The School-Based Health Alliance is the national school-based health care advocacy, technical assistance, and training organization based in Washington DC. The Alliance works to improve the health of children and youth by advancing and advocating for school-based health care. As youth-friendly and accessible settings, school-based health centers (SBHCs) are uniquely positioned to deliver high quality, confidential services that equip children and adolescents with the information, tools, and support they need to be healthy and safe where they are, when they need it… in school. Visit the website to access resources and learn more. Also stay tuned as PACHC is working with the School-Based Health Alliance to offer a webinar on Adolescent Motivational Interviewing sometime in July.
Insurer Participation in Rural Health Insurance Marketplaces: Are Some Markets Intrinsically More Competitive Than Others?
A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis authored by Abigail R. Barker, PhD; Timothy D. McBride, PhD; Keith J. Mueller, PhD
The Patient Protection and Affordable Care Act of 2010 established Health Insurance Marketplaces (HIMs) as a mechanism to improve the functioning of existing individual insurance markets. However, to be successful, this model requires the presence of at least a handful of insurers from which beneficiaries in each local market can choose. Over the first five years of HIMs, rural counties have often struggled to attract sufficient numbers of HIM insurers. In this project, county-level data were combined from HIM plan availability files, Medicare Advantage (MA) availability and enrollment files, and Federal Employees Health Benefits Program (FEHBP) availability and enrollment files. We calculated the Herfindahl Index, which is a measure of competition in a given market, for MA and FEHBP markets for each county in 2013-16.
We found that, within a given population density category, the number of HIM insurers was positively correlated with the prior level of FEHBP market competition in a county. Note, also, that market competition was generally higher as population density increased. In 2017, the pattern continued to hold, with those counties that still attracted several insurers (rather than just one or two) averaging the lowest prior-year FEHBP Herfindahl index. We found that many of the population measures were in fact significant in their own right, including population density, total population, primary care providers per capita, and rural status of the county. Furthermore, even when controlling for these measures, prior FEHBP market concentration (low competition) was a significant predictor of low insurer participation in HIMs. In addition, from 2014 to 2017, the magnitude of the effect increased.
Click to download a copy: Insurer Participation in Rural Health Insurance Marketplaces: Are Some Markets Intrinsically More Competitive Than Others?
Online Training and Resources for Rural First Responders
Online Training and Resources for Rural First Responders. The Rural Domestic Preparedness Consortium provides free online training and resources to help rural communities plan for and respond to mass injuries and fatalities. Supported by The Center for Rural Development, the site provides self-paced online training and scheduled, in-person training that has been certified by the U.S. Department of Homeland Security.
Comments Requested: CMS Issues Draft Guidance on Hospital Co-location
Comments Requested: CMS Issues Draft Guidance on Hospital Co-location – July 2. The Centers for Medicare & Medicaid Services (CMS) seeks public input on draft guidance regarding how CMS and State Agency surveyors will evaluate a hospital’s co-location of space and staff when assessing the hospital’s compliance with the Medicare Conditions of Participation (CoPs). It clarifies that sharing of staff may be done through a contractual arrangement where there are clear lines of authority and accountability and that sharing public areas, such as entrances and waiting rooms, would be permissible. RHIhub highlights several programs in rural communities that have used co-location of services and staff to improve efficiencies, including lessons learned about this approach. See Events section below for an upcoming session on this topic.
Cost-Sharing as a Barrier to Accessing Care at FQHCs and RHCs for Rural Medicare Beneficiaries
Cost-Sharing as a Barrier to Accessing Care at FQHCs and RHCs for Rural Medicare Beneficiaries. Cost is often a significant barrier to accessing care for the rural Medicare population, so having a better understanding of the variations in cost-sharing per claim (deductibles and coinsurance amounts) at various types of safety-net facilities is important. The purpose of this study from the North Carolina Rural Health Research and Policy Analysis Center is to investigate cost as a barrier to accessing care at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for the rural Medicare population.
Measuring Access to Care in National Surveys: Implications for Rural Health
Measuring Access to Care in National Surveys: Implications for Rural Health. In order to assess the efficacy of healthcare in meeting the needs of the population and to ensure access to timely, appropriate care, it is important to have nationally representative measures of access and barriers to healthcare. Given the unique healthcare context in rural settings, it is also important to understand whether, and how, access is measured in ways that are salient for rural populations. This brief from the University of Minnesota Rural Health Research Center reviews access measures included in major national surveys and presents implications for rural research on access to care.
Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence
Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence. Using 2010-2016 data from the National Survey on Drug Use and Health, researchers from the Rural and Underserved Health Research Center found that the overall mean prevalence of suicidal thoughts among adults was significantly higher for non-metropolitan and small metropolitan counties. This page on the Rural Health Research Gateway contains links to additional research on illicit drug and opioid use disorders in rural areas.
Trends in Meeting Physical Activity Guidelines Among Urban and Rural Dwelling Adults
Trends in Meeting Physical Activity Guidelines Among Urban and Rural Dwelling Adults. In its latest Morbidity and Mortality and Weekly Report, the Centers for Disease Control and Prevention finds that the prevalence for physical activity remains low, especially for some rural subgroups with high incidences of chronic diseases. The report recommends incorporating culturally appropriate strategies into local, evidence-based programs might help communities build on recent progress.
SAMHSA Behavioral Health Barometer
SAMHSA Behavioral Health Barometer. In this newly-released report, the Substance Abuse and Mental Health Services Administration (SAMSHA) provides a broad overview of behavioral health in metropolitan and nonmetropolitan areas of the U.S. with an emphasis on illicit drug, alcohol, and tobacco use, as well as the estimated percentage of people living with serious mental illness. The report includes a special focus on the misuse of prescription pain relievers, heroin use, and medication-assisted therapy (MAT) for opioid addiction. Significant rural-metropolitan differences found include past-month cigarette use among teenagers (2.8 percent urban vs. 5.1 percent rural) and past-year serious mental illness among adults aged 18 or older (4.4 percent urban vs. 5.2 percent rural).
Binge Drinking and Prescription Opioid Misuse
Binge Drinking and Prescription Opioid Misuse. Research published in the American Journal of Prescription Medicine examined the relationship between alcohol and drug use and found that prevalence of prescription opioid misuse was similar among nondrinkers, but was 3.5 times higher among binge drinkers (Binge drinking refers to consuming four or more drinks within a couple of hours). The research measured differences by race, gender, income and rural-urban location. Among the findings: binge drinkers in rural areas have a higher prevalence of prescription opioid misuse than binge drinkers in urban areas.