June 14, 2018
Atlas of Rural and Small-Town America. The Economic Research Service at the U.S. Department of Agriculture has updated its atlas of rural areas with the most recent data available from the Census Bureau and the Bureau of Labor Statistics on a number of socio-economic factors for the people who live in small towns. The interactive map provides a pop-up window for each county with information on demographics, rural-urban classification, income, employment trends and status of veterans. The 2018 County Health Rankings makes a direct correlation between these socio-economic indicators and health outcomes.
Rural Health Research
Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals. This brief just posted on the Rural Health Research Gateway reports on substantial differences in uncompensated care as a percent of operating expense between rural and urban hospitals and among regions of the country. Researchers at the North Carolina Rural Health Research and Policy Analysis Center examined 2014-2016 Medicare Cost Reports and found that median uncompensated care costs declined across hospitals and Census regions. However, the costs increased for hospitals with less than $20 million in net patient revenue. In 2016, the hospitals with the highest median uncompensated care as a percentage of operating expense were Critical Access Hospitals, other rural hospitals, and urban hospitals in the South.
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Policy Updates for Rural Health
Comments Requested: Rural Health Workgroup for Quality Measurement – July 2. The Federal Office of Rural Health Policy has been partnering with Centers for Medicare and Medicaid Services (CMS) and the National Quality Forum (NQF) on the Measures Application Partnership (MAP) Rural Health Workgroup. The group was formed by CMS in 2017 to include the perspectives of rural providers and patients as those most knowledgeable about the challenges in rural areas to measuring performance in health care delivery. The workgroup has developed recommendations and identified a core set of the best available (i.e., “rural relevant”) measures and identified rural-relevant gaps in measurement in the MAP Rural Health Draft Report 2 (pdf). Those wishing to comment on these recommendations can create an NQF account and submit online.
Comments Requested: Increasing Investment in the Healthcare Sector – July 7. The U.S. Department of Health & Human Services (HHS or the Department) seeks comment from the public on an effort to increase private sector innovation and investment in health care. Specifically, the Department seeks input on the structure of a workgroup formed to increase dialogue and engagement between HHS and “those focused on innovating and investing in the healthcare industry, such as healthcare innovation-focused companies, healthcare startup incubators and accelerators, healthcare investment professionals, healthcare-focused private equity firms, healthcare-focused venture capital firms, and lenders to healthcare investors and innovators.” The request pertains only to the way such a workgroup may be convened and structured and seeks other ideas for ongoing public-private engagement. Rural stakeholders may have something to contribute to specific areas of focus and inquiry for the workgroup, including perceived barriers to innovation and competition in the healthcare industry and the effect of HHS programs and regulations on rural areas.