The RUPRI Health Panel has released a new brief, Rural Hospitals’ Perspectives on Health System Affiliation. This brief explores the current trend in hospital affiliation from a rural perspective and offers guidance to rural hospital leaders in navigating a potential affiliation. With an understanding of the rural context and challenges facing rural hospitals, risks and …
Continue reading “RUPRI Health Panel Releases Brief on Rural Hospital Affiliations. April 2024.”
The RUPRI Health Panel offers comments in response to the Committee on Ways and Means Request for Information regarding Improving Access to Health Care in Rural and Underserved Areas. The comments focus on all five topics included in the RFI. The five topics include comments on: Geographic Payment Difference: The Panel recommends that changes to …
The RUPRI Health Panel responded to a CMS proposed rule CY 2024 Payment Policies Under the PhysicianFee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program. READ COMMENTS HERE
The RUPRI Health Panel provided comments on the HHS 2023 Smoking Cessation Framework. Read the Comments Here. To be most impactful in rural communities, the Panel recommends a broader approach to tobacco cessation, not just smoking cessation. The prevalence of smokeless tobacco (e.g., snuff, dip, snus, and chewing tobacco) is higher in rural areas than …
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The RUPRI Health Panel submitted comments on CMS-1785-P: Medicare Program: Proposed Hospital PPS for Acute Care Hospitals and the Long-Term Care Hospital PPS and Policy Changes and Fiscal Year 2024 Rates Proposed Rule Read Comments HERE
Keith Mueller presented State and National EMS Policy Recommendations at the 2023 National Rural EMS & Care Conference in April 2023. View Presentation Here
The RUPRI Health Panel has released a new brief, The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System, as a commentary on the preconditions for the optimum use of telehealth, looking at experiences of telehealth usage during the PHE. KEY CONSIDERATIONThe Panel continues to contribute to discussions …
The RUPRI Health Panel has released a new Policy Brief, State-Based Recommendations to Support Rural Ambulance Agencies. State-Based Recommendations• To ensure access to emergency medical services (EMS) for all rural residents, state legislatures should designate EMS as an essential service and provide a portion of the funding necessary to support the costs of maintaining essential …
The RUPRI Center for Rural Health Policy Analysis has released a new brief on Changes in Service Offerings Post-System Affiliation in Rural Hospitals. Affiliations between rural hospitals and regional and national health systems have increased from 10 to 30 per year in the 2000s to approximately 30 to 70 per year in the 2010s. This …
The RUPRI Center for Rural Health Policy Analysis has released a new policy brief COVID-19 Mortality Rates across Noncore, Micropolitan, and Metropolitan Counties by Community Characteristics, December 2020-January 2021. This policy brief examines differences in COVID-19 mortality rates across rural-urban designations and stratifications by geography, county-level sociodemographic factors, and county-level health care factors. Between December …
Research on Nonmetropolitan COVID-19 Cases & Death Rates from the RUPRI Center for Rural Health Policy Analysis was featured in a December 14, 2022 Scientific American® article on mortality rates in rural. The article, People in Rural Areas Die at Higher Rates Than Those in Urban Areas by Tanya Lewis, highlights RUPRI’s ongoing COVID tracking …
The National Advisory Committee on Rural Health & Human Services (NACRHHS) released a policy brief and recommendations to the Secretary of HHS on Rural Emergency Medical Services. Read the Brief Here The NACRHHS examines pertinent issues that affect the health and well-being of rural Americans through discussions with rural stakeholders. Following each meeting, the Committee …
The National Advisory Committee on Rural Health & Human Services (NACRHHS) released a policy brief and recommendations to the Secretary of HHS on the Rural Emergency Hospital Designation. Read the Brief Here The NACRHHS examines pertinent issues that affect the health and well-being of rural Americans through discussions with rural stakeholders. Following each meeting, the …
The RUPRI Health Panel Releases Evolution of Hospital Designations & Payment in the U.S.: Implications for Rural Hospitals Rural hospital closures have increased over the past few decades, and more are at risk for closure. Medicare hospital payment policies affecting rural hospitals play a significant role in the financial viability of rural hospitals. Programs have …
RUPRI’s Keith Mueller has been selected by the federal Health Resources and Services Administration (HRSA) to serve on a Delphi Panel tasked with developing consensus on a standard definition for “rural health equity.” A Delphi Panel is a selected panel of experts that participate in a structured process to arrive at a group opinion or …
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The RUPRI Center for Rural Health Policy Analysis released An Insurance Profile of Rural America: A Chart Book. READ the CHART BOOK HERE Over the past decade, health insurance coverage has changed in major ways in rural areas with shifts towards public and publicly subsidized coverage among the nonelderly – Medicaid, Marketplace plans — and …
The Rural Health Research Gateway will host a Webinar It’s Not Easy Being a Rural Pharmacy – Services, Payments, Closures, and Deserts with Fred Ullrich and Keith Mueller, PhD of the RUPRI Center for Rural Health Policy Analysis. November 14 at 1:00 pm Eastern. Register for Webinar Here Date: November 14, 2022Time: 10:00 am Pacific, …
The RUPRI Center for Rural Health Policy Analysis has released an update on Health Insurance Marketplaces: Issuer Participation Trends in Non-Metropolitan Places, 2014-22. Read the Report Here. Key Findings Include: Non-metropolitan counties (counties classified as either micropolitan or noncore using urban influence codes) have had less marketplace participation than metropolitan counties since their implementation in …
Continue reading “RUPRI Health Center Releases New Report on Health Insurance Marketplaces.”
