VRHA Weekly Update
In this Issue  June 19, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


June Newsletter





Call for Posters - CASH PRIZES! 

VRHA is now accepting applications for Poster Presentations from health and public policy students at the Virginia Rural Providers conference. A maximum of 15 applications will be approved for display and presentation.


  • First Place: $500
  • Second Place: $250
  • Third Place: $100

Posters will be on display and judged during the reception October 25th from 5:30-6:30.   

For details, click the conference logo to the right and visit the "Poster Presentations" tab on the conference webpage. 

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Members in the News

From the Edward Via College of Osteopathic Medicine

On Saturday, May 6, 2017, [VRHA member] Edward Via College of Osteopathic Medicine (VCOM) – Virginia campus, graduated 189 new doctors of osteopathic medicine. The commencement ceremony was held in a packed Burruss Hall auditorium at Virginia Tech.

Dr. Barbara Ross-Lee, the first African-American woman to serve as dean of a United States medical school, gave the commencement address, which focused on important lessons for the students to take with them as they begin their careers as doctors. She told them to be good, wise, proud, and to be visionaries because “Status-quo is the formula for mediocrity.”

VCOM-Virginia could not be more proud of the class of 2017 and is excited to now be 1,829 alumni strong. Many students from this class chose primary care as their specialty and will continue to serve the communities where they are needed most.

Read the full article.

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More Members in the News

From the Rappahannock Record

Over the past year, Bon Secours Rappahannock General Hospital has implemented several strategies to increase efficiency, reduce costs and overall, be more conscientious regarding environmental impact. This has been done through the work of the Green Team, a volunteer group of 13 staff members from various departments of the hospital who meet monthly with the mission of finding new ways to make the facility more environmentally friendly.

Read the full article.

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Virginia News

AHCA Bad for Rural

By Chad Stewart - Commonwealth Institute

Virginians who live in rural areas are likely to be particularly hard hit if repeal and replacement of the Affordable Care Act (ACA) moves forward. The recently proposed House replacement plan, the American Health Care Act (AHCA), would drastically cut federal Medicaid support for Virginia and subsidies for low-income individuals to purchase Marketplace insurance. Taken together, these two types of cuts could be devastating to rural communities that are struggling with simultaneous challenges like depopulation, relatively high unemployment, and low wages, – all of which are made worse by a lack of health coverage.

Overall, people in rural counties tend to have poorer health and are more likely to be covered by Medicaid. Furthermore, these communities have been hit hard by the ongoing opioid crisis in the state, which is only intensified by relatively high unemployment rates in these localities. These structural and demographic challenges have made the ACA critically important to rural localities, which have been among the biggest beneficiaries from the ACA. Most of the counties in rural Southwest and Southside Virginia have seen large decreases in the share of uninsured residents since the ACA was implemented.

Read the full article.

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Virginia Inpatient Care

From the Schroeder Center for Health Policy at the College of William and Mary

Hospital care is a vital component of the healthcare sector. Nationwide, inpatient and outpatient hospital care accounts for nearly one-third of the more than $3 trillion spent annually on all types of healthcare.  A new report from William & Mary’s Schroeder Center for Health Policy provides a detailed description of the inpatient care provided in Virginia’s community hospitals during nearly 850,000 hospitalizations in 2015. 

Inpatient Hospital Utilization in the Commonwealth of Virginia:  2015 Data Analysis is intended to provide a compendium of useful data and statistics to researchers, organizations, and others who are interested in the provision of healthcare in hospitals around the state. The report offers a statistical depiction of the characteristics of patients (their average age, sex, race/ethnicity), the most common types of conditions behind inpatient hospitalizations, and the source of payment for inpatient hospitalizations, among other types of information.

According to the report, inpatient hospitalizations at Virginia community hospitals in 2015 accounted for $30.7 billion in total charges. Adults between the ages of 65 and 84 represent the single largest age group of patients admitted to Virginia’s hospitals, and some of the most common conditions responsible for inpatient hospitalizations are childbirth, septicemia, osteoarthritis, mood disorders, and congestive heart failure.  Other findings from the report include:

  • Non-chronic conditions account for 61% of all hospitalizations. 
  • Over 59,000 hospitalizations in Virginia’s community hospitals are for mental health conditions, and these hospitalizations result in over $1.1 billion in hospital charges. 
  • Medicare is the primary source of payment for 40% of discharges and private insurance is the primary source of payment for 34% of discharges. 

