RUPRI Health Panel Releases Comments on Rural Emergency Hospital RFI

The Panel is pleased to comment in response to the proposed rule for Medicare hospital outpatient prospective payment system (OPPS) program and the Request for Information (RFI) on Rural Emergency Hospitals (REH). Our comments will focus only on the latter, Section XVII of the proposed rule, Federal Register pages 42285 – 42289. We also limit […]

Pharmacy Vaccination Service Availability in Nonmetropolitan Counties

The RUPRI Center for Rural Health Policy Analysis releases this report on Pharmacy Vaccination Service Availability in Nonmetropolitan Counties. In February 2021 the White House announced the launch of the first phase of the Federal Retail Pharmacy Program for COVID-19 Vaccination. The “public-private partnership with 21 national pharmacy partners and networks of independent pharmacies” is […]

Characteristics & Challenges of Rural Ambulance Agencies. RUPRI Health Panel. January 2021.

The RUPRI Health Panel has released a new brief, Characteristics and Challenges of Rural Ambulance Agencies. Every year, nearly 10 million rural Americans receive EMS care. There are 23,272 ambulance agencies in the U.S. and 73 percent of those agencies report serving rural areas. Thus, rural Americans rely on EMS professionals to deliver life-saving emergency […]

Advancing Population Health in Rural Places: New from RUPRI Health Panel. January 2021.

The RUPRI Health Panel has released a new paper, Advancing Population Health in Rural Places: Key Lessons and Policy Opportunities. This paper advances policy discussion of population health in rural places, focusing on the role of rural health care organizations. Lessons from ongoing programs provide policy considerations. Medicare and Medicaid programs should prioritize staff and […]

Rural Health Value to Hold Webinar on CHART Planning – December 14

In September, the Centers for Medicare & Medicaid Services Innovation Center (CMMI) released the notice of funding opportunity for the Community Health Access and Rural Transformation (CHART) Community Transformation Track. CMMI states that the “CHART Model will test whether aligned financial incentives, increased operational flexibility, and robust technical support promote rural health care providers’ capacity […]

The Evolving Landscape of National Telehealth Policies during a Public Health Emergency: Responsiveness to Rural Needs

The coronavirus pandemic precipitated significant but temporary changes in telehealth policy and the use of telehealth services to ensure access to needed health services during a public health emergency (PHE). Extending the temporary policy changes will require statutory and regulatory action. This paper takes stock of current telehealth policies and assesses options for expanding the […]

Maternal and Obstetric Care Challenges in Rural America: Policy Brief and Recommendations to the Secretary

August 26 @ 2:00 pm – 3:00 pm More than 700 women a year die of complications related to pregnancy in the U.S., and two-thirds of these deaths are preventable. Maternal mortality is disproportionally affecting black and American Indian/Alaska Native women in the U.S. Additionally, there are disparities between rural and urban populations. According to publicly available […]

Webinar: Community Health Access and Rural Transformation (CHART) Model – Overview

August 18, 2020 The Community Health Access and Rural Transformation (CHART) Model team will be hosting an overview webinar on Tuesday, August 18, 2020 from 1:00 – 2:30 PM EDT. Attendees will have the opportunity to hear an overview of the CHART Model, including its objectives, eligible participants and their roles, payment options, and timeline. Participants […]

Considerations for Defining Rural Places in Health Policies and Programs

The RUPRI Health Panel has released a new brief that identifies key questions to ask when creating, modifying, or using a definition. Rural definitions in statute and policy are used to direct resources to underserved peoples. But changes in population behavior and Census processes have led to concern about historic methods of defining rural. This […]

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties

The presence of COVID-19 cases impacts rural and metropolitan areas differently – a small number of cases creates stress for low capacity systems just as a large volume of cases creates stress for larger capacity systems. This RUPRI data brief shows the current nonmetropolitan and metropolitan spread of the disease, and the associated map shows […]

Behavioral Health in Rural America: Challenges and Opportunities

The prevalence of mental health and substance use diagnoses and unmet treatment needs are not equally distributed, with rural residence being one factor associated with these differences. Moreover, the rural context has proven challenging for ensuring the availability of and access to prevention, diagnosis, treatment, and recovery services in rural areas. This paper reviews the […]

