Funding Opportunity: Diverting to Care

Request for Applications from Missouri Foundation for Health (MFH)

This request for applications invites organizations in our service region to apply for funds to plan and develop, or implement a community-based, multisector, collaborative program that aims to minimize the use of law enforcement in situations involving individuals with mental health and substance use disorders.   

Click here to learn more

Applications must be received by noon on August 31, 2021.


In Missouri, like other states across the nation, law enforcement has become the default first responder for nearly all social issues from mental health to substance use. This is both ineffective and has cascading negative effects on our communities.

The criminal justice system is ill-equipped to treat behavioral health disorders, and in many cases, incarceration exacerbates them leading to long-term, multigenerational health impacts for individuals, their families, and our communities. But by taking very practical steps, we can fix this. This means dedicating resources to preventive resources and infrastructure that supports diversion.

For this work to be successful, it requires bridging new collaborations across sectors, shifting away from police-led responses, and implementing different approaches. 

MFH has a long history of working at the intersection of criminal justice and behavioral health. This includes addressing the school-to-prison pipeline, reducing recidivism, and efforts aimed at improving local behavioral health crisis response systems.

As a next step in this area, MFH is focusing on diverting people with mental health and substance use disorders from jail through community-based grants in two priority areas: partnership and planning, and strategic implementation. By joining together, MFH hopes to ensure all people have the support they need to lead healthy lives and avoid unnecessary involvement in the criminal justice system.

2020 Annual Primary Care Resource Initiative for Missouri (PRIMO) Report

The Office of Rural Health and Primary Care (ORHPC) is excited to announce that the 2020 Annual Primary Care Resource Initiative for Missouri (PRIMO) Report has been published. Please see the link below for access to the 2020 Annual PRIMO Report.

The PRIMO Program focuses on improving health care delivery systems and increasing the number of primary care medical, dental, and mental health professionals working in rural and underserved areas of Missouri. The delivery of primary health care services depends on these groups of trained health professionals who provide high quality health care services and population based preventive, restorative and rehabilitative care.

PRIMO is operated by the Missouri Department of Health and Senior Services. As a requirement of RSMo 191.411, the 2020 report can be viewed online at The report contains:

  • A brief overview of PRIMO and its purpose;
  • The four components of PRIMO; and
  • The Impact of PRIMO.

Any comments or feedback on the report can be submitted via email to

Primary Care Needs Assessment 2020

The Missouri Department of Health and Senior Services (DHSS), Office of Rural Health and Primary Care (ORHPC), Primary Care Office (PCO) conducted a Missouri Statewide Primary Care Needs Assessment (PCNA) 2020 to identify communities with the greatest unmet health care needs, disparities, health workforce shortages, and the key barriers to accessing primary health care services. The Missouri Statewide PCNA 2020 analyzes Missouri’s unmet needs, lack of access to health care services, and evaluates resources and services necessary to overcome disparities in Missouri. The Missouri Primary Care Needs Assessment 2020 report can be found on the Primary Care Publications webpage. Any comments or feedback on the report can be submitted via email to

Find a Primary Care Provider Near You

The Office of Rural Health and Primary Care created an interactive Primary Care Provider Search Map added to the Primary Care Office webpage. This Primary Care Provider Search Map can be used to locate primary care providers in Missouri using the search features by address, provider type, and provider name. The interactive map also allows the user to enter their own address to find providers within a specific distance from their location and get directions to that provider location. Access the Primary Care Provider Map Instructions that explain how to use this interactive map, which can also be viewed on the Primary Care Office webpage.

CMS Proposes Rule to Increase Price Transparency, Access to Care, Safety & Health Equity

July 19, 2021

The Centers for Medicare and Medicaid Services (CMS) is proposing actions to address the health equity gap, ensure consumers have the information they need to make fully informed decisions regarding their health care, improve emergency care access in rural communities, and use lessons learned from the COVID-19 pandemic to inform patient care and quality measurements.

In accordance with President Biden’s Competition Executive Order, CMS is further strengthening its efforts to increase price transparency, holding hospitals accountable and ensuring consumers have the information they need to make fully informed decisions regarding their health care.

“As President Biden made clear in his executive order promoting competition, a key to price fairness is price transparency,” said the Department of Health and Human Services (HHS) Secretary Xavier Becerra. “No medical entity should be able to throttle competition at the expense of patients. I have fought anti-competitive practices before, and strongly believe health care must be in reach for everyone. With today’s proposed rule, we are simply showing hospitals through stiffer penalties: concealing the costs of services and procedures will not be tolerated by this Administration.”

