Federal Office of Rural Health Policy Announcements

January 24, 2019

What’s New

CDC: Opioid Prescribing Higher in Rural Areas. In the latest Morbidity and Mortality Weekly Report, researchers for the Centers for Disease Control and Prevention (CDC) analyzed electronic health record data from 2014-2017 and found that patients in the most rural counties had an 87% higher chance of receiving an opioid prescription compared to patients in large metropolitan counties. The report posits higher odds may be attributed to several factors, including higher prevalence of conditions associated with pain and limited access to alternative therapies.

Funding Opportunities

NIH/NIDA: Mobile Technologies for Substance-Use Treatment – Letters of Intent February 19. The National Institutes of Health (NIH) and the National Institute on Drug Abuse (NIDA) seek grant applications from small business concerns (SBCs) to develop and test a prototype mobile/tablet technology-based application that primary care providers (PCPs) may use to deliver timely and tailored feedback to patients following up on interventions for risky substance use. The feedback delivered should make sure patients engage in appropriate self-monitoring and self-management skills in adherence to treatment plans. Last year, a report commissioned by the Appalachian Regional Commission identified mobile technology as one way to overcome barriers to recovery treatment in rural areas. Deadline for application is March 19.

Youth Health Equity Fellowship – February 22. Higher learning students, recent graduates and emerging health professionals with 1-5 years of experience may be eligible to apply for this opportunity offered by the U.S. Department of Health & Human Services (HHS) Office of Minority Health (OMH). The Youth Health Equity Model of Practice was launched by OMH to provide hands on, “in the field” learning opportunities for 10 weeks over the summer through short-term, project-based placements in diverse organizations or institutions that promote health equity and/or addresses health disparities. The goals of the fellowship and its targets align with the HHS strategic plan to eliminate health disparities for minorities as well as rural and underserved communities.

NIH: Small Business Innovations for Health Disparities – Letters of Intent March 1. The National Institutes of Health (NIH) invites small business concerns (SBCs) in the United States to conduct innovative research supporting development of a product, tool, technology, process or service for commercialization with the aim of eliminating disparities in socioeconomically disadvantaged populations, underserved rural populations, and sexual and gender minority populations or improving health in racial/ethnic minority populations. Technologies to address the unique health burdens experienced by health disparity populations in urban and underserved rural areas are of particular interest, including technologies to support healthy eating and active living, access and utilization of important governmental services and new scientific information and technologies that can help improve their quality of life; decrease food insecurity and decrease childhood obesity rates. Deadline for application is April 1.

Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov

Closing Soon: Comments for Reducing Burden Related to Health IT and EHRs – January 28. Per the requirements of the 21^st Century Cures Act of 2016, the U.S. Department of Health and Human Services seeks comment on a draft plan of action to reduce regulatory and administrative burden relating to the use of health information technology (IT) and Electronic Health Records (EHRs). The goals outlined intend to reduce the effort and time to record information in EHRs during care delivery; reduce the effort and time required to meet regulatory reporting requirements; and improve the functionality of EHRs. Stakeholders reported at listening sessions that small and rural hospitals face the highest hurdles in electronic reporting, as they are most resource-challenged. The proposed action plan seeks to minimize those burdens.

Comments Requested: Proposed Changes to the 2020 Health Insurance Marketplace – February 19. Last week, the Centers for Medicare & Medicaid Services (CMS) posted its proposed guidance to states and insurers for the administration of the American Health Benefit Exchanges (aka Marketplaces) in 2020. The proposed Notice of Benefits and Payment Parameters includes several proposals that would impact the cost of prescription drugs; a request for comment on the amount of time Navigator grantees spend providing post-enrollment assistance and the impact of making these services optional; and proposals to expand the roles of web-brokers and enrollment websites other than Healthcare.gov. The draft Annual Letter to Issuers includes application submission dates and requirements for Essential Community Providers (i.e. Rural Health Clinics, Critical Access Hospitals).  In 2018, about 18 percent of HealthCare.gov consumers lived in rural areas.  

Comments Requested: Accrediting Organizations Conflict of Interest and Consulting Services in Medicare – February 19. CMS recently issued a request for information (RFI) seeking public comment regarding the appropriateness of the practices of some Medicare-approved Accrediting Organizations (AOs) to provide fee-based consultative services for Medicare-participating providers and suppliers as part of their business model. This would include AOs that certify and survey rural health clinics (RHCs) and critical access hospitals (CAHs). CMS intends to consider information received in response to this RFI to assist in future rulemaking.

CMS Updates Medicare Advantage Value-Based Insurance Design Model. Last week, CMS announced a broad array of Medicare Advantage (MA) health plan innovations that the CMS Innovation Center will test in the Value-Based Insurance Design (VBID) model for calendar year 2020. Among other updates, beginning in 2020, CMS will allow plans to use access to telehealth services instead of in-person visits to meet a range of network requirements, as long as an in-person option remains. CMS expects that the use of telehealth in this model will provide MA plans with an opportunity to enter into underserved markets, including rural areas where there may be few to no MA plan choices.

CMS Introduces Part D Payment Modernization Model. In January 2020, the CMS Innovation Center will begin the Part D Payment Modernization model to test the impact of a revised Part D program design and incentive alignment on overall Part D prescription drug spending and beneficiary out-of-pocket costs. The model is open to eligible standalone Prescription Drug Plans (PDPs) and Medicare Advantage-Prescription Drug Plans (MA-PDs). Research in 2015 from the University of Minnesota Rural Health Research Center found that urban beneficiaries tended to have access to more plans and lower cost burdens than rural residents. More rural-specific research on Medicare Part D is available from the Rural Health Research Gateway.

Resources, Learning Events and Technical Assistance

National Drugs & Alcohol Facts Week – January 22-27. The National Institute on Drug Abuse (NIDA) created this week specifically to teach kids the difference between myth and facts about substance use. NIDA provides everything educators and communities need to explain science-backed facts, host their own events, and connect through social media. For more resources beyond the week, visit the Rural Health Information Hub for research, topic guides, and promising models for preventing teen substance use in rural communities.

Financing Rural Residency Programs – Monday, January 28 at 1:00 pm ET. This is the second in a two-part learning series on starting a program for graduate medical education (GME) and training for medical practice in rural areas. The hour-long session will review common costs and expenses and identify revenue sources for a sustainable residency program. These sessions are hosted by the Rural Residency Planning and Development Technical Assistance Center at RuralGME.org, which was funded by HRSA to support potential applicants and future grantees of the Rural Residency Planning and Development Program – an opportunity that is open until March 4.

Reducing Pregnancy Risks for Agricultural Producers – Tuesday, February 5 at 1:00 pm ET. The AgriSafe Network hosts this hour-long webinar to identify the risks to pregnancy and fertility that are associated with farm tasks and ways to reduce harm. Research is limited, but it has indicated an association between certain agricultural tasks and adverse health outcomes in women and infants.

Resource of the Week

Rural Philanthropy Toolkit. A new toolkit at the Rural Health Information Hub, developed in collaboration with the NORC Walsh Center for Rural Health Analysis, is designed to help rural organizations create and maintain partnerships with philanthropies. The toolkit provides steps and resources for connecting with philanthropic organizations and examples of emerging strategies in rural communities.