Author: barbarabrendel

Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021

Date: September 1, 2022

Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021

Nearly half of rural pharmacies are independently owned retail stores and are susceptible to closing due to financial hardship. This policy brief builds on the history of Rural Policy Research Institute projects examining the provision of pharmacy services and updates pharmacy closure in rural areas of the United States. Monthly data on all institutions providing pharmacy services in the 50 states and District of Columbia were obtained from the National Council for Prescription Drug Programs.

Key Findings:

  • Between 2003 and 2021, the number of retail pharmacies declined in noncore rural areas by 9.8 percent, and in rural micropolitan areas by 4.4 percent, while the number in metropolitan areas increased by 15.1 percent during the same period.
  • Between 2003 and 2021, the number of independently owned retail pharmacies declined in noncore areas by 16.1 percent, and in micropolitan areas by 9.1 percent, while the number in metropolitan areas increased by 28.2 percent during the same period.
  • Between 2003 and 2021, the number of chain pharmacies grew in all three geographies, with the largest growth occurring in metropolitan areas (noncore: 4.6 percent, micropolitan: 3.7 percent, metropolitan: 10.5 percent).
  • Franchise pharmacies have never represented a large segment of the market (1.1 percent of all retail pharmacies in 2021), but their number declined dramatically in all three geographies from 2003 to 2021.

Contact Information:

Keith J. Mueller, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.3832
keith-mueller@uiowa.edu

Additional Resources of Interest:

Providing High-Quality Support to Pregnant People and Their Families in Racially Diverse Rural Communities

Date: August 29, 2022

Providing High-Quality Support to Pregnant People and Their Families in Racially Diverse Rural Communities

Compared with urban birthing people, rural residents experience higher rates of infant mortality, maternal mortality, and severe maternal morbidity. Rural residents who are Black, Indigenous, and People of Color have the highest maternal mortality and infant mortality rates in the country. At the same time as mortality and morbidity are rising, a steady trend of rural hospital and maternity unit closures has reduced access to care for pregnant rural residents. Still, some rural communities thrive, providing high-quality support to pregnant people, parents, infants, and families. This case series highlights examples from racially diverse rural communities, where hospitals and health systems with obstetric units strive to meet patient needs and provide evidence-based, supportive services during pregnancy, childbirth, and the postpartum period.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401
tuttl090@umn.edu

Additional Resources of Interest:

HRSA Funding Opportunities

Date: August 25, 2022

Rural Health Network Development Program (Application Due Date: November 22, 2022) – The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP) will be making approximately 44 awards of up to $300,000 each for the 2023 Rural Health Network Development (RHND) Program. This four-year program will support integrated health care networks who collaborate to achieve efficiencies; expand access to, coordinate, and improve the quality of basic health care services and associated health outcomes; and strengthen the rural health care system as a whole. HRSA intends for the RHND Program to address gaps in service, enhance systems of care, and expand capacity of the local rural health care system.

Eligible organizations must be located in a domestic public or private, non-profit or for-profit entities, including faith-based, community-based, tribes and tribal organizations. The applicant organization may be located in a rural or urban area, but must have demonstrated experience serving, or the capacity to serve, rural underserved populations. The applicant organization must represent a network that includes at least three or more health care provider organizations and, at least 66% (or two-thirds) of network members must be located in a HRSA-designated rural area.

FORHP will hold a webinar for applicants on Wednesday September 7, 2022 from 2:00 PM – 3:30 PM EST / 1:00 PM – 2:30 PM CST. Log-in information is below:

Review the NOFO at: https://www.grants.gov/web/grants/search-grants.html?keywords=hrsa-23-030.

Healthy Tomorrows Partnership for Children Program (HTPCP) – Applications are due October 12, 2022 at 11:59 PM ET. The purpose of the program is to support community-based partnerships and collaborations aimed at promoting access to health care for under-resourced and underserved children, youth, and their families nationwide, through the implementation and evaluation of new or enhanced community-based projects and models of care. Recipients will implement community-based projects incorporating evidence-informed or evidence-based strategies or innovations to increase access to health care and preventive health services in rural and other underserved populations. An application webinar was held on Friday, July 29, 2022. To view the recording, go here.

AmeriCorps Grants Will Focus on Evidence-Based Interventions – Nonprofit organizations, tribes, and local governments are eligible for the next round of grants from AmeriCorps, the federal agency for community service and volunteerism. The funding for 2023 will prioritize evidence-based interventions proven to work in communities with concentrated poverty and/or historically underrepresented and underserved individuals. The programs present a unique opportunity for organizations who work in rural to help support public and community health and create potential career pathways while also addressing longstanding workforce capacity challenges. The deadline to apply for federal grants is January 4, 2023. Single-state applicant deadlines to State Commissions may be significantly earlier.

