November 27, 2017
What’s New
The Underestimated Cost of the Opioid Crisis. In a new report out this week, the White House Council of Economic Advisors (CEA) says that previous cost estimates focused mainly on healthcare costs and underestimated losses from overdose fatalities. The CEA reports that a recent study found opioid-related deaths in 2014 were 24% higher than officially reported and cost more than $431 billion in fatality costs. In a separate and unrelated report, the Office of the Inspector General at the U.S. Department of Health & Human Services named curbing the opioid epidemic the third Top Management and Performance Challenges Facing HHS. Last month, the Centers for Disease Control and Prevention issued a report showing that rural areas experience a higher rate of death from drug overdose.
Funding Opportunities
Training Nurses for Primary Care – January 29. This four-year training program from HRSA’s Bureau of Health Workforce (BHW) will prepare nursing students and current registered nurses (RNs) to practice in community-based primary care teams, with an emphasis on chronic disease prevention and control and including mental health and substance use conditions. Eligible applicants include accredited schools of nursing, health care facilities such as Critical Access Hospitals, or a school-facility partnership. Recruitment and retention of healthcare professionals is particularly challenging in rural areas, but training in a rural area makes staying there more likely. BHW will hold a webinar for applicants on Tuesday, November 28 at 2:00 pm ET. See link for more information.
Training and Enhancement – Primary Care Physicians and PAs – January 30. Public or nonprofit hospitals, community-based and tribal organizations join schools of medicine and physician-assistant training programs in eligibility for fellowship in Primary Care Training and Enhancement programs for community-based primary care physicians and/or physician assistants. This opportunity encourages applicants to work with National Health Service Corps (NHSC) sites and would allow graduates of the program to receive priority status for the NHSC Loan Repayment Program. HRSA’s Bureau of Health Workforce will hold a webinar for applicants on Tuesday, November 28 from 2:00 to 3:30 pm ET. See link for more information.
Rural Health Research
Rural Long-Term Services and Supports: A Primer. This paper from the Rural Policy Research Institute focuses on the population of older (i.e., age 65+) rural residents using long-term services and supports (LTSS) and discusses opportunities and limitations of current federal and state LTSS policy for transforming the rural health delivery system. Ideally, primary care, acute care, post-acute care, and LTSS form a continuum of coordinated services. In reality, these services tend to be fragmented, with only weak coordinating connections. The growing population of older adults in rural areas, combined with more limited capacity of rural LTSS systems, suggests the need for targeted initiatives, including expanded community-based service options, enhanced workforce capacity, and improved care coordination.
Rural Transportation: Challenges and Opportunities. Transportation, as it relates to health and healthcare, is widely acknowledged to present unique challenges in rural communities, but there is limited research on specific issues and potential policy interventions to alleviate them. For this study, the University of Minnesota Rural Health Research Center surveyed key informants in all fifty states as well as national organizations with relevant expertise to get a detailed illustration of difficulties to rural transportation.
Policy Updates
Questions about Rural Health Policy Updates? Write to ruralpolicy@hrsa.gov
Comments Requested: Changes to Medicare Advantage/Part D Plans – January 16. CMS has proposed several changes to Medicare Advantage and Part D Plan rules for 2019 that are relevant to rural enrollees, providers, and stakeholders, such as allowing plans to send more materials to enrollees electronically, increasing flexibilities in plan design, and adding tools for Part D plans to manage and monitor access to opioids.
News on Rural Community Hospital Demonstration. The aim of this program, initiated by CMS in 2004, is to determine the feasibility of cost-based reimbursement for small rural hospitals that are too large to be Critical Access Hospitals. Originally mandated to be a five-year demonstration, the program was extended by five years under the Affordable Care Act. More recently, another five-year extension was called for under the 21st Century Cures Act enacted in December 2016. This month, CMS announced selection of 13 new rural hospitals for the demonstration that will join 17 hospitals continuing their participation.
CMS Announces Provider Ombudsman for New Medicare cards – The new ombudsman, Dr. Eugene Freund, will serve as a resource for health care providers with concerns or questions about the new Medicare beneficiary enrollment cards. CMS will begin mailing the new cards to people with Medicare benefits, including rural beneficiaries, in April 2018 to meet the statutory deadline for replacing all existing Medicare cards by April 2019. The new Medicare cards will contain a unique, randomly-assigned number that replaces the current Social Security-based number. To reach the new ombudsman, email NMCProviderQuestions@cms.hhs.gov.
2018 Medicare Premiums and Deductibles Announced – In 2018, the standard Medicare premium for Part B, which covers physician, outpatient, home health, and other services, will be the same as 2017 ($134/month). However, some beneficiaries may see an increase in their premiums depending on their income and social security status. The 2018 deductible for Part A, which covers hospital services, will be $1,340, a $24 increase from last year. About one-quarter of Medicare beneficiaries live in rural areas.
Resources, Learning Events and Technical Assistance
NHSC/NURSE Corp Virtual Job Fair – Tuesday, November 28, 6:45 – 10:15 pm ET. At these regular online events held by the National Health Service Corps (NHSC) students, residents and practicing clinicians can connect with employers with job openings in primary care medical, dental and behavioral health disciplines.
Making Pharmacy Services Accessible – Thursday, December 7 at 1:00 pm ET. The AgriSafe Network will hold a one-hour webinar about clinical pharmacy services in rural communities and describe how students of health professions schools are being trained to provide health care outreach in rural areas .
Webcast: Mental Illness Committee Meeting – Thursday, December 14 at 10:30 am ET. The Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), which includes Federal and non-Federal members, will discuss advances related to serious mental illness and serious emotional disturbance as well as rural-relevant topics, such as the effect of federal programs on the quality of mental and substance use disorders treatment services. The public can attend via telephone or webcast. To obtain the call-in number, submit comments, or request special accommodations, email ismicc@samhsa.hhs.gov.
Approaching Deadlines
Survey: Federal Strategy for Childhood Lead Exposure – November 24
Comments Requested: HHS Partnerships with Faith Communities – November 24
Comments Requested: 2019 Health Insurance Marketplace (HIM) Changes – November 27
Comments Requested: PACE Quality Measures – November 30
Support for Rural Financial Institutions – November 30
Revitalize Rural Rental Housing – December 1
MIPS Virtual Group Election – December 1
USDA Community Food Projects – December 4
Recertify in 340B Drug Pricing Program – December 6
Rural Health Care Services Outreach Program – December 6
Enrollment for 2018 Medicare Advantage and Prescription Drug Plans – December 7
Public Health Crisis Response – December 11
Improve Tribal Road Safety – December 11
Rural Utilities Service Assistance for Communities – December 11
Deadline for Health Insurance Enrollment – December 15
Assessment for Preventing Medical Errors – December 15
Improving Rural Community Airports – December 15
New Geographic Service Areas for HIV Intervention – January 2
Nominations: HHS Advisory Committee on Minority Health – January 3
Researching Health Behavior for Young People – January 7
Treasury Loans for Rural Economic Development – January 9
Comments Requested: Changes to Medicare Advantage/Part D Plans – January 16
Preventing Intimate Partner Violence – January 16
Training Nurses for Primary Care – January 29
Training and Enhancement – Primary Care Physicians and PAs – January 30
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