Announcements from the Federal Office of Rural Health Policy

October 19, 2017

What’s New

CDC: Rate of Drug Overdose Death Higher in Rural Areas Than Urban.  While the number of people dying from drug overdose has been consistently higher in metropolitan areas, the rate of death in rural areas – that is, the number of deaths per 100,000 people – surpassed urban areas in 2015.  In the latest release from its Morbidity and Mortality Weekly Report (MMWR) Rural Health Series, researchers from the Centers for Disease Control and Prevention (CDC) find encouraging data showing a decline in illicit drug use by youth and a lower prevalence of illicit drug use disorders in rural areas from 2012-2014.  But they also call the rate of death from illicit drug use “a critical and complicated public health challenge” and prompt greater understanding of the differences between rural and urban areas in order to identify, monitor, and prioritize responses. “Consideration of where persons live and where they die from overdose could enhance specific interventions, such as training on naloxone administration or rescue breathing…and facilitating better access to medication-assisted treatment with methadone, buprenorphine, or naltrexone could benefit communities with high opioid use disorder rates.”

Learn about the unique rural challenges to combating substance use disorder on the Rural Health Information hub.  More data about the impact of substance use on rural communities can be found at the Rural Health Research Gateway.

Policy Updates

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MIPS Virtual Group Election – December 1.  As proposed in the 2018 Quality Payment Program proposed rule, solo practitioners and groups can choose to participate in the Merit-based Incentive Payment System (MIPS) as a virtual group for the 2018 performance period. Small clinician practices, including those in rural areas, may join virtual groups to combine their MIPS reporting. To form a virtual group for 2018, solo practitioners and groups would need to engage in an election process. The election period for virtual groups lasts from October 11, 2017 to December 1, 2017.

CMS Withdraws Rules: Rural providers should note several proposed rules that the Centers for Medicare & Medicaid Services (CMS) is not finalizing at this time:  the Medicare Part B payment model proposed rule, a two-phase model to test whether alternative drug payment designs would lead to a reduction in Medicare expenditures while preserving or enhancing the quality of care provided to beneficiaries; a rule proposed in 2014 that revised patients’ rights to ensure that same-sex spouses in legally-valid marriages were recognized and afforded equal rights in Medicare and Medicaid participating facilities; a proposed rule from 2014 that modified administrative requirements under the Health Insurance Portability and Accountability Act (HIPAA); and a rule proposed in January 2017 that specified the qualifications required for practitioners and suppliers of prosthetics and orthotics.

Quality Payment Program APM Look-Up Tool. CMS has developed an interactive tool where clinicians can look up their status as 2017 Advanced APM participants in Medicare’s Quality Payment Program (QPP). Under the QPP, eligible clinicians who meet certain criteria are considered qualifying participants (QPs) in Advanced APMs, and are therefore excluded from the MIPS quality reporting program. QPs identified based on the 2017 performance year will receive a 5 percent lump sum Medicare incentive payment in 2019. The calculations for this tool come from claims with dates of service between January 1 and March 31, 2017. CMS will soon update the tool to include dates of services through June 30, 2017.

Resource of the Week

Engaging Community Health Workers for Diabetes Management.  The Community Preventive Services Task Force, whose members are appointed by the Centers for Disease Control and Prevention (CDC), explains how community health workers can provide education, coaching and social support for diabetes self-management in one-on-one interaction or group sessions in home or community settings. According to the Rural Health Information Hub, rural residents have higher rates of lifestyle habits that increase the likelihood of being obese and developing diabetes.  The CDC has identified a diabetes belt, located mostly in the southern portion of the U.S. and provides resources for accessing data about diabetes prevalence at the county level.

Approaching Deadlines

Comments Requested: USDA Summer Meals Program – October 23
Comments Requested: Preventing Older Adult Falls – October 23
Local Foods, Local Places – October 25
Comments Requested: Job Corps Centers Closures – October 26
Comments Requested: Strategic Plan for HHS – October 27
Publish Rural Health Equity Research – November 1
Comments Requested: Telehealth for Veterans Care – November 1
Address Suicide Research Gaps in Rural Communities  – November 2
Comments Requested: Revisions to 911 Grant Program – November 6
Comments Requested: Rural Rental Housing Loans – November 13
Loan Repayment for Health Disparities Research – November 15
Comments Requested: Improving Care for Medicare Beneficiaries – November 20
Support for Rural Financial Institutions – November 30
MIPS Virtual Group Election – December 1
Rural Health Care Services Outreach Program – December 6
Improve Tribal Road Safety – December 11
Assessment for Preventing Medical Errors – December 15
Drinking Water and Waste Disposal for Rural and Native Alaskan Villages – Ongoing
HIT Strategies for Patient-Reported Outcome Measures – Ongoing
HIT to Improve Health Care Quality and Outcomes – Ongoing
Community Facilities Program –  Ongoing
Summer Food Service Program – Ongoing