NRHA members attend Senate Democratic Steering Committee Rural Summit

The Senate Democratic Steering and Outreach Committee will hold a Fostering the Next Generation of Rural America hearing Wednesday, June 29. The Committee facilitates an ongoing conversation between Senate Democrats and the public.

NRHA members Tim Putnam, President and CEO, and Nikki King, Administrative Fellow at the Margaret Mary Health, Batesville, Indiana will be sharing their personal stories about the economic challenges and solutions for rural America’s health care system.

NRHA is pleased that rural health care and our NRHA members will have a voice during this important hearing. Senator Klobuchar, Reid, Durbin, Schumer, Donnelly, Manchin and Shaheen will be among those in attendance.

NRHA applauds Senate Appropriations Committee for rural funding

The National Rural Health Association applauds the Senate Appropriations Committee for recognizing the importance of a strong investment in rural health delivery for fiscal year 2017.

NRHA thanks Chairman Cochran, Vice Chairwoman Mikulski, and the Committee members for the increase of funding for the Rural Outreach and Network Grants and Telehealth, both important programs for rural America. NRHA also applauds the Committee for the strong funding for the Rural Hospital Flexibility Grants which are used by each state to implement new technologies, strategies and plans in Critical Access Hospitals (CAHs). CAHs provide essential services to a community and their continued viability is critical for access to care and the health of the rural economy.

NRHA also thanks the Committee for recognizing the importance of Graduate Medical Education (GME), and its concern that the current funding for GME does not adequately address the needs of rural communities and the changing demands on the health care system. NRHA applauds the Committee for directing CMS to submit a report to Congress on what steps can be taken to address physician shortages.

Rural health programs assist rural communities in maintaining and building a strong health care delivery system into the future. Most importantly, these programs help increase the capacity of the rural health care delivery system and true safety net providers.

Programs in the rural health safety net increase access to health care, help communities create new health programs for those in need and train the future health professionals that will care for the 62 million rural Americans. With modest investments, these programs evaluate, study and implement quality improvement programs and health information technology systems.

Funding for the rural health safety net is more important than ever as rural Americans are facing a hospital closure crisis. Since 2010, 75 rural hospitals have closed, 10,000 rural jobs have been lost and 1.2 million rural patients have lost access to their nearest hospital. The most recent hospital closed in Georgia on Monday. Even more concerning is that 673 rural hospitals are at risk of closure, meaning sustained Medicare cuts threaten the financial viability of 1 in 3 rural hospitals. The loss of these hospitals would mean 11.7 million patients would lose access to care in their community.

NRHA asks Congress to support strong funding for these important rural health programs.

Rural broadband bill heads to president’s desk

The National Rural Health Association applauds the passage of S. 1916, the Rural Health Care Connectivity Act, which will expand the Universal Service Fund’s (USF) Rural Health Care Program (RHCP) to skilled nursing facilities (SNF).  This program provides funding for telecommunications and broadband services used to provide health care in rural communities. SNFs are an important source of health care for many seniors in rural America, and this bill will help these facilities have access to the broadband and telecommunications services that are so important to providing the care their patients need.

This important legislation sponsored by rural champion Sen. John Thune (R-SD), was included in the Toxic Substances Control Act conference report. The president is expected to sign the conference report.

No resolution yet for “Little Sisters of the Poor”

This morning, the U.S. Supreme Court issued an opinion in Zubik v. Burwell (more commonly known as the “Little Sisters of the Poor” case), the lawsuit challenging the Affordable Care Act birth control coverage requirement for religious, nonprofit employers. Yet, far from establishing a conclusion to the dispute, the case was sent back to the lower court with instructions for the parties to come to a solution that works for everyone. The Court explicitly stated they express “no view on the merits of the cases.”

After the case was argued before the Supreme Court, the justices requested additional information from the parties. Both parties agreed that “contraceptive coverage could be provided to petitioners’ employees, through petitioners’ insurance companies, without any such notice from petitioners.” In other words, if the employer is not required to do anything, they agreed their religious freedom is not infringed.

The process will take more time, and the ultimate agreement is still unknown.

NRHA announces 2016 Rural Health Award recipients

The National Rural Health Association is proud to announce its 2016 Rural Health Award recipients. The following organizations and individuals will be honored May 12 during NRHA’s 39th Annual Rural Health Conference, which will attract more than 800 rural health professionals and students to Minneapolis.

“We’re especially proud of this year’s winners,” said Alan Morgan, NRHA CEO. “They have each already made tremendous strides to advance rural health care, and we’re confident they will continue to help improve the lives of rural Americans.”

And the winners are…

Outstanding Rural Health Program
Disparities Elimination Summer Research Experience, Statesboro, Ga.

Outstanding Rural Health Organization
Richard G. Lugar Center for Rural Health, Terre Haute, Ind.

Rural Health Practitioner of the Year
Dustin Hager, Heart of America Medical Center physician assistant, Rugby, N.D.

Louis Gorin Award for Outstanding Achievement in Rural Health Care
Lynn Barr, National Rural ACO founder, Nevada City, Calif.