Health Panel Comment Letter – Anti-Kickback Statute – December 2019

The Panel is pleased to provide comment on the proposed rule Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements. The Panel is encouraged by OIG’s recognition that there are certain circumstances that warranttreating rural providers differently than those in urban geographies. The Panel offers comments ontwo specific […]

Health Panel Comment Letter – Stark Law – December 2019

The Panel is pleased to provide comments on the proposed rule Modernizing and Clarifying the Physician Self-Referral Regulations.The Panel is encouraged by CMS’s recognition throughout the proposed rule of the unique ruralhealth care environment. The Panel agrees that circumstances exist in which it is appropriate to treatrural providers differently than other kinds of providers. View […]

Health Panel Comment Letter – PFS Proposed Rule 2020 Revisions – September 2019

The Panel is pleased to offer comments in response to the proposed updates to the CY 2020 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) The Panel applauds CMS’s attention to rural issues throughout the proposed rule. CMS hasdemonstrated its commitment to rural areas in considering innovative telehealth care delivery foropioid use disorder […]

New Report from RUPRI Rural Health on Effects of the ACA on Coverage and Access to Care

A new policy brief from the RUPRI Center for Rural Health Policy & Analysis shows that access to health insurance coverage has changed significantly following changes in public and private insurance due to the Patient Protection and Affordable Care Act (PPACA). From 2013-2016, the PPACA led to an overall increase in coverage rates of nearly 13 and […]

Legatum Institute Releases State by State Prosperity Index at American Enterprise Institute

July 18, 2019 @ 3:00 pm – 5:00 pm Prosperity entails much more than wealth; it reaches way beyond the financial and into the well-being and character of a nation and its institutions. It is about creating an environment where citizens can reach their full potential. A nation is prosperous when it has an open economy, an […]

Toward a High Performing Rural Health Care System: Key Issues and Recommendations from Rural Health Care System Innovators. Roundtable with Rural Health Innovators. RUPRI Rural Health Panel. December 2018.

Toward a High Performing Rural Health Care System: Key Issues and Recommendations from Rural Health Care System Innovators View Report On December 6-7, 2018, the Rural Health Policy Research Institute’s (RUPRI) Health Panel convened a meeting in Washington, DC, of rural health leaders from around the country to discuss strategies and models for rural health […]

Health Panel Comment Letter – NQF Draft Report – February 2019

The Panel welcomes the opportunity to submit comments on Addressing the Low Case-Volume Challenge in Healthcare Performance Measurement of Rural Providers: Recommendations from the MAP Rural Health Technical Expert Panel. The RUPRI Health Panel strongly supports the NQF Measure Applications Partnership Rural Health Workgroup. Valid and reliable quality performance measures are critically important to rural […]

Meeting Needs in Rural Health Research, Action, Policy

In this presentation, we discuss the changing landscape of rural Accountable Care Organizations (ACOs), new models of care delivery, and community responses to loss of service. Presented by Keith J. Mueller, PhD (The University of Iowa and Director of RUPRI) to the American Health Association Rural Health Care Leadership Conference on February 5, 2019. View […]

Health Affairs blog Features RUPRI Writing on Affordable Health Insurance Options in Rural Areas

The Health Affairs blog recently featured a piece by Abigail Barker, Timothy McBride & Keith Mueller of the RUPRI Center for Rural Health Policy Analysis, examining whether the health insurance market can deliver affordable health insurance options in rural areas.   Can the Market Deliver Affordable Health Insurance for Rural Areas, discusses the multiple challenges that rural areas […]

Health Panel Comment Letter – Medicare, Medicaid & CHIP – January 2019

RE: 42 CFR Parts 438 and 457 – Medicaid Program; Medicaid and Children’s Health Insurance Plan (CHIP)Managed Care The Panel welcomes the opportunity to submit comments on the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly (PACE), Medicaid Fee-for-Service, and Medicaid Managed Care Programs for years 2020 and 2021 proposed […]

Health Panel Comment Letter – Medicare, Part D & Medicaid – December 2018

RE: 42 CFR Parts 422, 423, 438, and 498: Medicare and Medicaid Programs; Policy and Technical Changes tothe Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-Inclusive Care for the Elderly(PACE), Medicaid Fee-for-Service, and Medicaid Managed Care Programs for Years 2020 and 2021 The Panel welcomes the opportunity to submit comments on the Medicare Advantage, […]