The RUPRI Health Panel submitted a comment letter to CMS responding to Request For Information CMS-4203-NC: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs… Rural Emergency Hospitals. READ THE COMMENT LETTER HERE
The RUPRI Health Panel has submitted a response to CMS -17700P Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements. READ THE COMMENT LETTER HERE
The RUPRI Health Panel has responded to a CMS Request for Information on the Medicare Advantage program. READ COMMENT LETTER HERE Rural Perspective on Medicare AdvantageOur comments and feedback are offered from the rural perspective, where Medicare Advantage is an increasingly important source of health care coverage. As of March 2022, MA accounted for 45.7 …
Continue reading “RUPRI Health Panel Comment Letter on Medicare Advantage Program”
The RUPRI Center for Rural Health Policy Analysis released a Nursing Homes in Rural America Chartbook. Policymakers are increasingly concerned about the availability of post-acute care and long-term care services in rural areas. In this chartbook, we define nursing homes as Medicare and/or Medicaid certified facilities providing post-acute care (skilled nursing facilities) and/or long-term care …
Continue reading “RUPRI Releases Nursing Homes in Rural America: A Chartbook. July 2022”
Click Here for Comment Letter The Panel underscores the importance of recognizing the variance in demand for Medicaid access and coverage across non-metro and metro areas. In 2019, the percent of Medicaid coverage in non-metro areas was 22.4 percent, whereas in metro areas the percent of Medicaid coverage was 19.1. The three percent difference signifies …
Click Here for Comment Letter on 47 CFR Part 54 The Panel is encouraged by the efforts of the FCC to increase broadband access for rural providers. We encourage FCC to lead an effort to quantify the actual costs of connecting and operating broadband capacity supporting access to healthcare services. With that information subsidies could …
Listen to Podcast Here If you could hit the reset button on healthcare policy, what would you change? In this week’s episode, Dr. Keith Mueller shares his thoughts on what he would improve given the chance to hit the policy reset button, particularly in rural healthcare. “The pandemic taught us we need flexibility to move …
Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress. Given recent global economic and climate trends, including those induced by the COVID-19 public health emergency, behavioral health consequences related to economic distress will likely continue as a public health concern for the foreseeable future. The RUPRI Health Panel offers guidance for …
This document updates the RUPRI Health Panel’s framework for a high-performing rural health care system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality), and describes an underlying base of equity considerations. Abstract: This brief presents the RUPRI Health Panel’s …
Continue reading “RUPRI Health Panel Releases Updated High Performing Rural Health System Brief.”
On October 18 during the morning news program, Washington Journal on C-Span, Keith Mueller & Fred Ullrich discussed research from the RUPRI Center for Rural Health Policy Analysis on COVID-19’s impact on rural people and places. Watch the interview here.
Dr. Keith Mueller presented “Delivery of Healthcare in Rural America” to the Dakota Wesleyan University on September 28, 2021. View Presentation
The Panel is pleased to comment in response to the proposed rule for Medicare hospital outpatient prospective payment system (OPPS) program and the Request for Information (RFI) on Rural Emergency Hospitals (REH). Our comments will focus only on the latter, Section XVII of the proposed rule, Federal Register pages 42285 – 42289. We also limit …
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Read comment letter here.
Read comment letter here.