For more information, and to download the full report, please visit the Schroeder Center for Health Policy website.

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Merger Moves Forward

The merger between Mountain States Health Alliance and Wellmont Health System has taken another step forward. Tennessee Health Commissioner Dr. John Dreyzehner, in consultation with Tennessee Attorney General Herbert Slatery, announced in a news release that the Certificate of Public Advantage application from the two health system giants has been deemed complete and the COPA process will move forward.

A decision on the matter by Tennessee officials is due by Sept. 19, the release notes. The health care systems were notified earlier this month by Virginia Health Commissioner Dr. Marissa Levine that she would decide by Sept. 15 whether to approve the proposed merger.

Read the full article.

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National News


By Erin Mahn Zumbrun - National Rural Health Association

The National Rural Health Association urges the Senate to protect rural Americans’ access to health care and to vote no on the American Health Care Act (AHCA). NRHA does not support the AHCA and has called on members of Congress to vote no on this legislation. While many provisions of the Affordable Care Act (ACA) are not working in rural America, the AHCA does not address the problems and instead provides coverage for fewer rural Americans leading to poorer rural health outcomes and an increase in the rural hospital closure crisis.

If the AHCA is passed in its current form, CBO estimates this bill will result in 23 million fewer people with health insurance over 10 years and would reduce the deficit by $119 billion over 10 years, mainly a result of cuts to the Medicaid program.

Rural Americans are already facing an access to health care crisis. Since 2010, 79 rural hospitals have closed. Right now, 673 additional facilities are vulnerable and could close—this represents over 1/3 of rural hospitals in the U.S.

The Senate has long understood the challenges of the rural health care delivery system and the health care needs of the 62 million Americans that call rural home. NRHA asks the Senate to protect their access to health care.

Three critical improvements are needed for any health reform bill to be effective in rural America. The commonsense, low-cost amendments can be found here.

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Global Budgets for Rural Hospitals

By Joshua M. Sharfstein - Milbank Quarterly

Are rural hospitals an endangered species? Since 2005, more than one hundred have closed, with about one in four of the roughly two thousand remaining at high risk or mid-high risk for going out of business.
A website exists to track their demise.  Bipartisan legislation in the US House of Representatives is known as the Save Rural Hospitals Act, and there is a Twitter campaign with the hashtag #SaveRural.

What most needs saving in rural America, however, are the lives of those who reside there. According to the Agency for Healthcare Research and Quality, life expectancy is several years lower in rural America than elsewhere in the United States, with the gap growing larger. Key contributors to this disparity include heart disease, chronic obstructive pulmonary disease, lung cancer, stroke, diabetes, drug addiction, and suicide.

The most popular proposals to stem the tide of rural hospital closures would have little to no impact on the underlying health crisis, and some would actually widen disparities. But an emerging innovation—global hospital budgeting—could be a lifeline both for vital facilities and for their communities.

Read the full article.

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Funding Rural Aging

From the Daily Yonder

Older people in rural places face a range of daunting challenges as they age, from mobility and economic security to housing and health care. While older people across this aging nation face similar challenges, the physical and social isolation that can occur in a rural setting compounds problems and make it even more difficult to age in place, safely and well. “I have seen needs play out in a dire way in a rural community because there is nobody else around,” says Amy St. Peter, assistant director of the Maricopa Association of Governments in Arizona.  

Many rural communities lack the financial resources to help, yet private philanthropy has generally not taken a concerted interest in rural America or its older residents. “Rural aging tends to stay off the radar, for a combination of many different reasons,” said Charlotte Haberaecker, president and CEO of Lutheran Services in America.

That disparity, and the unmet needs it represents are “a powerful issue,” says Allen Smart, formerly vice president of programs and the director of the health care division at the Kate B. Reynolds Charitable Trust in North Carolina. Smart believes philanthropy must focus more attention on rural Americans, who “are not at the table, and are isolated politically, economically.”

Read the full article.