Outstanding Researcher Award
Jacob Warren, PhD, Mercer University Center for Rural Health and Health Disparities endowed chair and director, Macon, Ga.

Student Achievement Award
Matt Workman, East Tennessee State University Quillen College of Medicine student, Johnson City, Tenn.

Student Leadership Award
Hallie Foster, University of Toledo College of Medicine and Life Sciences student, Toledo, Ohio

President’s Award
Alana Knudson, PhD, NORC at the University of Chicago program area director and co-director of the Walsh Center for Rural Health Analysis

Volunteer of the Year
Janice Probst, PhD, South Carolina Rural Health Research Center director, Columbia, S.C.

View the press release for more information on the honorees.

NRHA, DentaQuest launch National Rural Oral Health Initiative

NRHA today announced that it will partner with the DentaQuest Foundation for the creation of the National Rural Oral Health Initiative.

The National Rural Oral Health Initiative is the combined effort of NRHA and the DentaQuest Foundation to improve the oral health disparities in rural America through policy, communications, education and research activities. As oral health issues have long impacted those living in rural communities, the activities included in this initiative are designed to enhance access to quality oral health care.

“We want to identify strategies that engage and establish oral health care as part of primary care,” says NRHA CEO Alan Morgan. “The DentaQuest Foundation is the perfect partner for this first-ever national, rural-focused oral health initiative. The DentaQuest Foundation has a longstanding commitment to improving oral health for the rural population through fostering collaborations, raising awareness, and supporting solutions.”’

The national initiative will highlight rural oral health care best practices, enhance research, advance policy, and provide technical assistance for communities in need.

“NRHA looks forward to leveraging our national and grassroots partnerships as we launch the National Rural Oral Health Initiative to bring attention, education and action to address rural oral health disparities,” Morgan said.

The DentaQuest Foundation is the leading U.S. philanthropy focused solely on oral health. The Foundation is supporting the development of the Oral Health 2020 network, a group of partners committed to working collectively at the national, state, and community levels to eradicate dental disease in children and improve lifelong oral health. The DentaQuest Foundation is the philanthropic arm of DentaQuest.

Help NRHA halt rural hospital closures

01.06.16 closures graphLess than a week into 2016, and we already have our first rural hospital closure of the New Year.

Saint Mary’s Hospital in Streator, Ill., a 94-bed rural hospital, closed inpatient and emergency room care on Jan. 4.

The National Rural Health Association urges policy makers to focus on this growing health crisis, which threatens basic access to health care for rural Americans.


According to the Sheps Center for Health Services Research at the University of North Carolina, there were 17 rural hospital closures in 2015 (and a total of 64 since 2010), which clearly demonstrates the growing crisis.

NRHA projects the potential for more than 200 additional rural hospitals to close in the near future without local, state and federal intervention.

Caring for patients in rural facilities is far more economic than providing care in urban settings. In fact, rural patients cost less to treat in eight of the nine Centers for Medicare and Medicaid Services (CMS) regions. Overall, CMS pays approximately $400 less per rural beneficiary than urban beneficiary per year.

Simply stated, when rural hospitals close, rural Americans are forced to travel greater distances to receive more expensive care.

This is the year to take action. NRHA will highlight the growing crisis and release new data on the issue during our 2016 Rural Health Policy Institute Feb. 2-4 in Washington, D.C. Plan now to attend and join us in our fight to save rural hospitals.

NRHA announces new and future leaders

Leadership for the National Rural Health Association is secure for 2016 and beyond, thanks to recent elections for Board of Trustees and Rural Health Congress positions and the selection of candidates for NRHA’s Rural Health Fellows program.

NRHA members chose David Schmitz, MD, as president-elect. Schmitz, Family Medicine Residency of Idaho chief rural officer and director for rural training tracks, will assume the duties of NRHA president in 2017.

“Being entrusted to serve the National Rural Health Association as a future president is a highlight of my career,” Schmitz says. “NRHA allows our voice to be louder and smarter. I am confident we can work together to benefit our members, our organization and most of all we can strive together for better rural health.”

He continues to practice family medicine, including obstetrics, as a medical educator at several Idaho locations.

Members selected Pat Schou to serve as NRHA’s board secretary in 2016 and 2017. Schou is executive director of the Illinois Critical Access Hospital Network.

Elected in 2014, Lisa Kilawee will serve as president in 2016.

NRHA is pleased to announce all individuals elected by their peers to serve in leadership roles.

NRHA is also proud to announce its 10th class of Rural Health Fellows.

After the completion of a competitive review process, 16 fellows were selected to participate in this yearlong, intensive program aimed at developing leaders who can articulate a clear and compelling vision for rural America.

“Once again, this class represents various levels of rural health expertise,” NRHA CEO Alan Morgan said. “With the successes achieved by the previous classes, we look forward to continuing the tradition of building rural health care leaders through this valuable program.”

The 2016 fellows’ first meeting will be during NRHA’s Rural Health Policy Institute Feb. 2-4 in Washington, D.C.

