Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  August 3, 2015

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter available




2015 VRHA Awards

All Virginia Rural Health Association members and member organizations are invited to submit nominations for the 2015 Virginia Rural Health Association Awards.  Nominees are not required to be members of the association.  Commitment and service to the advancement of rural health in Virginia may be in the form of direct provision of health care services, governmental or educational advocacy, activities or research that improves the health of communities or populations.

Awards Categories:

Lawmaker of the Year
Lawmaker of the Year is designed to give special recognition to an elected official at any level who has demonstrated support for improving health in rural Virginia.
The Charles Crowder, Jr. Award
This award is given annually by the Virginia Rural Health Association to recognize outstanding individual commitment and service to the advancement of rural health in Virginia.
The Best Practices in Rural Health Award
This award is given annually by the Virginia Rural Health Association to recognize a program or institution that exemplifies commitment and service to the advancement of rural health in Virginia.
The Ken Studer Friend of the Association Award
This award is given to recognize a program, institution or individual that has advocated for or aided the Association in support of the Association’s mission.

Nomination Deadline: September 4, 2015  Click here to download the nomination form.

Awards Presentation: Honorees will be recognized during the Awards Luncheon on October 13th, 2015 at the VRHA Conference in Staunton, Virginia.

You can also read about past honorees.

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Members in the News

[VRHA member] Virginia Health Workforce Development Authority (VHWDA) is pleased to announce the selection of Ms. Keisha L. Smith as its new executive director, effective July 1, 2015. Ms. Smith comes to VHWDA with years of experience in the private and public sectors.

As executive director of VHWDA, Ms. Smith will lead the Authority’s efforts in utilizing a multi-stakeholder collaborative model to identify, recruit and retain highly qualified health professionals to successfully create and improve a competitive health workforce throughout the Commonwealth.

Read the full press release.

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Virginia News

Tax Credits and the Gap

By Gabriel Morey - Commonwealth Institute

Last month the Supreme Court saved the health care of nearly 286,000 Virginians by upholding the tax credits that help make health insurance affordable in the state's federal marketplace. While this decision is a victory for those signed up for coverage, many Virginians who are eligible have yet to take advantage of the tax credits in the marketplace. It's time to renew enrollment efforts to sign people up for the health coverage they need and deserve.

Only 55 percent of Virginians who qualify for tax credits to help them purchase health insurance through the marketplace have signed up, according to the Kaiser Family Foundation. While that gives Virginia the 14th highest enrollment numbers in the nation, it also means that nearly 235,000 people are still missing out on affordable, high-quality health care. Getting these folks enrolled could mean more money in their pockets and reduced pressure on their families as they struggle to make ends meet. 

This problem exists because of the General Assembly's stubborn refusal to take the commonsense step of accepting billions of federal dollars to close the coverage gap. Lawmakers continue to block this funding despite the fact that this new coverage would free up hundreds of millions of dollars the state currently spends on health care and would  bring health, financial, and economic benefits to a large swath of Virginians.

Read the full commentary and related editorials in the Daily Press, and Washington Post

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Kids Doing Worse

By Dan Heyman & Tommy Hough - Public News Service

Children in Virginia are faring worse, and the state's ranking on key measures of caring for them has fallen, according to the latest Annie E. Casey Foundation KIDS COUNT report. The annual survey found about 40,000 more Virginia children are living below the federal poverty line now than at the lowest ebb of the Great Recession.

Ted Groves, KIDS COUNT director with Voices for Virginia's Children, says one-third of families in the commonwealth are in poverty or near poverty, and too many have been left behind by the selective economic recovery.

He says one simple thing the state could do is expand Medicaid under the Affordable Care Act. The Commonwealth Institute estimates about 200,000 Virginians now fall into what's known as a "coverage gap." Groves says those families could get much better healthcare access with expansion, which would help their children.

Read the full article.

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Stream Protection

By Dan Heyman - Public News Service

The Office of Surface Mining's (OSM) new stream protection rule shows federal regulators bending too much to the coal industry, according to community and health advocates. Many are still digesting the complex regulation OSM proposed last week.