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Better Behavioral Health

From the Health Resources and Services Administration

Parents of children living in rural America are more likely than urban dwellers to have financial problems, less access to health care and live in neighborhoods with poor housing conditions and fewer amenities. However, they are also more apt to feel secure in their social networks, a recent CDC publication finds.

Paradoxically, perhaps, that social interdependence also leaves them less inclined to disclose mental health issues or seek care – even as one in six children across rural America is estimated to have a behavioral health disorder.

The CDC report analyzed 2012 data from the National Survey on Children's Health -- a quadrennial product of HRSA's Maternal and Child Health Bureau that is closely watched by children's' advocates, researchers and state officials

Read the full article.

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Mark Your Calendar

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

June 21: Responding to Natural Disasters in Rural Communities  - webinar
June 27: Cyber Insurance: Tangible Risks and Virtual Coverage - webinar
June 28: Report on Lessons Learned from Rural Opioid Overdose Grant Recipients - webinar
July 6: Reporting Preventive vs Problem Oriented Services for RHC and FQHC  - webinar
August 16: A Focus on Suicide Prevention in Rural Communities  - webinar
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA

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Critical Access Hospital Pro Forma for Shared Savings
The Rural Health Value team has developed an Excel-based financial modeling tool to help critical access hospitals assess the financial implications of joining a Medicare Shared Savings Plan Accountable Care Organization.

CDC's Vital Signs Takes Close Look at African American Health
Each month, the CDC Vital Signs Program releases a call-to-action about an important public health topic based on the latest available data and analysis. This month's Vital Signs presents CDC's comprehensive analysis of African American (black) health, using multiple national data sources that span 17 years from 1999 – 2015

Updated Website for Mapping Health Trends
The Centers for Disease Control and Prevention have updated their interactive database providing information about health status by geographic location.  The tool collects data from multiple sources on obesity, physical activity, eating habits and other behaviors and allows the users to sort by state and topic area and customize charts and maps, which may help rural stakeholders with funding applications and policy decisions.

Quick Rural Data
These data resources were put together to help people, and especially VISTA members, working in rural areas quickly find information. Each link connects to pages that contain most, if not all, of the 50 states and data are available at the county level or smaller. 

Food Insecurity by County. The hunger-relief organization Feeding America has created an interactive map of county level food-insecurity rates in the United States. 

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Funding Opportunities

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

Suicide Prevention
Health agencies with mental and behavioral health functions may apply for awards up to $700,000 to implement Zero Suicide in Health Systems.  In cooperative agreements with the Substance Abuse and Mental Health Services Administration (SAMHSA), successful applicants will raise awareness of suicide, establish referral processes and work to improve care and outcomes for adults 25 and older who are at risk for suicide.  SAMHSA will hold a pre-application webinar on Friday, June 2 at 2:00 pm ET.  For more information, contact James.Wright@samhsa.hhs.gov.  Earlier this year, a report from the Centers for Disease Control and Prevention identified data showing higher risk and rates of suicide in rural communities
Deadline: July 18

USDA Rural Telemedicine Development
The U.S. Department of Agriculture Rural Utilities Service (RUS) seeks applicants for the 2017 Distance Learning and Telemedicine (DLT) grant program, providing up to $500,000 to support access to education, training, and health care resources for rural residents through telecommunications technologies. This year, RUS will prioritize $1.6 million for communication upgrades between ambulances, emergency transportation vehicles, and medical facilities. Applicants should be aware that DLT grants require a minimum 15% match, which cannot be from another federal source.
Deadline: July 17

Health Information Technology (IT) ResearchOngoing.  For rural providers who have participated in Meaningful Use and/or other CMS clinical Quality Measure Programs, two new funding opportunities from the Agency for Healthcare Research and Quality may offer an opportunity to contribute to improving health information technology (HIT).

USDA Rural Telemedicine Development – July 17. The U.S. Department of Agriculture Rural Utilities Service (RUS) seeks applicants for the 2017 Distance Learning and Telemedicine (DLT) grant program, providing up to $500,000 to support access to education, training, and health care resources for rural residents through telecommunications technologies. This year, RUS will prioritize $1.6 million for communication upgrades between ambulances, emergency transportation vehicles, and medical facilities. Applicants should be aware that DLT grants require a minimum 15% match, which cannot be from another federal source.

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