Announcements from the Federal Office of Rural Health Policy

October 26, 2017

What’s New

Open Enrollment Runs November 1 – December 15.  For those without health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying health coverage, the period to enroll through Healthcare.gov or your state’s Health Insurance Marketplace begins on Wednesday, November 1st and runs through Friday, December 15th.   Plans acquired in this period begin coverage on January 1, 2018.  People in most states use Healthcare.gov to apply but some states have their own Health Insurance Marketplace.  Those who are already covered by a plan found in the 2017 Marketplace may be automatically re-enrolled for 2018 and should log into their accounts beginning on November 1 to learn their status.

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NRHA and HealthSure Launch National Program

October 25, 2017

NRHA and HealthSure launch national program
Singular focus on rural hospitals goes countrywide

The National Rural Health Association (NRHA) and HealthSure announce the creation of a new risk and insurance management program available to all rural hospitals in America.

Called Rural Hospital Insurance of America (RHIA), the program’s overarching purpose is to ensure rural hospitals, stay safely ahead of the game.

“We have been listening to what our members need,” says Larry Bedell, executive director of NRHA Services. “We’ve done thorough research to get to the bottom of what has been working for rural hospitals. Because of what we’ve been told and what our research shows, we believe HealthSure is the best fit for this program.”

Larry says HealthSure’s singular focus on rural hospitals and the years of success it has achieved regionally makes it ideal for the national stage. “Barry and Brant really know what makes rural hospitals tick. Barry has tremendous insight thanks to his many years of experience as a hospital board member. They have both proven themselves to be valuable partners of the hospitals they serve. Most of all, they have a precise understanding of the amount of risk rural hospitals can safely manage. And, when called upon to do so, they know how to deliver the most effective, economical and appropriate prevention and protection solutions available.”

“Everything we’ve learned during 20 plus years of helping rural hospitals succeed is going into this new program,” says Barry Couch, HealthSure’s CEO and founder. “Because of our deep, practical understanding of the challenges and opportunities ahead for rural hospitals, the risk and insurance management expertise and solutions we deliver are unique.”

Using a carefully designed education and information campaign, NRHA and HealthSure will deliver proven strategies developed from the collective experience, effort, and determination of all program participants.

“Our experience in Texas and beyond proves there is strength in numbers,” Barry says. “With RHIA, the influence and power of participating rural hospitals will be multiplied resulting in more options, greater value, and better service from property and casualty, health, professional, and other insurance solution providers.”

Brant Couch, president of HealthSure, says “With decades of experience acquired by focusing exclusively on rural hospitals, we know what works best for gaining greater control of costs, preventing avoidable risk, tackling the rising cost of health insurance, and protecting rural hospitals today and in the future.”

The RHIA program is offered to all rural and critical access hospitals nationwide (NRHA membership is not required). Its mission is to keep all American rural and critical access hospitals safely ahead of the game. Program members benefit from group buying power, access to innovative, class-leading solutions, and the collective wisdom that comes from decades of dedication to rural hospital success.

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

Questions about Rural Health Policy Updates? Write to ruralpolicy@hrsa.gov

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

Lupus Foundation of America-Heartland Chapter Lupus Awareness Campaign

October 19, 2017

Be Fierce. Take Control. to Raise Awareness of Lupus

While many people have heard of lupus, few know anything about the disease beyond its name. Lupus is a lifelong autoimmune disease that is most common in young women. It can cause inflammation and damage to any part of the body, causing symptoms like joint pain, fatigue, and skin rashes. Because these symptoms are also common for many other medical conditions— and symptoms show up differently for everyone who has lupus—it can take years to receive an accurate diagnosis and begin proper care. During that time, lupus continues to cause irreversible damage to the body.

The American College of Rheumatology (ACR) and the Lupus Foundation of America (LFA) wanted to change that and minimize the impact of lupus on the lives of young women. They’ve teamed up to launch the Be Fierce. Take Control.™ campaign to raise awareness of lupus, its symptoms, and how to take the next step if they are experiencing symptoms. The campaign encourages African American and Latino women, who are 2-3 times more likely to develop lupus, to take control of their health, the way they run the other important areas of their lives, and not ignore it if they haven’t been feeling their best.

The campaign website, befiercetakecontrol.org, houses a number of resources to help women take control of their health:

  • Resources about lupus, its symptoms, and frequently asked questions
  • Could it be Lupus?” interactive questionnaire that willhelp women figure out what to do about their symptoms
  • Symptom tracker for keeping track of symptoms over time
  • Guide for preparing for a health care provider visit

You can help spread the word about Be Fierce. Take Control.™ by sharing the website and using #BeFierceTakeControl on social media. By sharing, you are becoming a vital partner in driving further awareness about this mysterious disease to those who need it most.