- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden-Harris Administration Takes Historic Action to Increase Access to Quality Care, and Support to Families and Care Workers
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed
- Rural Communities Face Primary Care Physician Shortage
- Miles for Milk: How Student-Run Grocery Store Reshaped Rural Community's Food Access
- Native Americans Have Shorter Life Spans, and It's Not Just Due to Lack of Health Care
- Promotoras Play Essential Role in Connecting Farmworkers with Health Care in Rural NorCal
- Using Medicaid to Address Young People's Mental Health Needs in School Settings
- Across the Country, Amish Populations Are on the Rise
- Sunsets, Wildlife and Limited Care: Challenges of Aging in Place in Rural America
- City-Country Mortality Gap Widens amid Persistent Holes in Rural Health Care Access
- Tribal Environmental Impact Network
- Minnesota's Rural Ambulance Providers Look to State Capitol for Their Own Lifeline
- Biden-Harris Administration Takes Action to Support the Primary Care Workforce
New Report Raising Alarms in Millennial Health
According to a new report by the Blue Cross Blue Shield Association, as millennials age their health is declining faster than the previous generation’s, and they’re increasingly suffering from conditions like hypertension, high cholesterol, depression and hyperactivity. If the pattern continues, millennials’ mortality rate could climb by more than 40% compared to Gen-Xers when they were the same age.
The biggest changes are in millennials’ behavioral health. In 2017, accidental deaths, including overdoses and suicides, caused 60% of deaths among 25- to 29-year-olds, according to the Centers for Disease Control and Prevention (CDC). Read more.
Open Enrollment Off to a Healthy Start
More than 177,000 people signed up for Health Insurance Marketplace plans during the first two days of open enrollment, according to numbers released by the Trump administration. Nov. 1 marked the first day of open enrollment on HealthCare.gov, the federal government’s enrollment platform used by 38 states. Of the 177,082 people who selected plans, nearly 49,000 were new customers.
Countdown to Community HealthChoices (CHC) in Remaining 48 Counties
Community HealthChoices (CHC) is Pennsylvania’s mandatory managed care program for individuals 21 years of age or older who are dually eligible for Medicare and Medicaid or who receive long-term services and supports through Medicaid because of disabilities. CHC is currently live in southwest and southeast Pennsylvania and will launch in the remainder of the state on Jan. 1, 2020. Here are some resources to be sure you are ready:
- Third party liability (TPL) & Coordination of Benefits Fact Sheet
- 30-minute online CHC training
- Comprehensive question and answer document
- Question portal
- CHC website
- CHC listserv for ongoing updates
The Department of Human Services has notified Pennsylvania residents who are eligible for CHC of the transition to this new program, what it means for them, and important deadlines throughout the summer and fall. Eligible participants have until Nov. 13 to select their managed care organization (MCO). After this date, participants will be automatically enrolled in one of the three MCOs providing services for CHC participants. If a participant would like to change their MCO, they are able to do that at any time. Participants have until Dec. 20 to make a plan selection change in order for it to be effective Jan. 1, 2020. After that point, MCO changes will take effect beginning later in 2020.
Pennsylvania Department of Human Services (DHS) to Launch New Website
Over the next few weeks, the Pennsylvania Department of Human Services (DHS) will launch a redesigned website. The homepage will still be accessible at www.dhs.pa.gov, but existing hyperlinks will change under the new structure. If you have bookmarked pages, they may no longer work. If you are trying to access a page and the link no longer works, go to the DHS homepage and use the search function to find the page you are looking for. All pages and content will still be available with the migration even if the old link is no longer functional. If you identify a problem following the transition, contact DHS’ Communications Office at RA-PWDHSPRESSOFFICE@pa.gov.
Pennsylvania Transitions Jan. 1 to Single Statewide Preferred Drug List
Pennsylvania’s Medicaid program will have a single statewide Preferred Drug List (PDL) effective Jan. 1, 2020. The statewide PDL was developed by the Department of Human Services (DHS) Pharmacy and Therapeutics (P&T) Committee and published via an Oct. 10, 2019 MA Bulletin. Officials with the Department of Human Services (DHS) report that requiring the Medicaid managed care plans to use a single medication formulary will result in substantial cost savings for the Medicaid program and improve consistency for providers and recipients.
- Under the statewide PDL, all Medicaid HealthChoices and Community HealthChoices plans as well as MA Fee-for-Service (FFS) will use the same list of preferred medications and the same prior authorization guidelines
- The DHS pharmacy director reported at a public meeting in late October that 149,741 consumers would be impacted by the transition, meaning they would need to change medications or get prior authorization to continue taking their current medication
- Of those impacted, about 39,000 would have more than one medication impacted
- Both FFS MA and the Medicaid managed care plans are scheduled to mail letters to impacted consumers by Nov. 1, 60 days prior to the effective date
- Medicaid consumers who get a letter about the new PDL should talk to their doctors about the preferred medication listed and will need prior authorization to have their current medication covered once the new PDL goes into effect in January
- The Medicaid MCOs are required to decide prior authorization requests within 24 hours
- Any Medicaid consumer who has a script denied at the pharmacy because the medication they have been taking now requires prior authorization can request a 15-day emergency supply, which is reimbursed by the MCO but provided at the discretion of the pharmacist
- Consumers who are denied a medication can contact the PHLP Helpline at 1-800-274-3258
More information on the Medicaid program PDL and the P&T Committee
Prepare for National Children’s Dental Health Month
National Children’s Dental Health Month is in February. This year’s theme is “Fluoride in water prevents cavities! Get it from the tap!” and celebrates the 75th anniversary of community water fluoridation. Free resources are available.
National Rural Hospital Week & National Rural Health Day
During the week of November 18, 2019, the National Rural Health Association (NRHA) will partner with the Federation of American Hospitals to celebrate National Rural Hospital Week (November 18-22). NRHA will share messages on the importance of rural hospitals and ways rural providers do more with less together via a variety of media platforms: including an Op-Ed in ModernHealthcare, an episode of the Hospitals in Focus podcast, social media shares, and more! NRHA will also partner with the National Organization of State Offices of Rural Health (NOSORH) to promote National Rural Health Day (November 21) and will share stories and factoids that highlight the #PowerofRural. Join NRHA as they draw attention to the challenges in rural America and celebrate the ways that rural health care is special.
Rural Americans are More Likely to Die from Preventable Causes
A new government study shows that rural Americans die more often from potentially preventable causes than their urban counterparts. The U.S. Centers for Disease Control and Prevention (CDC) studied preventable diseases from cancer, heart disease and respiratory disease in rural areas and compared the outcomes with city areas. The results saw that between 2010 and 2017, rural counties saw a widening disparity in preventable deaths from cancer, heart disease and respiratory disease, compared to city areas. Researchers found a “persistent and striking gap between rural and urban Americans for this (cancer) and other leading causes of death.”
Best Performing Health Care CEOs
Harvard Business Review recently released its annual ranking of the 100 “Best-Performing CEOs in the World,” and the list includes nine CEOs in the health care industry. Health care CEOs who made the list lead companies in the pharmaceutical, life sciences, and other health-related sectors. (Source: Harvard Business Review, November-December 2019)
Public Comment Period for Council on Pennsylvania Reform Recommendations
This summer Pennsylvania Governor Wolf announced the creation of the Council on Reform, aimed at providing policy recommendations on vulnerable populations, with a report due by the end of the year. The Council recently released its draft recommendations. Recommended policies range from focusing on prevention in the child welfare system to increasing home visiting services for women and children. The recommendations are now open for a 45-day public comment period with a deadline of December 16.
Click here to provide comments or recommendations.