The RUPRI Center for Rural Health Policy Analysis releases this report on Pharmacy Vaccination Service Availability in Nonmetropolitan Counties. In February 2021 the White House announced the launch of the first phase of the Federal Retail Pharmacy Program for COVID-19 Vaccination. The “public-private partnership with 21 national pharmacy partners and networks of independent pharmacies” is …
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The RUPRI Health Panel has released a new brief, Characteristics and Challenges of Rural Ambulance Agencies. Every year, nearly 10 million rural Americans receive EMS care. There are 23,272 ambulance agencies in the U.S. and 73 percent of those agencies report serving rural areas. Thus, rural Americans rely on EMS professionals to deliver life-saving emergency …
The Midwest Public Health Training Center in the College of Public Health at the University of Iowa is hosting a new podcast series on rural health. In the series Share Public Health: Rural Health listeners will hear a variety of perspectives about their experiences in rural life, employment and health. Listen to the Podcast Here
The RUPRI Health Panel has released a new paper, Advancing Population Health in Rural Places: Key Lessons and Policy Opportunities. This paper advances policy discussion of population health in rural places, focusing on the role of rural health care organizations. Lessons from ongoing programs provide policy considerations. Medicare and Medicaid programs should prioritize staff and …
Read comment letter here.
In September, the Centers for Medicare & Medicaid Services Innovation Center (CMMI) released the notice of funding opportunity for the Community Health Access and Rural Transformation (CHART) Community Transformation Track. CMMI states that the “CHART Model will test whether aligned financial incentives, increased operational flexibility, and robust technical support promote rural health care providers’ capacity …
Continue reading “Rural Health Value to Hold Webinar on CHART Planning – December 14”
Health Panel member Jennifer Lundblad participated on a Panel at the Bipartisan Policy Center in October 2020 on the state of rural healthcare in Minnesota and other states. View Presentation
The coronavirus pandemic precipitated significant but temporary changes in telehealth policy and the use of telehealth services to ensure access to needed health services during a public health emergency (PHE). Extending the temporary policy changes will require statutory and regulatory action. This paper takes stock of current telehealth policies and assesses options for expanding the …
August 26 @ 2:00 pm – 3:00 pm More than 700 women a year die of complications related to pregnancy in the U.S., and two-thirds of these deaths are preventable. Maternal mortality is disproportionally affecting black and American Indian/Alaska Native women in the U.S. Additionally, there are disparities between rural and urban populations. According to publicly available …
August 18, 2020 The Community Health Access and Rural Transformation (CHART) Model team will be hosting an overview webinar on Tuesday, August 18, 2020 from 1:00 – 2:30 PM EDT. Attendees will have the opportunity to hear an overview of the CHART Model, including its objectives, eligible participants and their roles, payment options, and timeline. Participants …
The RUPRI Health Panel has released a new brief that identifies key questions to ask when creating, modifying, or using a definition. Rural definitions in statute and policy are used to direct resources to underserved peoples. But changes in population behavior and Census processes have led to concern about historic methods of defining rural. This …
Continue reading “Considerations for Defining Rural Places in Health Policies and Programs”
In May 2020, the Health Panel offered comments in response to the CMS Maternal and Infant Health Care in Rural Communities Request for Information. View Comment Letter
The Health Panel is pleased to offer comments in response to the proposed rule CMS-4190-P related to Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicaid, Medicare Cost Plan, among other policy areas. View Comment Letter
The presence of COVID-19 cases impacts rural and metropolitan areas differently – a small number of cases creates stress for low capacity systems just as a large volume of cases creates stress for larger capacity systems. This RUPRI data brief shows the current nonmetropolitan and metropolitan spread of the disease, and the associated map shows …
Continue reading “Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties”
The Panel is pleased to offer comments in response to the proposed 2020-2025 Federal Health IT Strategic Plan. View Comment Letter
The prevalence of mental health and substance use diagnoses and unmet treatment needs are not equally distributed, with rural residence being one factor associated with these differences. Moreover, the rural context has proven challenging for ensuring the availability of and access to prevention, diagnosis, treatment, and recovery services in rural areas. This paper reviews the …
Continue reading “Behavioral Health in Rural America: Challenges and Opportunities”
The Panel is pleased to provide comment on the proposed rule Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements. The Panel is encouraged by OIG’s recognition that there are certain circumstances that warranttreating rural providers differently than those in urban geographies. The Panel offers comments ontwo specific …
Continue reading “Health Panel Comment Letter – Anti-Kickback Statute – December 2019”
The Panel is pleased to provide comments on the proposed rule Modernizing and Clarifying the Physician Self-Referral Regulations.The Panel is encouraged by CMS’s recognition throughout the proposed rule of the unique ruralhealth care environment. The Panel agrees that circumstances exist in which it is appropriate to treatrural providers differently than other kinds of providers. View …
Continue reading “Health Panel Comment Letter – Stark Law – December 2019”
Rural Policy Research Institute
The University of Iowa
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