Rural Health
Resources by Topic: Social determinants of health
Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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A Recap of Medicaid Non-Emergency Medical Transportation (NEMT) Listening Sessions
Provides an overview of the impact of Medicaid Non-Emergency Medical Transportation (NEMT) services as well as feedback from mobility providers and stakeholders during Center for Medicare & Medicaid Services (CMS) listening sessions. Presents discussions about public transportation coordination, the relationship between transportation services and social determinants of health, implications of Transportation Network Companies (TNCs) on users with disabilities, and data reporting. Includes information specific to rural populations.
Date: 09/2022
Type: Document
Sponsoring organization: National Aging and Disability Transportation Center
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Provides an overview of the impact of Medicaid Non-Emergency Medical Transportation (NEMT) services as well as feedback from mobility providers and stakeholders during Center for Medicare & Medicaid Services (CMS) listening sessions. Presents discussions about public transportation coordination, the relationship between transportation services and social determinants of health, implications of Transportation Network Companies (TNCs) on users with disabilities, and data reporting. Includes information specific to rural populations.
Date: 09/2022
Type: Document
Sponsoring organization: National Aging and Disability Transportation Center
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Consumer Finances in Rural Appalachia
Describes the financial needs and challenges of consumers in rural Appalachia. Features sections on consumer finance profiles, including a section on medical debt, and consumer distress and delinquencies. Appendix A includes state-level statistics for the 13 Appalachian states, including percent of rural people with medical debt in the state.
Author(s): Matthew Liu, Cooper Luce, Michael Orevba, Shawn Sebastian, Cortnie Shupe
Date: 09/2022
Type: Document
Sponsoring organization: Consumer Financial Protection Bureau
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Describes the financial needs and challenges of consumers in rural Appalachia. Features sections on consumer finance profiles, including a section on medical debt, and consumer distress and delinquencies. Appendix A includes state-level statistics for the 13 Appalachian states, including percent of rural people with medical debt in the state.
Author(s): Matthew Liu, Cooper Luce, Michael Orevba, Shawn Sebastian, Cortnie Shupe
Date: 09/2022
Type: Document
Sponsoring organization: Consumer Financial Protection Bureau
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"How Do We Get to Them?" Insights on Preconception and Interconception Health for Women in Rural Northwest Ohio
Examines preconception and interconception health concerns for women of a reproductive age living in rural Hardin County. Analyzes semistructured interviews with 14 community participants and discusses 3 themes related to women's health: available resources, community observations about social determinants and access, and potential health intervention strategies.
Author(s): Akia D. Clark, Natalie A. DiPietro Mager
Citation: Ohio Journal of Public Health, 5(1), 85-93
Date: 08/2022
Type: Document
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Examines preconception and interconception health concerns for women of a reproductive age living in rural Hardin County. Analyzes semistructured interviews with 14 community participants and discusses 3 themes related to women's health: available resources, community observations about social determinants and access, and potential health intervention strategies.
Author(s): Akia D. Clark, Natalie A. DiPietro Mager
Citation: Ohio Journal of Public Health, 5(1), 85-93
Date: 08/2022
Type: Document
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Spatial Access to Hospital-Based Obstetric Units in Minoritized Racial/Ethnic Areas
Documents geographic accessibility and travel burdens for obstetric care based on local minoritized racial/ethnic group (MRG) distributions at the ZIP Code Tabulation Area (ZCTA) level. Features statistics with breakdowns by race or ethnicity and urban or rural ZCTA, and maps showing geographic distribution of ZCTAs meeting the 95th percentile threshold, locations of hospital-based obstetric units across top MRG ZCTAs in 2019, and driving distances to a hospital obstetric unit by MRG classification.
Author(s): Peiyin Hung, Gabriel Benavidez, Melinda A. Merrell, et al.
Date: 08/2022
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Documents geographic accessibility and travel burdens for obstetric care based on local minoritized racial/ethnic group (MRG) distributions at the ZIP Code Tabulation Area (ZCTA) level. Features statistics with breakdowns by race or ethnicity and urban or rural ZCTA, and maps showing geographic distribution of ZCTAs meeting the 95th percentile threshold, locations of hospital-based obstetric units across top MRG ZCTAs in 2019, and driving distances to a hospital obstetric unit by MRG classification.