American Heart Association Rural Health Care Outcomes Accelerator – Ongoing. The three-year initiative is designed to eliminate health disparities with learning collaboratives and professional education for hospitals and clinicians. The national nonprofit will support up to 700 rural hospitals at no cost. 

Availability of Home Health, Hospice, and Pharmacy Services in Minoritized Racial/Ethnic Group Areas

Date: August 25, 2022

Availability of Home Health, Hospice, and Pharmacy Services in Minoritized Racial/Ethnic Group Areas

This series of briefs documents disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic group (MRG) residents.

Availability of Home Health Services in Minoritized Racial/Ethnic Group Areas

  • In the U.S., home health agency reporting services are not available in 5.9% of all ZCTAs and an additional 10.3% of ZCTAs receive services from a single agency.
  • In 2020, 10.3% of all rural ZCTAs and 2.2% of all urban ZCTAs lacked home health service access. As a ZCTA becomes more rural and remote, these communities are more likely to lack any home health care or have limited service.
  • Within rural ZCTAs in the top 5th percent for minoritized population group representation, non-Hispanic Black representation was less likely to lack all home health services and non-Hispanic American Indian/Alaska Native representation was more likely to lack all home health services when compared to “all other” rural ZCTAs.

Availability of Medicare-Certified Hospice Services in Minoritized Racial/Ethnic Group Areas

  • Centers for Medicare & Medicaid Services-certified hospice providing services are not available in 5.6% of ZCTAs and 14.2% are served by a single hospice.
  • In 2020, 2.4% of all urban ZCTAs had no service while 9.4% of all rural ZCTAs had no service.
  • Within rural ZCTAs in the top 5th percent for minoritized population group representation, American Indian/Alaska Native (32.6%), Asian American/Pacific Islander (12.9%), non-Hispanic white (24.7%), and multiple MRG groups (23.1%) were each more likely than “all other” rural ZCTAs to lack any hospice service (4.5%).

Availability of Pharmacies in Minoritized Racial/Ethnic Areas

  • The mean density of pharmacies across rural ZCTAs was 1.2 pharmacies per 10,000 persons. The mean density of pharmacies across urban ZCTAs was 1.7 pharmacies per 10,000 persons.
  • The lowest density of pharmacies across rural-urban MRG designation was found in rural Hispanic ZCTAs.

Contact Information:

Janice C. Probst, PhD
Rural and Minority Health Research Center
Phone: 803.251.6317
jprobst@mailbox.sc.edu

Additional Resources of Interest:

More information from the Rural Health Information Hub’s topic guides: Healthcare Access in Rural Communities, Rural Home Health Services, Rural Hospice and Palliative Care, Rural Pharmacy and Prescription Drugs

Delta Regional Authority, Department of Defense Medical Missions Completed Services Valued Over $1.1 Million at No Cost to 2,920 Patients

Date: August 24, 2022

Delta Regional Authority, Department of Defense Medical Missions Completed Services Valued Over $1.1 Million at No Cost to 2,920 Patients

Mission servicemembers in Western Kentucky, South Central Missouri, and Southern Illinois performed over 9,000 medical, dental, and optical care services as part of joint military training program.

CLARKSDALE, MS – The Delta Regional Authority (DRA) announced its partnership with the U.S. Department of Defense (DoD) resulted in over $1.1 million in estimated value of services at no cost to the 2,920 patients cared for during the Western Kentucky, South Central Missouri, and Southern Illinois Wellness Missions. The medical missions brought hundreds of servicemembers to Hopkinsville, Kentucky; Ava, Eminence, and Houston, Missouri; and Carbondale, Illinois during three medical training missions this summer which provided for over 9,000 medical, dental, and optical care services. 

“While the availability of quality, affordable healthcare is a challenge for many Americans, especially within our rural communities, Delta Regional Authority continues to seek solutions to combat this issue,” said Delta Regional Authority Federal Co-Chairman Dr. Corey Wiggins.  “Through our partnership with the Department of Defense, nearly 3,000 Delta residents were able to have a troublesome tooth extracted, receive a new pair of glasses, or get a blood pressure checkup, all at no cost to them.  Bringing IRT missions to Delta communities is just one way that DRA is working to create better access to quality healthcare for the people we serve.”

