The National Rural Health Association joined 34 other organizations and entities in sending a letter to Federal Communications Commission (FCC) Chairman Thomas Wheeler urging the FCC to move forward as quickly as possible to implement a Connect America Fund (CAF) mechanism for small, rural, rate-of-return-regulated carriers that will provide sufficient and predictable support for broadband-capable networks across rural America.
Read the full letter here.
John Cougar Mellencamp sang in his 1985 hit song Small Town, “I was born in a small town… probably die in a small town.”
Unfortunately for John, it also appears that he will probably die sooner in a small town.
A study published last month in the American Journal of Preventative Medicine by Dr. Gopal Singh examines the trends in life expectancy disparities between rural and urban areas in the United States between 1969 and 2009. The article finds that the disparity has increased since 1990, because life expectancy has grown more rapidly in urban than in rural areas.
“Between 1969 and 2009, residents in metropolitan areas experienced larger gains in life expectancy than those in nonmetropolitan areas, contributing to the widening gap,” Singh stated in his conclusion.
According to the research findings, the life expectancy disparity of urban over rural areas stood at 2.4 years in 2005-2009. Furthermore, the findings indicate that mortality from cardiovascular diseases, injuries, lung cancer and COPD is much higher in rural than in urban areas. For more data on this, visit NRHA’s “What’s Different About Rural Health.”
“The rural poor and rural blacks currently experience survival probabilities that urban rich and urban whites enjoyed four decades earlier,” according to the report’s conclusion. Four decades. Another way of saying this is that advances in public health and preventative care are not reaching rural communities.
Life expectancy estimates are routinely available for gender, racial/ethnic and socioeconomic groups. However, few articles have looked at how disparities in life expectancy have changed over time. Zip codes should never be a predictor of life expectancy. And this recent study points to a disturbing trend that certainly merits more research and a closer look at national policies that are leading toward longer, healthier lives in cities over small towns.
President Obama’s budget proposal, released earlier this morning, continues to be a source of concern for many rural health providers. While the non-binding budget proposal is unlikely to be adopted by Congress, the President again proposes cuts to the Critical Access Hospital (CAH) system and other members of the rural health safety net. As in years past, the President’s proposal suggests cutting all CAH reimbursement from 101% of cost to 100% while completely excluding current CAHs that are within 10 miles of another health care facility, regardless of the care that other facility offers or who it is intended to serve. Additionally, the budget proposal calls for additional cuts to bad debt reimbursement for all providers. Even discretionary programs designed to help CAHs are being cut; the Rural Health Flexibility Grant line is cut by 15 million dollars.
The President’s proposal is not all bad, though. As part of an effort to expand access to primary care providers, the President has proposed a significant investment in the National Health Service Corps (NHSC). In addition to nearly 310 million dollars in mandatory funding for the NHSC enacted as part of the Affordable Care Act (ACA), the budget asks for an additional 100 million dollars in FY 2015 to train more primary care providers to serve newly insured populations throughout rural America. Similarly, the Teaching Health Center program would continue to receive significant funding, as mandated by the ACA.
While NRHA is appreciative of this funding, a number of other programs are targeted for cuts in the President’s budget. Area Health Education Centers would see their federal funding completely eliminated. A grant program designed to help rural communities acquire emergency medical devices would also be left without funds. Taken in concert with the cuts proposed to CAHs, these sections of the President’ budget would severely damage the rural health safety net. NRHA will continue our efforts to ensure that these cuts are not enacted while working with the Administration and Congress to adequately train and retain a quality workforce in rural America. If you have any questions, please contact NRHA Government Affairs Staff at (202) 639-0550.
If you work in rural health, the latest article published in NRHA’s Journal of Rural Health isn’t going to surprise you.
But you’re also aware of the misconceptions about cost and quality of care, so it’s great to have research back up what we already know.
“I hope this study helps dispel myths about rural health care,” says NRHA CEO Alan Morgan. “Quality health care can be found in rural towns all across America. Rural primary care often faces significant challenges with equal or better patient outcomes. It’s time to start looking at what’s done right in rural.”
A survey of 2,000 rural and urban family practitioners indicated that while rural communities may have fewer training options, rural primary care physicians are significantly more likely to participate in quality improvement activities.
The study also found that rural doctors were more likely to agree that physicians should discuss the costs of care with their patients and to report having added Medicaid or uninsured patients during the preceding year.
“Rural physicians are dedicated to providing high quality care and committed to supporting safety net patients,” said study co-author Anne Kirchhoff, PhD, University of Utah assistant professor of pediatrics. “The Affordable Care Act should help more primary care providers receive payments for care they currently provide without charge. But as the Medicaid expansion is limited to only half the states, many rural providers will still shoulder a disproportionate cost burden compared with urban physicians.”
These findings correlate with other recent research, including a 2013 study which indicates rural health care quality is equal to or better than urban care and the cost per Medicare beneficiary is 3.7 percent less for patients treated in rural areas versus those who seek urban health care.
The peer-reviewed article on the study, supported by a grant from the Columbia University Institute on Medicine as a Profession, is available here.
Congress agreed to extend sequestration on Medicare for an additional year, to 2024, as an offset to restore military cost-of-living adjustments. The bill also allocates $2.3 billion for the next “doc fix.”
