivery is still months off, but her worry these days is whether she will get to a maternity hospital from her rural Elk County home in time for the birth. Penn Highlands Healthcare Elk Hospital, 20 miles away, is closing its obstetrics unit May 1, leaving a six-county area of north-central Pennsylvania — twice the size of Delaware — without hospital maternity care. “I like being in the woods, surrounded by the Allegheny National Forest,” Ms. Zuroski, 32, said about the home she shares with husband, Nathan, 30, but “this is the downfall of living in rural Pennsylvania.”

Rural hospitals are in crisis, experts say, and shuttering maternity units is the just latest cost-cutting move to stem the flow of red ink. In addition to Elk County, maternity units in Clarion and McKean counties have closed in recent years at a time when infant mortality rates exceeded the statewide average.

McKean County, population 39,866, had an average infant mortality rate of 7 deaths per 1,000 births for the years 2016 through 2020, the most recent numbers available and well above the statewide average of 5.9 infant deaths before the age of 1, according to the state Department of Health. Infant mortality rates for the other five counties were not available from the health department. Cameron, Clinton, and Forest counties are the other areas without hospitals to care for new moms.

At a meeting Friday at the St. Marys hospital, which was closed to the public, health system executives said the hospital only had 147 births last year, far short of the 1,000 births needed for such a program to break even, according to Ridgway Borough Council member Zack Pontious, who was in attendance. Mr. Pontious didn’t think there was any chance the decision would be reversed. “I don’t think anything’s going to change,” he said.

Meanwhile, the population of the new maternity care desert will grow to 156,664 — four times bigger than Cranberry Township in Butler County, north of Pittsburgh, which is served by four hospitals, including one offering maternity care that opened in 2021. Cranberry’s population is about 33,000.

Read the full article.

Is the Nation’s Primary Care Shortage as Bad as Federal Data Suggest?

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Federal policymakers have been trying for a long time to lure more primary care providers to understaffed areas. The Biden administration boosted funding in 2022 to address shortages and Sen. Bernie Sanders (I-Vt.) pushed sweeping primary care legislation in 2023.

But when KFF Health News set out last year to map where the primary care workforce shortages really are — and where they aren’t — we encountered spotty data and a whole lot of people telling us the absence of better information makes it hard to know which policies are working. Turns out, consistent national data is a pipe dream.

We analyzed the public data that does exist: the federal government’s official list of primary care health professional “shortage areas,” created to help funnel providers where they’re most needed. We found that more than 180 areas have been stuck on the primary care shortage list for at least 40 years.

Read more.

CMS Finalizes DSH Payment Cuts for Some Safety-Net Hospitals: 8 Things to Know

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From Becker’s Healthcare

CMS will cut Medicaid disproportionate share hospital payments for some safety-net hospitals in fiscal year 2024, which began Oct. 1, 2023, according to a final rule published Feb. 20.

The rule will result in an $8 billion reduction in DSH payments annually from fiscal year 2024 to 2027, culminating in a $32 billion overall cut over the four-year period, according to CMS.

Eight things to know:

  1. Following a congressional directive from the Consolidated Appropriations Act of 2021, the final rule outlines how hospital-specific payment limits will be calculated and clears up ambiguities within the DSH program to improve administrative efficiency, according to Bloomberg.
  2. Hospitals previously calculated Medicaid shortfalls (the difference between costs and payments for Medicaid-eligible patients) by projecting yearly treatment costs for Medicaid patients alone as well as those with other types of coverage, including Medicare or commercial coverage.
  3. Under the new rule, hospitals can only include costs and payments for services provided to beneficiaries for whom Medicaid is the primary payer for such services. The limit excludes costs and payments for services provided to Medicaid beneficiaries with other sources of coverage.
  4. The final rule does not apply to safety-net hospitals serving the highest percentage of low-income patients. Hospitals in and above the 97th percentile of inpatient days comprising  patients who are entitled to Medicare Part A benefits and Supplemental Security Income benefits are exempt.
  5. The exception provides qualifying hospitals with a hospital-specific limit that is the higher of that calculated under the methodology in which costs and payments for Medicaid patients are counted only for beneficiaries for whom Medicaid is the primary payer, or the methodology in effect on Jan. 1, 2020.
  6. New York ($3.9 billion) spends the most on Medicaid DSH payments annually, followed by Texas, Pennsylvania and Louisiana, which pay $1.2 billion, according to data published in November by KFF.
  7. Hospital groups have pushed back against DSH cuts set out in the Affordable Care Act, arguing that the need for DSH funding is even greater now as hospital expenses per patient have increased significantly since the pandemic.
  8. The American Hospital Association said it is concerned about the effect that DSH cuts will have on hospital finances. “This policy was based in-part on the flawed notion that hospitals receive the entirety of a Medicare or Medicaid payment rate when in reality most state Medicaid programs pay less than that,” Ben Finder, AHA’s vice president of coverage policy, said in a statement provided to Becker’s. “That means that many hospitals are not compensated fully for care provided to patients dually eligible for Medicare and Medicaid and this policy would reduce their ability to offset those cuts and potentially create additional financial strain at a time when many hospitals are already struggling.”

These changes will take effect April 27, 60 days after the final rule’s publication in the federal register.

Click here for more details on the final rule.

CareQuest Releases New Teledentistry Toolkit

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The CareQuest Institute for Oral Health has released Teledentistry Regulation and Policy Guidance: A Toolkit to Promote Access and Quality Care Through Teledentistry. This document identifies primary considerations for regulators and policymakers regarding teledentistry and includes key recommendations. Model teledentistry rules within the toolkit can form a basis for discussions on how to improve the regulatory climate for teledentistry moving forward.

In Pennsylvania, there is legislation pending in the Senate Banking and Insurance Committee (HB1585) that would direct our State Board of Dentistry to develop guidelines for Pennsylvania.

Policy Statement Released on Integrating Oral Health into Primary Care

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The ASTDD Dental Public Health policy committee is pleased to announce the availability of a new ASTDD policy statement, Integrating Oral Health into Primary Care. They extend their appreciation to Katrina Holt, MPH, MS, RD, FAND; Katy Battani, RDH, MS; and Ruth Barzel, MA, of the National Maternal and Child Oral Health Resource Center for their support and collaboration in the development of this document.

Click here to view the statement.

New Research Explores Influences of Online Information for Aspirin Use

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The Heterogeneous Influences of Online Health Information Seeking on Aspirin Use for Cardiovascular Disease Prevention

Authors: Jingrong Zhu, PhD; Yunfeng Shi, PhD; Yi Cui, PhD; Wei Yan, Ph.D., Penn State

Making decisions related to health and healthcare is an important part of life for most consumers. As sources of health information have expanded explosively, consumers’ information seeking and processing in the context of health decision making have also become increasingly complicated.

Previous research has shown that online health information seeking is associated with medication adherence. However, less is known about the factors that moderate such a relationship. This study examines four different sources of health information jointly and their interactive roles in consumers’ decisions on using aspirin for cardiovascular disease (CVD) prevention: the advice from health care providers, prior CVD diagnosis, CVD risk factors due to co-morbidities, and online health information.

Our results indicated that online health information seeking had heterogeneous influences on aspirin use for CVD prevention, depending on other factors such as provider advice, prior CVD diagnoses, and CVD risk factors, and potentially leading to both overuse and underuse.

Find more details about the article here.

Unrelenting Pressure Pushes Rural Safety Net into Uncharted Territory

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America’s rural health safety net has been in crisis mode since 2010. Rural hospital closures, decreasing reimbursements, declining operating margins, and staffing shortages have all coalesced to undermine the delivery of care in communities whose populations are older, less healthy, and less affluent. The mission of the safety net to serve under-resourced communities is unraveling.

The latest research conducted by the Chartis Center for Rural Health points to a startling new phase of this crisis as rural hospitals fall deeper into the red, “care deserts” widen throughout rural communities, and the increasing penetration of Medicare Advantage could further disrupt rural hospital revenue.

Click here to read the report.