Author(s): Peiyin Hung, Gabriel Benavidez, Melinda A. Merrell, et al.
Date: 08/2022
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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A Health Equity Framework for Pacific Islanders (PI)
Infographic describing health disparities, social determinants of health, and community-based strategies to address health inequity among Pacific Islanders. Discusses health workforce and healthcare access issues, as well as the need for chronic disease prevention and public health collaboration.
Date: 08/2022
Type: Document
Sponsoring organization: Asian & Pacific Islander American Health Forum
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Infographic describing health disparities, social determinants of health, and community-based strategies to address health inequity among Pacific Islanders. Discusses health workforce and healthcare access issues, as well as the need for chronic disease prevention and public health collaboration.
Date: 08/2022
Type: Document
Sponsoring organization: Asian & Pacific Islander American Health Forum
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A Health Equity Framework for Native Hawaiians (NH)
Infographic highlighting barriers to health equity and community-based intervention strategies to support Native Hawaiians. Describes health disparities, social determinants of health, and and the importance of trauma-informed mental health programs.
Date: 08/2022
Type: Document
Sponsoring organization: Asian & Pacific Islander American Health Forum
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Infographic highlighting barriers to health equity and community-based intervention strategies to support Native Hawaiians. Describes health disparities, social determinants of health, and and the importance of trauma-informed mental health programs.
Date: 08/2022
Type: Document
Sponsoring organization: Asian & Pacific Islander American Health Forum
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Advancing Primary Care Innovation in Medicaid Managed Care: A Toolkit for States
Designed to help states leverage their Medicaid managed care contracts and request for proposals (RFPs) to advance primary care innovation (PCI). Outlines strategies for states to conceptualize and design advanced primary care core functions and use managed care contract levers to drive uptake and spread. Provides examples of state approaches, with rural considerations, for identifying and addressing social determinants of health, integrating behavioral healthcare, developing team-based care, implementing technology to improve access, and more.
Date: 08/2022
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Designed to help states leverage their Medicaid managed care contracts and request for proposals (RFPs) to advance primary care innovation (PCI). Outlines strategies for states to conceptualize and design advanced primary care core functions and use managed care contract levers to drive uptake and spread. Provides examples of state approaches, with rural considerations, for identifying and addressing social determinants of health, integrating behavioral healthcare, developing team-based care, implementing technology to improve access, and more.
Date: 08/2022
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Inequities in Availability of Evidence-Based Birth Supports to Improve Perinatal Health for Socially Vulnerable Rural Residents
Examines the social risk factors rural residents face related to maternal and infant mortality. Utilizes data from 285 rural hospitals across the United States that have inpatient birthing centers to measure the availability of maternal and postpartum supports such as breastfeeding support groups, nurse home visiting, childbirth education classes, and more. Evaluates each hospital's social vulnerability index (SVI) on the county-level to determine the level of birth support inequities in rural areas and for residents who are Black, Indigenous, and People of Color (BIPOC).
Author(s): Bridget Basile Ibrahim, Julia D. Interrante, Alyssa H. Fritz, Mariana S. Tuttle, Katy Backes Kozhimannil
Citation: Children, 9(7), 1077
Date: 07/2022
Type: Document
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Examines the social risk factors rural residents face related to maternal and infant mortality. Utilizes data from 285 rural hospitals across the United States that have inpatient birthing centers to measure the availability of maternal and postpartum supports such as breastfeeding support groups, nurse home visiting, childbirth education classes, and more. Evaluates each hospital's social vulnerability index (SVI) on the county-level to determine the level of birth support inequities in rural areas and for residents who are Black, Indigenous, and People of Color (BIPOC).
Author(s): Bridget Basile Ibrahim, Julia D. Interrante, Alyssa H. Fritz, Mariana S. Tuttle, Katy Backes Kozhimannil
Citation: Children, 9(7), 1077
Date: 07/2022
Type: Document
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