Media & Information

News, Magazines, & Videos

Health Care Provider Deserts May Leave Patients in the Cold

Posted on by lad3
Rural Affordable Care Act insurance consumers may need to travel farther for care
A person in a business suit trying to hitch hike in the middle of the desert
People with ACA health insurance may be more likely to find themselves in “artificial provider deserts,” according to new Penn State research.Image: GettyImages Adventure_Photo

UNIVERSITY PARK, Pa. — People with health insurance under the Affordable Care Act (ACA) may have access to fewer health care providers — and may also have to drive further to see them — than people with other plans, according to researchers.

In a new study — published Nov. 4 as part of the November issue of Health Affairs — researchers found that people with ACA health insurance are more likely to find themselves in “artificial provider deserts,” areas where the health care providers near a customer are not covered by their insurance plan, leaving them without access to care even though providers are nearby.

Simon Haeder, assistant professor of public policy, said this is usually not a problem for people living in cities, but it can quickly become an issue for people living in more rural areas.

“If you’re of high socioeconomic status and relatively healthy, traveling long distances for care might be easier or not be a big issue for you,” Haeder said. “But if you’re more economically disadvantaged, and if you potentially don’t speak English or have multiple medical conditions, these challenges with provider networks can have large implications for your health.”

The researchers said that after the ACA was passed, there was a lot of research done on how ACA plans compared to commercial plans, like the ones people access through their employers. Haeder said that while this previous work found that ACA plans covered fewer providers and had lower premiums, researchers did not factor in how far people had to travel to see the health care providers covered by their insurance.

Read the entire press release here.

Legislation Seeks to Decrease Rural Maternal Deaths

Posted on by lad3

Daily Yonder, Liz Carey

The maternal death rate is 60% higher in rural areas than central parts of metropolitan areas. A bill introduced by a member of Congress from New Mexico seeks to close the gap.

As pregnancy-related deaths in rural areas climb, federal lawmakers hope to reverse the trend with legislation that will attract more healthcare providers to rural areas and identify the causes of pregnancy-related deaths.

In September, U.S. Representative Xochitl Torres Small, D-New Mexico, introduced HB 4243, the Rural Maternal and Obstetric Modernization of Services Act (the Rural MOMS Act). The bill would add incentives to attract healthcare providers, fund equipment purchases, and support data collection on maternal health and morbidity in rural areas.

The U.S. ranks as one of the worst developed nations for maternal mortality, with more pregnancy-related deaths than Saudi Arabia and Kazakhstan. Rural parts of the U.S. have 60% higher mortality rates, according to 2015 data from the Centers for Disease Control (CDC). The report says the mortality rate in large central metropolitan areas was 18.2 per 100,000 live births, compared to 29.4 per 100,000 live births in the most rural areas.

In May, Seema Verna, the director of the Center for Medicare and Medicaid Services, said in her statement to the National Rural Health Association Conference in Atlanta that maternal health was one of her department’s top priorities.

“Maternal health is a growing concern in the country,” she said in her remarks. “About 700 women die each year in the U.S. due to pregnancy or delivery complications.”  Nearly two-thirds of those deaths are preventable, she said.

Rural America’s higher maternal mortality rate “is particularly concerning to me… because early in my career, I worked on a healthy babies program and here we are… decades later… dealing with the same challenges… some of which have gotten worse,” Verna said. “Statistics show that pregnancy-related mortality deaths have almost doubled in the last 30 years.”

Since Verna’s speech in May, there’s been lots of discussion and fact finding, said Katy Backes Kozhimannil, director of the University of Minnesota Rural Health Research Center.

Click here to access the full article.

Rural and Safety Net Hospitals Prepare for Cut in Federal Support

Posted on by lad3

Daily Yonder,

Absent action by Congress in the next couple of weeks, Dr. Michael Waldrum, CEO of Vidant Health, is going to have to figure out what medical services to deny hard-pressed communities in rural eastern North Carolina.  “It runs the gamut,” Waldrum said in an interview last week. “Do we close hospitals? Do we close services within hospitals?”

