Rural Health Special Report: COVID-19 Update for Rural Hospitals and Health Systems

View stories from the field and important resources.

The AHA remains committed to helping rural hospitals and health systems address the COVID-19 pandemic in their communities. Many states are removing restrictions under new local, state and federal guidelines, and hospitals are resuming non-emergency procedures.

In Washington, D.C., the AHA is advocating on behalf of rural hospitals and health systems and working to convince Congress that it must provide additional funding and resources during these challenging times. As we navigate the new normal, don’t hesitate to reach out with questions or concerns so that we can work to address the unique needs of rural communities. Contact John Supplitt at jsupplitt@aha.org.

In this newsletter, you’ll find a wealth of new assets to help you meet your communities’ needs amid the shifting COVID-19 landscape. Thank you for all you do. You are our hospital heroes.

Case Studies

A case study from Harrison Memorial Hospital in Cynthiana, Ky., showcases how one small-town community and hospital confront COVID-19 together. View AHA’s updated Rural Health Services webpage for a full compendium of resources.

Additional Resources

New AHA fact sheet: Rural Community Hospital Demonstration

The Rural Community Hospital demonstration tests an alternative payment model for small rural hospitals in response to concerns that these facilities face financial difficulties with Medicare’s inpatient prospective payment system. In this AHA fact sheet, read the basis for our position that Congress should extend the RCH program for an additional five years and require a case mix adjustment be applied to the target amount in order to account for fluctuations in patient acuity.

AHA podcast: Marshall Medical Center

On this podcast, Siri Nelson, CEO of Marshall Medical Center in Placerville, Calif., shares how her hospital in El Dorado County prepared for the COVID-19 pandemic, including partnering with community leaders, communicating with the public and redeploying clinical and support staff. Listen here.

AHA podcast: King’s Daughters Medical Center

This podcast features Alvin Hoover, CEO of King's Daughters Medical Center in Brookhaven, Miss., sharing how his hospital quickly responded to a surge in COVID-19 cases through mobile screening, securing personal protective equipment and protecting health care workers. Listen here.

Telehealth best practices

This AHA fact sheet provides health care organizations with tips for implementing telehealth and virtual care visits. It shares how hospitals and health systems can successfully use telehealth to combat COVID-19 and covers how to best care remotely for persons with COVID-19, protecting health care workers and leveraging telehealth technology vendors. Read here how Riverwood Health, Aitkin, Minn. introduced telehealth under the emergency blanket waivers for COVID-19.

Letter from Rural Health Services Advocate

In this letter to rural health care leaders, Marty Fattig, CEO of Nemaha County Hospital in Auburn, Neb., shares the value of support from AHA’s Rural Hospital Executive Community. “The feedback continues to be positive and we encourage our colleagues from across rural America to use this resource for problem solving and knowledge transfer,” Fattig writes. “This is a safe and secure platform to examine key operational and management priorities with input from rural health care subject matter experts and thought leaders.”

New Pathways to Recovery resource

The AHA recently shared with members COVID-19 Pathways to Recovery, an updated resource which includes considerations, questions and checklists for hospitals and health systems to consider as they work toward a safe, orderly return to providing comprehensive health care services to their communities. A recently formed AHA Board Task Force led the development of the compendium, drawing from input from many association members.

New AHA Connect App

The AHA has a new members-only app designed to help you stay current with the latest health policy news and legislative updates. The app offers a personalized experience through customization according to your issue interests, enables you to contact your congressional representatives with a single tap and participate in discussion groups. The app includes a link to the AHA Rural Forum digital community. Learn more here.

Legislative and Regulatory Updates

FCC approves $200 million for emergency COVID-19 telehealth; $100 million for connected care pilot program

Using money from the Coronavirus Aid, Relief, and Economic Security Act, the Federal Communications Commission recently established a $200 million COVID-19 telehealth program to help health care providers provide connected care services to patients at their homes or mobile locations. The program will fully fund their telecommunications services, information services and devices necessary to provide connected care services. In addition, the agency officially approved a broader and longer-term Connected Care Pilot, a three-year pilot program providing up to $100 million to support telehealth services for mainly low-income Americans and veterans, including in rural areas.

HHS provides $225 million to rural health clinics for COVID-19 testing

The Health Resources and Services Administration May 20 provided $225 million to rural health clinics (RHCs) for COVID-19 testing. The funding will support the expansion of testing to more than 4,500 RHCs in underserved rural areas nationwide. In addition, HRSA said it will award $500,000 to support RHCs' COVID-19 technical assistance efforts, which include conducting webinars and providing resources and guidance for implementation and management of testing programs. Read more here.

HHS extends deadline for attestation, acceptance of terms and conditions for emergency fund payments to 90 days

The Department of Health and Human Services May 26 extended the deadline for health care providers to attest to receipt of payments from the Public Health and Social Services Emergency Fund and accept the terms and conditions. Providers now will have 90 days, increased from 45 days, from the date they receive a payment to attest and accept the terms and conditions or return the funds.

CMS changes to Medicare Advantage and Part D

The Centers for Medicare & Medicaid Services May 22 issued a final rule that will increase access to telehealth for seniors in Medicare Advantage plans, expand the types of supplemental benefits available for beneficiaries with an MA plan who have chronic diseases, provide support for more MA options for beneficiaries in rural communities and expand access to MA for patients with end stage renal disease. This flexibility will encourage plans to enhance their benefits to give beneficiaries access to the latest telehealth technologies and increase plan choices for beneficiaries residing in rural areas.

AHA letter to House and Senate Labor/HHS Appropriations Subcommittees on considerations for health care program funding priorities

The AHA May 21 urged leaders of the House and Senate Appropriations Subcommittees on Labor, Health and Human Services, Education, and Related Agencies to support a number of issues important to hospitals and health systems as they consider funding for health care programs for fiscal year 2021. Read the full letter here.

Funding and Training Opportunities

Rural Residency Planning and Development Program – June 30

This grant program addresses physician workforce shortages and challenges faced by rural communities by supporting the development of new rural residency programs in family medicine, internal medicine, public health and general preventive medicine, psychiatry, general surgery and obstetrics and gynecology. View more information here.

Agency for Healthcare Research and Quality innovation challenge for rural postpartum mental health – September 15

A total prize pool of $175,000 will be awarded for local innovations that improve postpartum mental health care for rural mothers and their families. View more information here.

Free telehealth training – ongoing

Avera eCARE® offers free training and resources to help health care facilities use virtual health care. The classes can assist with concerns that often arise when using telemedicine services. View more information here.