Assessing the Unintended Consequences of Health Policy on Rural Populations and Places

The RUPRI Rural Health Panel, through the support of the Federal Office of Rural Health Policy (FORHP) in the Department of Health and Human Services, has released a new Policy Brief, Assessing the Unintended Consequences of Health Policy on Rural Populations and Places. The purpose of this paper is to illuminate the unintended consequences of health […]

David Terrell, Executive Director of RUPRI Center for State Policy, spoke at Harvard Conference on Rural America, Video Recording Now Available

David Terrell, Executive Director of the RUPRI Center for State Policy and the Indiana Communities Institute spoke at a Harvard T. H. Chan School of Public Health conference on Rural America, co-sponsored by the Robert Wood Johnson Foundation and National Public Radio.  David joined other speakers to discuss the Health and Economic Concerns of Rural […]

RUPRI Research on Rural Pharmacy Closures featured in US New & World Report

Ongoing research on rural pharmacy closures by the RUPRI Center for Rural Health Policy Analysis was featured in a US News & World Report article, Rural Pharmacies and Closing: Where Does That Leave Patients. “IN RURAL AND SMALL-TOWN America, independent pharmacies play a vital role for the customers who rely on them. However, U.S. rural pharmacies are dwindling. Since […]

Health Panel Comment Letter – ACO Proposed Rule – October 2018

RE: 42 CFR Part 414 and 425: Medicare Program; Medicare Shared Savings Program; Accountable CareOrganizations – Pathways to Success The Panel is pleased to offer comments in response to this particular proposed rule. Our comments are limited to rural-specific issues and are structured to parallel questions posed, or issues stated, by CMS (not technical comments […]

LIVE Stream 9:00 Central October 9: RUPRI Scholars present Lecture “Details of the Rural Health Framework-A Comprehensive Measure of Economic Well-Being

October 9, 2018 @ 10:00 am – 11:30 am On October 9, RUPRI Scholars, Dr. Tom Johnson & Dr. Matt Fannin, will present a lecture on the “Details of the Rural Health Framework – A Comprehensive Measure of Economic Well-Being” to faculty and students at the University of Iowa’s College of Public Health.

RUPRI’s Rural Health Research Findings included in new GAO Report on Rural Hospital Closures

The United States Government Accountability Office was asked by Members of Congress to examine Rural Hospital Closures and the Number and Characteristics of Affected Hospitals and Contributing Factors. Research and policy considerations from the RUPRI Health Panel, the RUPRI Center for Rural Health Policy Analysis and Rural Health Value, in partnership with Stratis Health, were included in the report. GAO’s analysis […]

Health Panel Comment Letter – Outpatient Payment & Interoperability – Septembe 2018

RE: 42 CFR Part 416 and 419: Medicare Program; Proposed Changes to Hospital Outpatient ProspectivePayment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Requests forInformation on Promoting Interoperability and Electronic Health Care Information, Price Transparency, andLeveraging Authority for the Competitive Acquisition Program for Part B Drugs and Biologicals for a PotentialCMS Innovation Center […]

Webinar – Insuring Rural America: Health Insurance Challenges and Opportunities

September 17, 2018 @ 12:00 pm – 1:00 pm Current U.S. policy utilizes various market-based models within Medicare, Medicaid, and Health Insurance Marketplaces to ensure access to health insurance coverage, but access is increasingly uneven and unaffordable, especially in some rural areas. After giving an overview of some of the relevant economic theory, this webinar will take […]

Insuring Rural America: Health Insurance Challenges and Opportunities

This presentation discusses the economic theory and the potential of regulated markets as well as rural-specific issues such as network information and adequacy. Policy opportunities and recommendations are also touched upon. Presented by Timothy D. McBride (PhD) and Abigail R. Barker (PhD) from the Rural Policy Research Institute on September 17, 2018. View Presentation

HHS National Advisory Committee on Rural Health and Human Services Fall Meeting

September 10, 2018 – September 12, 2018 The Secretary’s National Advisory Committee on Rural Health and Human Services (NACRHHS) has scheduled a public meeting for September 10-12. The meeting will be held in CHarlotte, NC, along with site visits to rural North Carolina. Information about NACRHHS and the agenda for this meeting can be found on the NACRHHS website. During the […]