The coal industry's political allies are already attacking it in Congress, saying it would make mountaintop removal mining unprofitable in Virginia and neighboring states. But Michael Hendryx, a public health professor at Indiana University, says the new rule is weaker than what it replaces. He says it would allow such serious health impacts as birth defects and cancer to continue.

Read the full article and a related editorial from Daily Yonder.

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National News

Save Rural Hospitals Act

Fifty-five rural hospitals have closed since 2010, and 283 more are on the brink of closure, risking access to much-needed health care for more than 700,000 Americans.

That’s why the National Rural Health Association advanced the Save Rural Hospitals Act, introduced today by U.S Reps. Sam Graves (R-Mo.) and Dave Loebsack (D-Iowa).

The bipartisan bill will stabilize and strengthen rural hospitals by:

  • Stopping the many cuts in Medicare that rural hospitals have endured for years,
  • Providing rural hospitals with new funding so they can provide quality primary care to rural patients across the nation, and
  • Creating a path forward for struggling rural hospitals by allowing them to provide care that makes sense in their communities and receive fair reimbursement for emergency room and primary care.

Ask your representatives to co-sponsor NRHA’s Save Rural Hospitals Act today to ensure the future of rural America.

And join NRHA’s continued campaign to #‎SaveRural‬ hospitals, patients and communities.


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Rural ACO Rules

By Beth Kutscher - Modern Healthcare

The CMS is making it easier for rural healthcare providers and small physician groups to participate in Medicare accountable care organizations.

The changes are being made to the ACO Investment Model, which provides loans to rural and underserved communities that would otherwise lack the capital to participate in the ACO program. The funds help providers set up the health information technology or data and analytics that they'll need to track and manage the health of their populations. A total of $114 million is expected to be awarded to about 75 ACOs to make these upfront investments.

The two modifications to the initiative will allow ACOs already participating in the 2015 Medicare Shared Savings Program to apply in the next application round. And they remove the restriction that requires rural ACOs to have 10,000 or fewer assigned beneficiaries.

Read the full article.

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Why Rural Hospitals Are Closing

By Wayne Myers - Daily Yonder

Rural hospital leaders are quick to blame Medicaid, Medicare, and federal regulations for their financial crisis. But the biggest reason so many rural hospitals are in danger of closing is because they don’t have enough patients. And under the current system of government reimbursements, patient stays are what pay the bills.

Since these hospital admissions are the primary mechanism through which hospitals get paid by Medicare and Medicaid, the lack of patients is creating big economic problems. That threatens all the other critical services hospitals provide that aren’t about inpatient care: emergency rooms, ambulance service, telemedicine, and skilled nursing.

Read the full article.

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Rural Publications

Colonoscopy in rural communities: a systematic review of the frequency and quality
Can rural generalists safely and effectively perform colonoscopy? This international review yielded information on specialty types and quality in rural colonoscopy providers.

Dentist Supply, Dental Care Utilization, and Oral Health
Do adults in rural locations report lower dental care utilization or higher prevalence of dental disease or both compared with their urban counterparts? This analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) shows that residents of non-metropolitan counties were significantly less likely than residents of metropolitan counties to report having a dental visit or teeth cleaning in the past year and significantly more likely to report undergoing tooth extraction. These findings persisted even when controlling for demographic factors, income, insurance and health and smoking status. Policies aimed at increasing the supply of generalist dentists who will choose to work in rural areas may reduce these substantial rural/urban disparities in access to oral health care and dental outcomes. 

Factors Affecting Former Residents' Returning to Rural Communities
Persistent population loss is a challenge for many rural communities in the United States, especially those in more remote counties lacking scenic amenities. Young people often leave such communities to obtain an education, find a job, join the military, build personal relationships, or otherwise gain life experiences in a different locale. However, reducing rural population loss and spurring economic development may depend less on retaining young adults after they graduate from high school and more on attracting them back later in life. Return migration plays a largely overlooked role in replenishing population numbers while raising education levels and labor supply, and increasing the social vitality of thousands of rural communities nationwide.