CMS issues final rule on access

CMS just released a final rule for the Methods for Assuring Access to Covered Medicaid Services, finalizing a proposed rule issued in 2011.

The final rule require state Medicaid agencies collect data to demonstrate access to care by examining enrollee needs, the availability of care and providers, and the utilization of services. Beneficiary experiences are to be a primary determinant of whether access is sufficient. While the rule includes guidelines for this review, it demurred on the issue of a core set of measures, indicating no measures received a consensus and were universally applicable. Rate reductions must be supported by a data review and public process, or may be rejected by CMS.

The final rule clearly indicated that the Supreme Court’s decision in Armstrong v. Exceptional Child Center, Inc., (2015), which found that Medicaid statute does not provide a private right of action in federal court to providers to challenge whether a state’s Medicaid program is designed to ensure sufficient provider participation to ensure access to care for beneficiaries, was not anticipated in the original 2011 proposed rule. This ruling indicated CMS is ultimately responsible for enforcing the statutory requirement that state’s Medicaid programs must be structured to ensure sufficient participation by providers to provide access to care for beneficiaries.

CMS made it clear more is to come on this topic, as they are concurrently issuing a request for information (RFI) soliciting feedback on core access measures, thresholds, and appeals processes to ensure access to care for Medicaid beneficiaries.

NRHA is pleased CMS is working to ensure Medicaid programs are structured to ensure access for the vulnerable rural Americans who rely on Medicaid for access to health care and will continue to review the final rule and the RFI to help ensure the rule will improve access to care for Medicaid beneficiaries in rural America.

Get to know NRHA’s 2016 candidates

Two members are vying to be NRHA’s president-elect and two more for NRHA’s Board of Trustees secretary position.

Multiple others are nominated for Board of Trustees and Rural Health Congress positions.

Please review each officer candidate’s nomination submission below in advance of the voting period beginning Nov. 3 for NRHA members.

The president-elect will serve in that role in 2016 and as president in 2017.

Tommy Barnhart for president-electBarnhart 200
“In my 40-plus year health care career I have seen tremendous change but none as dramatic or all-encompassing as we are now experiencing or about to undergo. In my consulting experience, I have been extensively involved with rural providers of all types and would leverage that experience in my NRHA presidency. NRHA is the strongest voice for rural health and needs strong leadership during these changing times.

“NRHA must continue to advocate for sustainable payment systems while new systems are developed, tested and implemented while advocating for sustainable rural workforce and delivery programs.

“The rural delivery system was developed by complex regulatory and payment “silo” provisions that inhibit the development of new high quality patient-centered systems of care that are more cost effective. Through a thoughtful approach we can develop new systems of care and payment.

“I can provide leadership necessary to guide NRHA into the future.”

Dave Schmitz, MD, for president-electSchmitz 200  
“I ask for your vote for NRHA’s president-elect. The Save Rural Hospitals Act is but one example of what we are doing together through NRHA, making a difference for rural health care today and for the future.

“I ask for your vote to allow me to continue serving NRHA by leading our rural health mission at a time of unprecedented importance. NRHA is the one place where our collective experience and expertise can benefit those we are serving.

“Together at NRHA our voice is louder and smarter. As a constituency group chair, leading NRHA issues groups, in policy writing and through our NRHA projects, I am constantly inspired by our organization and our members.

Spanning my time from being an NRHA Rural Health Fellow to being humbled by the 2014 NRHA Volunteer of the Year Award, I have continued to channel my energies and experience toward this next step in NRHA leadership. Thank you for your support.”

Don Kelso for secretaryKelso200
“I am asking for your support by voting for me to be the secretary of the NRHA Board of Trustees.

“I have been blessed to be the executive director of the Indiana Rural Health Association for the past eight years. We have grown our association substantially during that time and continue to find creative and proactive ways to serve the rural population and health care providers in rural Indiana.

“Before this opportunity I worked in administration at two Indiana rural hospitals for 17 years. We have modeled IRHA after NRHA in many ways, and I have personally attended each NRHA Annual Conference and Policy Institute since 2008. I have also had the pleasure of serving on the NRHA Services Corporation board for the past four years.

“I would appreciate your vote to expand my involvement with NRHA.”

Pat Schou for secretarySchou 200
“Rural health has been my passion for many years.  I live and work in a rural community and see firsthand the value and importance of the rural health care system not only for care but for maintaining the local economy.

“I very concerned the impact of today’s changing health care landscape and our struggling economy will have on the long-term viability of rural communities and preserving their access to local care. I believe one of the most significant strategies is for rural to work together to tell our story and speak as a loud voice. NRHA provides that opportunity for rural providers and leaders nationally to advocate as a group and offer ideas and solutions as well as raise tough issues and address disparities.

“I have served on NRHA committees and the Rural Health Congress for several years and have seen the commitment of members to keep rural strong. It would be an honor and privilege to serve as secretary and represent NRHA and its many constituents in our joint effort to help ensure rural health has a better tomorrow.”