“CMS is committed to addressing significant and persistent inequities in health outcomes in the United States and today’s proposed rule helps us achieve that by improving data collection to better measure and analyze disparities across programs and policies,” said CMS Administrator Chiquita Brooks-LaSure. “We are committed to finding opportunities to meet the health needs of patients and consumers where they are, whether it’s by expanding access to onsite care in their communities, ensuring they have access to clear information about health care costs, or enhancing patient safety.” 

The proposed rule includes the following actions:

 Price Transparency:

Hospital price transparency helps Americans know what a hospital charges for the items and services they provide. CMS takes seriously concerns it has heard from consumers that hospitals are not making clear, accessible pricing information available online, as they have been required to do since January 1, 2021.

CMS proposes to increase the penalty for some hospitals that do not comply with Hospital Price Transparency final rule. Specifically, CMS is proposing to set a minimum civil monetary penalty of $300/day that would apply to smaller hospitals with a bed count of 30 or fewer and apply a penalty of $10/bed/day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500. Under this proposed approach, for a full calendar year of noncompliance, the minimum total penalty amount would be $109,500 per hospital, and the maximum total penalty amount would be $2,007,500 per hospital.

Based on information that hospitals have made public this year, there is wide variation in prices – even within the same hospital or the same system, depending on what each insurance plan has negotiated with that hospital. CMS is committed to ensuring consumers have the information they need to make fully informed decisions regarding their health care, since health care prices can cause significant financial burdens for consumers. 

 Health Equity:

CMS is seeking input on ways to make reporting of health disparities based on social risk factors and race and ethnicity more comprehensive and actionable. This includes soliciting comments on potential collection of data and analysis and reporting of quality measure results by a variety of demographic data points including, but not limited to, race, Medicare/Medicaid dual eligible status, disability status, LGBTQ+, and socioeconomic status.

 Access to Emergency Care in Rural Areas:

Since 2010, 138 rural hospitals have closed – disproportionately within communities with a higher proportion of people of color and communities with higher poverty rates. Rural communities experience shorter life expectancy, higher mortality, and have fewer local providers, leading to worse health outcomes than in other communities.

Rural hospital closures deprive people living in rural areas of crucial services, including access to emergency care. To address these concerns, Congress enacted Section 125 of the Consolidated Appropriations Act of 2021 (CAA), which establishes a new provider type for Rural Emergency Hospitals (REHs). REHs will be required to furnish emergency department services and observation care and may provide other outpatient medical and health services as specified by the Secretary through rulemaking. In this proposed rule, CMS is requesting information to inform the development of requirements that would apply to REHs. This new provider designation will apply to items and services furnished on or after January 1, 2023.

CMS is seeking feedback on a wide-range of issues to help inform policy proposals for the CY 2023 rulemaking cycle, including feedback on the potential services to be provided by REHs; health and safety standards and quality measures to be established for REHs; and payment provisions for this provider type.

 COVID-19 Lessons:

To incorporate lessons learned from the COVID-19 pandemic, CMS is seeking comment on the extent to which hospitals are using flexibilities offered during the COVID-19 public health emergency to provide mental health services remotely and whether CMS should consider changes to account for shifting practice patterns. In addition, CMS is proposing changes to measure how many of our nation’s front-line healthcare workers in hospital outpatient departments and Ambulatory Surgical Centers (ASCs) are vaccinated against COVID-19 and to make this information available to the public so consumers know how many workers are vaccinated in different health care settings.

Improving Patient Experience and Outcomes:

The Radiation Oncology (RO) Model aims to improve the quality of care for cancer patients receiving radiotherapy and move toward a simplified and predictable payment system. The RO Model tests whether prospective, site neutral, modality agnostic, episode-based payments to physician group practices, hospital outpatient departments, and freestanding radiation therapy centers for radiotherapy episodes of care reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.

CMS is proposing changes to the RO Model, which aim to improve the experience of patients receiving radiation treatment, while incorporating evidence-based best practices to help providers improve patient outcomes.

Patient Safety:

CMS is increasing Medicare beneficiary safety by reversing changes made for 2021 regarding the care setting for which Medicare will pay for surgical procedures that may pose risk to patients.

Specifically, the agency is proposing to halt the phased elimination of the Inpatient-Only (IPO) list—procedures that Medicare will only make payment for when provided in the inpatient setting. There are some services designated as inpatient only that, given their clinical intensity, would not be expected to be performed in the outpatient setting. CMS adopted a policy for 2021 to eliminate this list over a phased period and removed musculoskeletal procedures from the list in 2021.

This change happened without individually evaluating whether the procedures met the long-standing criteria previously used to determine if a procedure could be safely removed. Some of the musculoskeletal services removed includes services like limb amputations and invasive spinal procedures.

