The Centers for Medicare and Medicaid Services (CMS) released a detailed summary of the mitigation strategies states are using to address areas of non-compliance with Medicaid renewal requirements. This includes a summary of the top 10 mitigation strategies and information on each state’s area(s) of non-compliance and the adopted strategies to address non-compliance. This information is current as of March 31, 2023. CMS also released a three-page summary on CMS authority and oversight on returning to regular Medicaid renewals. This document outlines the data monitoring strategy CMS is implementing, actions CMS can take when states are not complying with federal requirements and technical assistance opportunities from CMS.

Researchers interviewed 20 individuals – clinicians, peer support specialists, cultural practitioners, and others familiar with OUD treatment – in a Minnesota tribal community.  The Cascade of Care model measures the quality of outcomes at each stage of treatment, from diagnosis to long-term maintenance, and was first proposed in 1998 as an approach to care for HIV/AIDS.

By law, health plans must provide their members with reasonable access to in-network providers and services. Yet many Pennsylvanians face delays of months or even years in scheduling appointments as well as excessively long driving distances to treatment locations.

Our new report, Healthcare Network Inadequate to Serve All: Causes and Solutions in Pennsylvania, discusses what happens when health plan networks are inadequate to serve their members, why this happens, and what the Commonwealth of Pennsylvania can do about it.

 The National Conference of State Legislatures provides an overview of programs states have implemented to address or mitigate workforce shortages.  The report describes programs across various stages of education, including K-12, community college, and undergraduate programs.

 This report from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) details key trends in factors that will be important to evaluate the No Surprises Act (NSA) and describes the framework for future evaluations.  The NSA, enacted on December 27, 2020, addresses certain instances of surprise billing where individuals with private health coverage receive unexpectedly high medical bills when they are unknowingly or unavoidably treated by an out-of-network provider, facility, or provider of air ambulance services.  ASPE found that overall, between 2012 and 2020, out-of-network claims decreased similarly in rural and urban areas. 

 In this report, the Centers for Medicare & Medicaid Services (CMS) provide an extensive analysis of Medicaid coverage of NEMT, including the types of medical services accessed, monthly trends in the use of NEMT versus telehealth services, and a comparison of the volume of NEMT services used by states and geographic area. For example, in 2021, about 7 percent of beneficiaries living in frontier or remote areas used NEMT compared to less than 4 percent of all Medicaid beneficiaries. 

  Among the findings from the RUPRI Center for Rural Health Policy Analysis:

• Non-metropolitan respondents more frequently reported lack of transportation, whereas metropolitan respondents were more likely to report not getting appointments scheduled soon enough (both examples of accommodation barriers).
• Among the non-metropolitan respondents, lack of transportation was most common among Hispanic, non-Hispanic Black, and American Indian/Alaska Native respondents compared to non-Hispanic White counterparts.
• Among non-metropolitan respondents, a higher percentage of American Indian/Alaska Native respondents reported not being at all satisfied with their care.

As more pandemic assistance programs were phased out in 2022, small businesses in our region still needed funding. And many were coping with supply chain issues, staffing challenges, and rising prices. This is what small businesses in our region reported to the Fed’s Small Business Credit Survey in the fall of 2022.

Using data from the 2023 Report on Employer Firms: Findings from the 2022 Small Business Credit Survey, four briefs offer a snapshot of small business conditions in Pennsylvania, New Jersey, the Philadelphia metro, and the Third District states overall (Delaware, New Jersey, and Pennsylvania).

Here is what small businesses in our region said about their conditions in 2022:

• Many firms saw increases in revenue compared with 2021. But a majority reported financial conditions were still poor or fair and many continued to need funding.
• The biggest operational challenges were supply chain issues, hiring or retaining qualified staff, and reaching customers or growing sales.
• Their biggest financial challenges? Rising costs of goods, services, or wages, paying operating expenses, uneven cash flow, and weak sales.

Read the briefs.

  The Merit-based Incentive Payment System (MIPS) is a pay-for-performance system for clinicians under the Medicare Quality Payment Program designed to reward clinicians for providing higher quality of care and lower costs. This study from the RUPRI Center for Rural Health Policy Analysis compared clinicians’ MIPS performance in 2018 based on their practice location, size, and minority population proportion.