The Western Kentucky Wellness Mission (Hopkinsville, Kentucky from June 15-25, 2022), South Central Missouri Wellness Mission (Ava, Eminence, and Houston, Missouri from June 29-July 8, 2022), and Southern Illinois Wellness Mission (Carbondale, Illinois from July 22-31, 2022) were all part of the Innovative Readiness Training (IRT) program, a DoD military training program that delivers joint training opportunities to increase deployment readiness while simultaneously providing key healthcare services with lasting benefits for Delta communities. By utilizing their extensive resources, the military is able to meet some of the region’s most urgent healthcare needs. Among the services provided during IRT missions are basic medical and wellness exams, vision exams and single vision glasses, and dental exams and extractions. Military personnel offered vision, dental, and basic medical services to the public at no cost to patients. 

A breakdown of the mission outcomes are as followed:

Western Kentucky Wellness Mission

  • Total Number of Patients: 807
  • Total Number of Procedures/Services Provided: 2,385
    • Medical, Nutrition, Behavioral Health: 799
    • Dental: 1,589
    • Optometry: N/A
  • Total Mission Value: $221,553.06

South Central Missouri Wellness Mission

  • Total Number of Patients: 1,358
  • Total Number of Procedures/Services Provided: 4,438
    • Medical, Nutrition, Behavioral Health: 291
    • Dental: 3,687
    • Optometry: 460
  • Total Mission Value: $661,643.00

Southern Illinois Wellness Mission

  • Total Number of Patients: 755
  • Total Number of Procedures/Services Provided: 2,456
    • Medical, Nutrition, Behavioral Health: 318
    • Dental: 1,708
    • Optometry: 430
  • Total Mission Value: $275,011.67

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About the Delta Regional Authority

The Delta Regional Authority (DRA) is a federal-state partnership created by Congress in 2000 to promote and encourage the economic development of the lower Mississippi River Delta and Alabama Black Belt. DRA invests in projects supporting transportation infrastructure, basic public infrastructure, workforce training, and business development. DRA’s mission is to help create jobs, build communities, and improve the lives of those who reside in the 252 counties and parishes of the eight-state region.

18th Annual Health Ethics Conference

Date: August 24, 2022

18th Annual Health Ethics Conference

Burnout, incivility, and moral injury: Optimizing ethical response in times of crisis.

Date: October 6, 2022

Location: Hampton Inn Events Center, Columbia, Missouri

Through the exploration of patient and provider stories, this conference will focus on navigating ethical challenges heightened by the global pandemic, divergent belief structures, and misinformation further polarizing communities. Join the conference to listen to wellness advocates and a range of healthcare professionals who have first-hand experience of the challenges encountered in today’s complex healthcare environment leading to rising incivility, burnout, and moral injury. Participants will explore these challenges as well as interventions, processes and resources aimed at optimizing well-being and mitigating harm to health professionals.

The conference agenda is posted on the website.

Presented By:

Center for Health Ethics
MU Sinclair School of Nursing
MU Continuing Education for Health Professions
MU Extension

Accreditation Information

Continuing Medical Education (CME)

Activity approved for AMA PRA Category 1 Credits™

Continuing Nursing Education (CNE)

University of Missouri Sinclair School of Nursing is approved as a provider of nursing continuing professional development by the Midwest Multistate Division, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Midwest Multistate Division Provider Number MO1022-6

Other credit being pursued: Licensed Professional Counselors, Psychologists, and Social Workers with Missouri licenses

Medicare Beneficiary Access to Prescription Drugs in Rural Areas

Date: August 24, 2022

Medicare Beneficiary Access to Prescription Drugs in Rural Areas

Data from the National Council for Prescription Drug Programs from 2016-2017 was used to identify four cohorts of rural counties based on pharmacy availability: counties with no retail pharmacy, counties with an independent pharmacy only, counties with one chain or franchise pharmacy only, and other rural counties with more than one pharmacy. Medicare Part D claims data from 2017 for beneficiaries residing in each of the county cohorts was analyzed to determine the source of their prescription medications.

Key Findings:

  • More Part D beneficiaries residing in rural counties with no retail pharmacy (19.5 percent) used a mail-order pharmacy compared to beneficiaries in rural counties with a pharmacy presence (15.8 – 17.1 percent across the three other cohorts).
  • Part D beneficiaries in rural counties with no retail pharmacy used a higher number of pharmacies overall (1.84 pharmacies) compared to Part D beneficiaries in rural counties with a pharmacy presence (1.68-1.74 pharmacies).
  • Beneficiaries residing in rural counties with no retail pharmacy traveled an average of 28.5 miles to use a community pharmacy compared to an average range of 6.5 – 13.1 miles for beneficiaries residing in rural counties with some type of pharmacy presence.

Contact Information:

Keith J. Mueller, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.3832
keith-mueller@uiowa.edu

Additional Resources of Interest: