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Announcements from the Federal Office of Rural Health Policy

April 19, 2018

What’s New

Experts Meet to Discuss Rural Health.  The National Advisory Committee on Rural Health & Human Services convenes this week for its first meeting of 2018.  This panel of experts from both public and private sectors will conduct site visits and hold discussions on two subjects: the challenges to rural health insurance markets and the impact of adverse childhood experiences.  Policy briefs, with recommendations to the Secretary of Health & Human Services, typically come out about three months after each meeting.  See the events section below for a webinar discussion of the committee’s December 2017 brief on suicide in rural America.

Medicaid Spending on Overdose Treatment.  Policy researchers at the Urban Institute looked at state-by-state Medicaid spending on prescription drugs for opioid use disorder.  They found that the average annual spending increase on these drugs between 2011 and 2016 was 19 percent.  Most was spent on buprenorphine, a drug that reduces cravings, for which spending increased 98 percent in that time period.  More dramatic spending increases went to naltrexone, which blocks the effects of opioids (up 1,072 percent) and naloxone, a drug that reverses overdose effects, for which spending increased 90,205 percent in that five-year period.  The report includes spending tables for each state and comparison charts for states with the five highest drug overdose mortality rates, including the mostly rural states of West Virginia, Kentucky, and Ohio.

Burden of Disease Among US States.  New research published in the Journal of the American Medical Association examined state-level data on factors affecting health, life expectancy and mortality and found that, while overall death rates declined between 1990 and 2016, the likelihood of dying young increased in some states.  The primary risk factors for morbidity and mortality were those most common in rural areas – poor diet, smoking, high blood pressure and obesity.  One significant change was found in the metrics for disability-adjusted life years, or DALYs, defined by the World Health Organization as years of healthy life lost due to disease or disability.  The two leading causes of DALYs for 1990 and for 2016 were ischemic heart disease and lung cancer. The third leading DALY cause in 1990 was low back pain; in 2016, it was chronic obstructive pulmonary disease, something that’s more common in states with large rural areas.

Rural Health  Research

Measuring Swing Bed Quality at CAHs. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) mandates CMS develop standardized quality measures to enable comparison of post-acute care services in nursing facilities, inpatient rehabilitation facilities, long-term care hospitals, and home health agencies.  These measures under development include topics such as functional abilities, discharge to community, and potentially preventable return trips to the hospital.  Swing-bed providers at Critical Access Hospitals (CAHs) also provide post-acute care services but have been largely omitted from the IMPACT Act provisions.  In this policy brief from the University of Minnesota Rural Health Research Center researchers find that CAHs are beginning to assess the quality of care provided to swing-bed patients with measures very similar to those being developed under the IMPACT Act.  Adoption of a common set of quality measures across all post-acute care settings could help rural beneficiaries and their families make care decisions based on information reflecting all their provider choices.

Policy Updates

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

CMS Releases 2018 MIPS Eligibility Tool. You can now use the updated CMS MIPS Participation Lookup Tool to check on your 2018 eligibility for the Merit-based Incentive Payment System (MIPS). Rural providers can enter their National Provider Identifier (NPI) to find out whether they’re re required to participate during the 2018 performance year.

Resources, Learning Events and Technical Assistance

Application Assistance for USDA Telemedicine Grants – Thursday, April 19 at 10:00 am.  The US Department of Agriculture will host this 90-minute webinar for its Distance Learning and Telemedicine Grant Program (DLT) that helps rural communities with health-related telecommunications.  A second webinar will be held on Wednesday, April 25th.

Serving Racial and Ethnic Minority Populations – Thursday, April 19 at 2:00 pm ET.  The HHS Office of Minority Health hosts this webinar to describe benefits of National Culturally and Linguistically Appropriate Services standards to advance health equity. Recent research shows that rural areas are becoming more diverse, and that racial and ethnic minorities fare worse in health outcomes.

Assistance with USDA Grants for Opioid Crisis in Rural – Monday, April 23 at 3:30 pm ET.  The US Department of Agriculture (USDA) is reserving $5 million in the Community Facilities Grant Program and giving priority to Distance Learning and Telemedicine Grant (DLT) Program applications proposing innovative projects to address the opioid epidemic in rural communities. This hour-long webinar will help inform participants about the major eligibility and regulatory requirements of the programs and provide further details on the process.

Impact of Suicide in Rural America – Tuesday, April 24 at 2:00 pm ET.  Following its Fall 2017 meeting, the National Advisory Committee on Rural Health and Human Services (NACRHHS) sent a policy brief to the Secretary of HHS with a set of recommendations for addressing the issue. In this hour-long webinar, national suicide trends, federal efforts, and the Committee’s recommendations will be discussed.

OMH: Strategies for Opioids in Minority Communities – Wednesday, April 25th at 10:00 am ET.  The CMS Office of Minority Health (OMH) will partner with the Substance Abuse and Mental Health Services Administration to talk about challenges and solutions around opioid use and behavioral health, specifically those that uniquely affect minority communities.  Attendees will receive updates of strategies and solutions for prevention, diagnosis, intervention, treatment/recovery and access to behavioral health services.  Model programs and lessons learned on successful projects to combat the opioid epidemic will be highlighted as well as information on the latest resources available to support behavioral health.   Please select the livestream/online registration option when registering if you would like to view the forum online. If viewing online, you can submit your questions for the panelists by sending them to questions@hhs.tv.

CMS: Transitioning to Advanced APMs – April 30 at 12:00 pm ET. Subject matter experts from CMS will review the Merit-based Incentive Payment System (MIPS) Alternative Payment Model (APM) and answer questions on the final rule for 2018.  Rural providers participating in the Quality Payment Program, especially those participating through MIPS APMS such as Medicare Accountable Care Organization Track 1, could learn about information and resources for transitioning to advanced APMs.

CMS: Quality Payment Program, Year 2 – May 1 from 12-1:30 ET.  Rural providers participating in the Quality Payment Program can get an overview of Program Year 2 at this 90-minute webinar hosted by the Philadelphia Regional Office of the Centers for Medicare & Medicaid Services.

California Telehealth Resource Center (TRC) Regional Conference – May 16-18. Topics covered at this two-day conference include: federal and state telehealth policy, mobile health, school-based telehealth, project ECHO for pain management and opioid addiction treatment, telehealth and EHR integration, and direct-to-consumer strategies. Clinician champions, coordinators, C-suite leadership, and IT professionals will among the 300 attendees at this regional conference hosted by the California TRC, one of twelve HRSA-funded Telehealth Resource Centers throughout the country.

National Rural Institute on Alcohol and Drug Abuse – June 10-14.  Registration is now open for this annual conference in Menomonie, Wisconsin.  The four-day agenda includes keynote presentations and meeting sessions on substance abuse treatment from a rural perspective.

Approaching Deadlines

National Health Service Corps Loan Repayment Program – April 23
Comments Requested: Changes to Short-Term, Limited Duration Health Insurance – April 23
Tribal-Researcher Capacity Building Grants – April 23
Submit Abstracts for National HIV Conference – April 30
Nominations: Advisory Council for Antibiotic-Resistant Bacteria – April 30
Grants and Loans for Renewable Energy in Rural America – April 30
Highway Safety in Indian Country – May 1
Johns Hopkins Center for American Indian Health Scholarship – May 1
Funding to Improve Quality Payment Program Measures  – May 2
Department of Labor Re-entry Projects – May 4
Funding for Inclusive Transit Systems – May 4
NHSC State Loan Repayment Program – May 7
National Health Service Corps Scholarships – May 10
USDA Community Connect Grants – May 14
CDC Funding for Opioid Overdose Prevention Research – May 15
Nominations for the U.S. Preventive Services Task Force (USPSTF) – May 15
Comments Requested: CMS Proposal Reducing State Medicaid Reporting Burden – May 22
USDA Rural Health and Safety Education Grants – May 24
Grants for Family Planning – May 24
AHRQ Research Demonstration and Dissemination Grant – May 26
HCOP Funding for Health Professions Schools – May 29
Nominations: Advisory Committee on HIV, Viral Hepatitis and STD Prevention – May 30
Save the Date: Rural Cancer Control Research Meeting – May 30-31
Funding for Patient-Involved Research – June 1
Grants for Distance Learning and Telemedicine Programs – June 4
CDC Funding for Diabetes, Heart Disease, and Stroke – June 11
CDC Health Promotion Research Centers – June 25
CMS Annual Call for Medicare EHR Incentive Program Measures  – June 29
Rural Health Care Telecommunications Program – June 29
Guaranteed Loans for Rural Rental Housing – Ongoing through 2021
Telecommunications Infrastructure Loans – Ongoing
Funding for Rural Water and Waste Disposal Projects –  Ongoing
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