CMS reviewed each procedure code of services that were removed and found none met criteria for removal, with insufficient supporting evidence that the service can be safely performed on the Medicare population in the outpatient setting.

CMS is proposing to add them back on to the list in 2022, and is seeking comment on whether to maintain the longer-term objective of eliminating the IPO list, maintaining the IPO list, or maintaining the list but continue to streamline the list of services. The latter would continue systematic scaling of the list back to ensure inpatient-only designations are consistent with current standards of practice.

CMS is also proposing to reinstate the patient safety criteria it uses to evaluate whether a procedure should be payable in the ASC setting that were removed in 2021. CMS is proposing to adopt a nomination process whereby the publicly can formally nominate procedures it believes are safe to perform for the Medicare population in the ASC setting.

More Information:

2021 CMS National Training Program Virtual Workshops

Registration for the 2021 Centers for Medicare & Medicaid Services (CMS) National Training Program (NTP) virtual workshops is open. Session dates are listed below. Select the hyperlinked event title(s) to register for those you’re interested in attending. You’ll be prompted to login to the NTP virtual workshop webpage. To login, use the same email address and password you use to register for all NTP webinars. If you don’t have an account, you’ll need to create one before registering. After you register for an event, you’ll get an email confirmation and calendar appointment. Please email if you need help with your account or registration. Sessions will start at 1pm and conclude no later than 3:30pm (ET). Sessions will be recorded for later viewing.

July 2021

August 2021

September 2021

Session materials will be available for download at the time of the events.

NOTE: Registration requests will be considered on a first-come, first-serve basis until each session reaches capacity. The number of attendees from the same organization may be limited. If any session reaches capacity, we’ll work to schedule an additional offering for a later date.

Please send all correspondence to

Comprehensive ESRD Care (CEC) Model Beneficiary and Provider RIF files now available on ResDAC and CCW

The Centers for Medicare and Medicaid Services (CMS) is pleased to announce the availability of two new Research Identifiable Files (RIFs) that contain data from the Comprehensive ESRD Care (CEC) Model. The first file, the CEC Beneficiary RIF, contains enrollment data for beneficiaries in the CEC Model. A second file, the CEC Provider RIF, contains identifying information about the providers participating in the CEC Model.

The CEC Model is designed to identify, test, and evaluate new ways to improve care for Medicare beneficiaries with End-Stage Renal Disease (ESRD). Through the CEC Model, CMS is partnering with health care providers and suppliers to test the effectiveness of a new payment and service delivery model in providing beneficiaries with person-centered, high-quality care. The CEC Model builds on Accountable Care Organization experience from the Pioneer ACO Model, Next Generation ACO Model, and the Medicare Shared Savings Program to test Accountable Care Organizations for ESRD beneficiaries.

For more information about the CEC Model, please visit

Federal Office of Rural Health Policy Announcements

July 15, 2021

HHS Boosts Funding for COVID-19 Response in Rural Areas.  The U.S. Department of Health & Human Services (HHS) announced $398 Million for COVID-19 testing and mitigation.  The funds will be distributed by State Offices of Rural Health to 1,540 rural hospitals through the Small Rural Hospital Improvement Program.

One Month Left to Enroll in, or Change, Health Insurance Marketplace Coverage.  HHS released a report on current trends and challenges to accessing affordable health care in rural America.  Analysts found that, although uninsured rates have fallen in rural areas, other barriers to care such as geographic distances, infrastructure limitations, and provider shortages contribute to rural health disparities.  The report comes one month before the special enrollment period for qualified individuals and families ends on August 15.  As noted in the HHS brief, 65 percent of the 1.9 million rural uninsured individuals in states may be able to find a zero-premium plan on the platform.

NOSORH Accepting 2021 Community Star Nominations.  The National Organization of State Offices of Rural Health (NOSORH) seeks nominations until August 2 of individuals, organizations, or consortia making a big difference in the health of rural communities.

Biden-Harris Administration Provides Nearly $144 Million in American Rescue Plan Funds to Support COVID-19 Response Efforts in Underserved Communities

July 15, 2021

As part of the Biden-Harris Administration’s ongoing efforts to respond to the COVID-19 pandemic, today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded nearly $144 million in American Rescue Plan funding to 102 HRSA Health Center Program look-alikes (LALs) to respond to and mitigate the spread of COVID-19, and enhance health care services and infrastructure in communities across the country. LALs are community-based health care providers that provide essential primary health care services to underserved communities and vulnerable populations but do not otherwise receive HRSA Health Center Program funding.

Read the release.