The bill passed with a vote of 326-90 in the House Tuesday and 95-3 in the Senate Wednesday. President Obama is expected to sign the bill.
The National Rural Health Association will continue to fight to protect against the disproportionate harm that sequestration has on the rural health safety net. Decreasing Medicare payments to rural hospitals will push many of these health care facilities to the brink of closing their doors.
A unified, authentic rural voice is needed now in Washington D.C. more than ever before.
More than 430 rural advocates were that voice in our nation’s capitol last week as part of the National Rural Health Association’s 25th annual Rural Health Policy Institute. It was our largest ever D.C. event, evidence of the growing concern that rural Americans have about the future of rural health care today.
It’s been 22 years since I worked on the Hill for a member of Congress. But I remember that while it was certainly nice to meet industry lobbyists, I wanted to hear from constituents, real people. Even more importantly, I wanted to hear from various interests, with a common agenda or path forward. That is precisely the perspective and the approach that hundreds of NRHA members took to meeting after meeting on the Hill last week.
Divisiveness spikes television ratings, but it does not result in good policy. Actually, it results in no policy as we have seen far too often. We expect our policy leaders to work together to find common sense solutions for our country. Is it so difficult to believe that our policy makers likewise expect communities to come together to propose common solutions?
It is a powerful message when a rural doctor, a rural nurse and a rural community leader come together to share why critical access hospitals are necessary for the survival of rural America. You would expect to hear that message from NRHA staff and from the hospital CEO, and we make sure policy makers often hear that message. But it is another thing altogether to hear that message from the community itself. It becomes your voice, louder.
As we move forward, I hope you consider adding your voice to NRHA. The 25th annual Policy Institute was a great start to 2014, but a unified voice must be maintained if rural America hopes to maintain health care access for future generations.
The National Rural Health Association, in conjunction with its 25th annual Rural Health Policy Institute, is pleased to announce the winners of its 2014 Legislative Awards, which recognize outstanding leadership in rural health issues by both members of Congress and congressional staff.
This year’s member recipients are Sen. Amy Klobuchar (D-MN), Sen. Jerry Moran (R-KS), Senator John Thune (R-SD), Rep. Lynn Jenkins (R-KS) and Rep. Peter Welch (D-VT).
Staff awards will be presented to Veronica Duron of the Office of Sen. Charles Schumer and Rodney Whitlock of the Office of Sen. Charles Grassley.
“NRHA greatly appreciates the hard work and dedication displayed by this year’s Legislative Award winners,” says Maggie Elehwany, NRHA government affairs and advocacy vice president.
NRHA’s 2014 Policy Institute brought 430 rural health advocates to DC for education and advocacy on Capitol Hill Feb. 4-6. For more information, visit RuralHealthWeb.org/pi.
Representative Adrian Smith (R-NE), who spoke at NRHA’s Rural Health Policy Institute earlier today, has introduced the Critical Access Hospital Relief Act (H.R. 3991). This bill, which is cosponsored by Representatives Lynn Jenkins (R-KS), Greg Walden (R-OR), and David Loebsack (D-IA), would eliminate the current Condition of Payment requirement that physicians at Critical Access Hospitals certify, at the time of admission, that Medicare and Medicaid patients will not be at the facility for more than 96 hours. This important legislation will go far in helping alleviate unnecessary red-tape for Critical Access Hospitals throughout the nation. NRHA commends these rural health champions for their leadership and encourages Congress to act quickly to pass this legislation.
Sen. Heidi Heitkamp (D-ND) received a big round of applause during the National Rural Health Association’s Rural Health Policy Institute today in DC when she said her priorities are “1) rural health care and 2) preventative public health.”
“We don’t do public health in America; we do curative medicine,” she said. “Yes, we need to cure disease, but we really want to prevent disease.”
Heitkamp advised attendees to build relationships “to make sure there’s a core of advocates in the Senate supporting public health in rural communities.”
430 Policy Institute attendees will meet with their legislators on Capitol Hill Wednesday as part of the 25th annual NRHA event.
For more on the nation’s largest rural advocacy event, visit RuralHealthWeb.org/pi.
Mary Wakefield, PhD, Health Resources and Services Administration administrator, used to attend the National Rural Health Association’s Policy Institutes as a participant.
Nowadays, she’s at the podium, still singing NRHA’s praises like she did today on the first day of the 25th annual event in DC.
Wakefield told 430 attendees “I don’t know how they did it, but congratulations to NRHA. They’ve got an incredibly robust agenda lined up for you, and I’m not talking about me; I’m always here.”
She pointed to a recent statistic that rural residents live an average of 2.4 fewer years than urban dwellers.
“This finding speaks to the tremendous importance of what you do and the tremendous importance of us at HRSA and the Office of Rural Health Policy to stay focused on rural so we’re leveraging all our assets to impact the health status of people who live in rural communities,” she told the rural health professionals gathered for the advocacy event.
Wakefield said her goal is to “ensure rural America is a clear focus in virtually every one of our programs at HRSA” and highlighted efforts in telemedicine, behavioral health, early childhood services, workforce, insurance and more.
For more on the nation’s largest rural advocacy event, visit RuralHealthWeb.org/pi.