The Persistence of Poverty in Rural America

The Housing Assistance Council (HAC) is a national nonprofit focused on improving conditions in the poorest rural places.  In this policy brief, HAC identifies 377 persistent poverty counties in the United States – those classified by the Census Bureau as having poverty rates of 20 percent or more for three consecutive decades.  Approximately 81 percent of these counties are outside of metropolitan areas.

The Successful Federal Efforts to Address SDOH

Social determinants of health (SDOH) include factors such as housing, food and nutrition, transportation, social mobility, and environmental conditions as having a significant impact on health outcomes.  In this series of policy briefs, the U.S. Department of Health & Human Services describes the Department’s strategic approach to SDOH and provides successful examples of current federal programs.

New Federal Bill to Provide Rural Hospitals with Financial Stability

Sens. Chuck Grassley (R-Iowa) and Bob Casey (D-Pa.) recently introduced the Rural Hospital Support Act, which would permanently extend two key Medicare rural hospital programs and establish a new rebasing year. “As rural America rebounds from the COVID-19 pandemic, now is not the time to let lifeline programs lapse,” says NRHA CEO Alan Morgan. “Reauthorization is critical to ensuring stability for the rural health safety net.” Complementary legislation, the bipartisan Save America’s Rural Hospitals Act, was recently introduced to the 117th Congress with the goal to raise the rural health safety net, which is crucial to the survival of rural communities.

Interested in advocating on behalf of rural health? Sign up to participate in NRHA’s rural health advocacy campaigns and be sure to review NRHA’s updated advocacy 101 guide.

HHS Distributing $1.75 Billion in Provider Relief Fund Payments to Health Care Providers Affected by the COVID-19 Pandemic

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), today announced more than $1.75 billion in Provider Relief Fund payments to 3,680 providers across the country. With this disbursement, HRSA has distributed approximately $13.5 billion from the Provider Relief Fund to nearly 86,000 and nearly $7.5 billion in American Rescue Plan (ARP) Rural payments to more than 44,000 providers since November 2021.

“Health care providers have been tireless in protecting their communities and working to maintain access to health services during the pandemic,” said HRSA Administrator Carole Johnson. “Provider Relief Fund resources continue to make it possible for providers to recruit and retain key personnel, implement safety measures, and keep their doors open to care for their patients.”

In September of 2021, HHS opened applications for $25.5 billion in COVID-19 provider funding. With this latest round of payments, nearly $21 billion of this funding has been distributed. Phase 4 payments reimburse smaller providers for a higher percentage of losses during the pandemic and include bonus payments for providers who serve Medicaid, Children’s Health Insurance Program (CHIP), and Medicare beneficiaries.

Providers can use Provider Relief Fund payments received in the first half of 2022 to cover losses and expenses until June 30, 2023. With these latest payments, approximately 92 percent of all Phase 4 applications have been processed. Remaining applications require additional manual review and HRSA is working to process them as quickly as possible.

Provider Relief Fund payments have played an important role in the national response to COVID-19, helping health care providers prevent, prepare for, and respond to the coronavirus. Health care providers can use the payments for a variety of COVID-related expenses. These include maintaining access to care for patients by addressing workforce challenges through recruitment and retention efforts (PDF).

View a state-by-state breakdown of all Phase 4 payments disbursed to date.

View a state-by-state breakdown of all ARP Rural payments disbursed to date.

As individual providers agree to the terms and conditions of Phase 4 payments, it will be reflected on the public dataset.

For additional information, visit www.hrsa.gov/provider-relief.

CMS Proposes Updates for Hospice

On Monday, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would update the hospice wage index, payment rates, and aggregate cap amount for Fiscal Year (FY) 2023. CMS estimates that hospices in urban areas will experience, on average, a 2.7 percent increase in estimated payments compared to FY 2022; while hospices in rural areas will experience, on average, a 2.6 percent increase in estimated payments compared to FY 2022.

CMS Proposes Updates for Rehabilitation Facilities

Last week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that would update Medicare payment policies and rates under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the IRF Quality Reporting Program for fiscal year (FY) 2023. IRF payments per discharge are estimated to increase by 2.0 percent in urban areas and 1.8 percent in rural areas, compared with estimated FY 2022 payments. Additionally, CMS is soliciting comments on the methodology used to update the IRF facility-level adjustments (specifically, the rural, low-income, and teaching status adjustments).

CMS Proposes Updates for Psychiatric Facilities

This week, the Centers for Medicare & Medicaid Services (CMS) published a proposed update to the prospective payment rates, the outlier threshold, and the wage index for Medicare hospital services provided by Inpatient Psychiatric Facilities (IPF), which include psychiatric hospitals and certain psychiatric units at acute care hospitals and critical access hospitals. Compared to payments in 2022, total payments to IPFs are estimated to increase by 1.4 percent for urban facilities and 1.7 percent for rural facilities in FY 2023.