Health Panel Comment Letter – Revisions to Physician Payments – September 2018

RE: 42 CFR Part 405, 410, 411, 414, 415, and 495: Medicare Program; Revisions to Payment Policies Under thePhysician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings ProgramRequirements; Quality Payment Program; and Medicaid Promoting Interoperability Program The Panel is pleased to offer comments in response to the proposed rules […]

Spread of Medicare Accountable Care Organizations in Rural

Accountable care organization (ACO) models are the most widely adopted value-based payment initiatives from the Centers for Medicare & Medicaid Services. The Shared Savings Program, started in 2011, is the most commonly adopted Medicare ACO model. This policy brief updates findings from previous RUPRI Center reports. It shows that there is continued growth in the […]

RUPRI Center for Rural Health Policy Analysis Featured in Washington Post

Research released last month on rural independent pharmacy closures by the RUPRI Center for Rural Health Policy Analysis was highlighted in The Health 202, a morning health care policy newsletter published by the Washington Post. As the newsletter states, “The impact on rural pharmacies’ profits is tangible. The RUPRI report found that 630 rural communities saw their only pharmacy close […]

Primary Care: The Foundation for a High-Performance Rural Health Care System

This paper will review elements of a robust rural primary care system, including development and maintenance of a high performance rural primary care system and workforce as well as policy considerations and opportunities that address the sustainability of rural primary care. Written by Keith J. Mueller (PhD), Charlie Alfero (MA), Andrew F. Coburn (PhD), Jennifer […]

Insuring Rural America: Health Insurance Challenges and Opportunities

This paper discusses the realities and challenges of designing a market structure that will result in affordable health insurance being offered in rural markets, and reviews the rural implications of policies affecting rural health insurance markets and health systems. Written by Keith J. Mueller (PhD), Charlie Alfero (MA), Andrew F. Coburn (PhD), Jennifer P. Lundblad […]

Oral Testimony for the U.S. Senate Committee on Finance

This testimony focuses on three areas of particular relevance, rural experience with Medicare’s accountable care organization and use of Telehealth. It will conclude with general observations about future directions in rural health policy. Spoken by Keith J. Mueller (PhD) (Interim Dean, College of Public Health; Director, RUPRI Center for Rural Health Policy Analysis; Chair, RUPRI […]

Written Statement for the U.S. Senate Finance Committee

This statement focuses on three areas of particular relevance, rural experience with Medicare’s accountable care organization and use of Telehealth. It will conclude with general observations about future directions in rural health policy. Written by Keith J. Mueller (PhD) (Interim Dean, College of Public Health; Director, RUPRI Center for Rural Health Policy Analysis; Chair, RUPRI […]

United States Senate Finance Committee Public Hearing on Rural Health

May 24, 2018 @ 9:00 am – 11:00 am Keith Mueller, Ph.D.,  Interim Dean of the College of Public Health at the University of Iowa and Director and Chair of RUPRI’s Rural Health Initiatives, has been invited to testify at a United States Senate Finance Committee Public Hearing on rural health.  The hearing will be held on […]

Owensboro Gathering a win for Food, Art, and Health in Kentucky!

This week, RUPRI partnered with the Kentucky Arts Council, Owensboro Health, the Kentucky Highlands Investment Corporation, and Art of the Rural to host a statewide conversation in Owensboro, KY about the dynamic intersection of food, art and health. More than seventy-five people travelled to Owensboro to attend the event, which offered participants a broad understanding of […]

Taking Stock: Policy Opportunities for Advancing Rural Health

This paper examines the progress of health system transformation and the gaps that remain as they affect rural people, places, and providers. The health system transformation activities examined here are not limited to the Patient Protection and Affordable Care Act of 2010 (PPACA), but also touch upon activities undertaken by states, insurance plans, and public […]

Health Panel Comment Letter – FCC Promoting Telehealth in Rural America – January 2018

Promoting Telehealth in Rural America 47 CFR Part 54 The Panel is pleased to offer comments in response to the proposed rule for Promoting Telehealth in Rural America, specifically the Federal Communications Commission (FCC) Rural Healthcare (RHC) Program. View Comment Letter