With an operating margin of less than 0.5% — comparable to most other rural and safety net hospitals — and an expected loss of $7.7 million in federal money this year, which would double next year, Vidant, a multi-hospital safety net health system, could drop into the red.

Across the country, similar health systems face unwelcome choices about how to handle the coming funding cuts. They knew it was coming — the Affordable Care Act ordained a pullback in federal support for hospitals’ charitable care — and yet hospital leaders continue to hold out hope that Congress will protect the funding before the cuts go into effect in a few weeks.

“The consequences would be absolutely devastating,” said Beth Feldpush, a senior vice president for America’s Essential Hospitals, a trade association for safety net hospitals, which provide medical care for all comers, no matter their ability to pay.

Even without these prospective cuts, both safety net and rural hospitals, most of which have slim or negative operating margins, have been facing perilous economic times. At least 118 rural hospitals have closed since 2010, and a number of safety net hospitals also have shuttered or merged with for-profit health systems.

Hospitals in the 14 states that did not expand Medicaid will be hurt the worst, because they already miss out on the extra federal money that comes with expansion.  “How many punches can you take?” said John Henderson, president and CEO of the Texas Organization of Rural and Community Hospitals. Texas, which has not expanded Medicaid, leads the country in the number of closed rural hospitals with 23 since 2005.

The federal money reimburses hospitals for the care they provide to people who can’t afford to pay and offsets the cost of care that hospitals provide to Medicaid patients that Medicaid does not cover. The federal cuts amount to $4 billion this year and $44 billion through 2025.

The hospitals’ total loss of funding could be even more significant because the program includes state matching funds. If state cuts are commensurate with federal ones, the overall reduction would go from $4 billion to more than $7 billion in 2020.  As one example, the North Carolina Department of Health and Human Services said in an email to Stateline that if the federal cuts go into effect this year, the state would reduce its contribution by $47 million in addition to the expected $98 million cut in federal money.

Access the full article here.

Report Assesses Children’s Drink Choices

Posted on by lad3

A new report from the University of Connecticut’s Rudd Center for Food Policy and Obesity assesses the sales, nutrition, and marketing of children’s drinks. Their findings show that sweetened drinks with added sugars and often low-calorie sweeteners continue to dominate sales and advertising of drinks marketed for children’s consumption. Overconsumption of these drinks can have adverse effects on children’s oral and overall health.

Click here to view the report.

Pennsylvania Title V Needs and Capacity Assessment Survey

Posted on by lad3

The Pennsylvania Department of Health’s Bureau of Family Health is completing its Title V Five-Year Needs and Capacity Assessment. The assessment provides the opportunity to evaluate the health status of women, infants, children, adolescents, and children and youth with special health care needs in Pennsylvania, to identify priority health needs, and to guide state and local public health work over the next five years. The survey is for those who were not able to attend the in-person prioritization events to share input on potential priorities. Consider including the importance of oral health in responses. Complete the survey by November 14, 2019.

Click here to complete the survey. 

ADA Guideline Advises Against Antibiotics for Dental Pain

Posted on by lad3

A new ADA guideline indicates that “antibiotics are not needed to manage most dental pain and intraoral swelling associated with pulpal and periapical infections.” The guideline advises against using antibiotics for most pulpal and periapical conditions and instead recommends only the use of dental treatment and, if needed, over-the-counter pain relievers. This guideline is part of larger efforts across the globe to prevent antibiotics from becoming ineffective in treating bacterial infections.  Click here for more information.

Dissemination of Rural Health Research: A Toolkit

Posted on by lad3

The Rural Health Research Gateway released a Dissemination of Rural Health Research Toolkit to help researchers develop appropriate, timely, accessible, and applicable products as well as social media campaigns to get the word out about their work. The toolkit provides descriptions for multiple modes of dissemination, including:  policy briefs, fact sheets, infographics, journal publications, poster presentations, chartbooks, PowerPoint presentations, working papers and reports, and promotional products. The toolkit, which is free and downloadable, also includes a brief discussion on the purpose of each product, which product is appropriate given the topic and intended audience, and how to format and design each product. Effective examples are provided.