Rural Women Delivering Babies in Non-Local Hospitals
This policy brief describes the extent to which rural pregnant women give birth in non-local hospitals, and to analyze current patterns of non-local delivery by rural women's health insurance status and residential rurality.

Care Coordination in Rural Communities
Care coordination has emerged as a key strategy under new health care payment and delivery system models that aspire to achieve Triple Aim objectives—better patient care, improved population health, and lower per capita cost. Achieving these objectives requires conceptualizing and planning care delivery in a new way that not only involves coordinating medical care, but helping people get the care and the support services they need to address the “upstream” social determinants of health. In rural places, these are especially important considerations. While care coordination models vary, all include multidisciplinary teams and networks, a person-centered focus, and timely access to and exchange of information. The purpose of this paper is to examine care coordination programs and processes that affect rural people and places to discover what is happening now in rural communities, how different programs and approaches are working, who benefits, and make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.

Impact of the Northern Studies Stream and Rehabilitation Studies programs on recruitment and retention to rural and remote practice: 2002-2010
A new generation of health professionals is being produced and care gaps still exist in rural and remote areas. Is this new generation still influenced by origin, training factors and practice support?

Rural Enrollment in Health Insurance Marketplaces
This brief provides analysis of Health Insurance Marketplace enrollment outcomes for 2015 at the rating area and county levels. Enrollment rates are reported by number of firms participating and for multiple geographic categories: population density, Census region, and metropolitan status of the county. Rural rates are similar to urban rates in many places, but areas of concern exist and may benefit from additional outreach in the future. 

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Mark Your Calendar

For more information about these and other events, visit the VRHA Calendar

August 5: Reducing Hospital Readmission Rates - webinar
August 24-27: Arthritis, AgrAbility, and Rural Health Conference - Knoxville, TN
August 25: Reimbursement 101 for Rural Health Care - webinar
September 8-10: National Rural Assembly - Washington, DC
September 29-30: Rural Health Clinic Conference - Kansas City, MO
September 30-October 2: Critical Access Hospital Conference - Kansas City, MO
October 13-14: VRHA Annual Conference - Staunton
October 15: REVIVE! Training of Trainers - Staunton
December 3: TCI Policy Summit

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Medicaid at 50: Its Impact in Your State
State-by-state data on how Medicaid improves access to health care for millions of families and individuals.

Year Two of the ACA Coverage Expansions
This brief provides insight into these questions through an on-the-ground view of ACA implementation in five states (including Virginia) that identifies areas of progress as well as issues to be addressed.

The Health and Well-Being of Children in Rural Areas
Chartbook based on data from the latest round of the National Survey of Children's Health, explores the health and well-being of children, the supportive and risk factors in the family environment, and aspects of the neighborhood that may support or threaten families and children on the national level within the subpopulations who are at particular risk.

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Funding Opportunities

For funding opportunities without a specific deadline, please visit the VRHA Resources page

Strategies to Increase Delivery of Guideline-Based Care to Populations with Health Disparities (R01)
Due: October 21, 2015
NIH awards funding for innovative, multi-level studies to test systems, infrastructures, and strategies that will accelerate the adoption of guideline-based recommendations into clinical care relevant to heart, lung, blood diseases, and sleep disorders. Vulnerable populations include medically underserved individuals, racial and ethnic minorities, low income groups, and rural-dwelling patients. Practice settings could include Federally Qualified Health Centers.

Wrigley Company Foundation Community Service Grants
Due: Oct 1, 2015
Award ceiling: $5,000
The ADHA Institute for Oral Health / Wrigley Company Foundation are pleased to offer the members of the American Dental Hygienists' Association (ADHA) the opportunity to apply for community service grants leading up to National Dental Hygiene Month”.

Accelerating Community-Centered Approaches in Health
Applications accepted on an ongoing basis.
Funding amount varies.
The Kresge Foundation offers “Accelerating Community-Centered Approaches in Health” to support innovative population health programs and policies that work to improve health at the community level, including the use of new financial models to achieve cost effective solutions. 

Developing Healthy Places
Applications accepted on an ongoing basis.
Funding amount varies.
The Kresge Foundations provides funding to improve the places that shape health, including programs that promote healthy housing and neighborhoods. 

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