MHA's Center for Rural Health

Rural group thankful key building blocks remain

Officials for the National Rural Health Association, which never took an official stance on the reform law, are glad that certain workforce provisions will survive thanks to the U.S. Supreme Court decision, said Maggie Elehwany, vice president of government affairs and policy for the association. Read more from Modern Healthcare here.

Adolescent Alcohol Use: Do Risk and Protective Factors Explain Rural-Urban Differences?

Rural adolescent alcohol use is a complex social problem. Using data from the 2008-2009 National Survey of Drug Use and Health, this study examines alcohol use among rural and urban adolescents between the ages of 12 and 17.

After controlling for a broad range of key risk and protective factors, it is clear that an unexplained rural effect persists, with rural adolescents still exhibiting higher alcohol use than their urban counterparts. Findings suggest that rural adolescents who start drinking at an earlier age are more likely to engage in problem drinking behavior as they get older, leading to a need for interventions that target pre-teens and younger adolescents.  There are also urban-rural differences in specific protective factors, which may be the most promising for evidence-based, rural-specific prevention strategies targeting parents, schools, and churches.

Value of Rural Hospitals Linked to ED Utilization

Any comparisons of urban and rural healthcare costs come freighted with caveats.

For starters, rural hospitals usually cannot provide the array of specialized and expensive care seen in larger urban hospitals, making per-patient cost comparisons difficult. There can also be stark differences in patient populations. And rural hospitals do not enjoy the economy of scale and leverage with vendors and insurance companies that are seen in larger urban hospitals. Critical access hospitals get higher reimbursements from the federal government for care delivery, further muddying comparisons.

Still, there is a nagging perception out there that the 1,700 or so management teams at rural hospitals across the nation don't provide the same level of care delivery value as urban hospitals.

A study by Portland, ME-based consultants iVantage Health Analytics challenges that perception. Read more from HealthLeaders Media here.

Patients in Rural Areas Benefit From Telemedicine, Study Finds

As our country ages (and grows ever bigger), diabetes and other endocrine disorders, like thyroid disease and osteoporosis, are rising, particularly in rural areas. But virtual examining rooms may just be the answer for people with chronic diseases living far from doctors and hospitals.

Read more from HealthTech Zone here.

AHA urges support for rural extenders legislation

The American Hospital Association on June 13 urged members of Congress to support the extension of expiring Medicare programs critical to small and rural hospitals. In letters to every member of the House and Senate, AHA expressed support for the R-HoPE Act (H.R.3859/S.1680), which would extend several of these critical provisions, including the outpatient hold harmless payments and direct billing for the technical component of pathology services.

In addition, AHA urged support for the Rural Hospital Access Act (H.R.5943/S.2620), which would extend the Medicare-dependent hospital program and enhanced Medicare low-volume adjustment until September 30, 2013.

“Hospitals strive to provide their communities with quality care every day, and they face tough challenges to ensure patients continue to have timely access to essential services,” AHA said. “However, it is often difficult to plan for community and patient needs when there is uncertainty over whether a program will continue.”

House companion to rural hospital bill introduced

At the urging of the American Hospital Association, Reps. Tom Reed (R-NY) and Peter Welch (D-VT) on June  8 introduced a House companion to the Rural Hospital Access Act, legislation that would reauthorize the Medicare-Dependent Hospital program and extend the enhanced low-volume Medicare adjustment for prospective payment system hospitals for one year (through September 2013). The House bill also calls for the Government Accountability Office to study the impact of the add-on payments.

Rural hospitals are more dependent on Medicare revenue and financially vulnerable to prospective payment because of the high percentage of Medicare beneficiaries who live in rural areas. To reduce this risk, the MDH program pays 211 eligible hospitals for inpatient services the sum of their prospective payment system rate plus three-quarters of the amount by which their cost per discharge exceeds the PPS rate.

The AHA expressed support for the legislation in a letter to Reed and Welch.