Rural Health Information Hub Latest News

Federal Health Insurance Exchange Weekly Enrollment Snapshot: Week 1 Week 1, November 1-November 7, 2020

In week one of the 2021 Open Enrollment period, 818,365 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.

Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchange and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.

The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.

As a reminder, New Jersey and Pennsylvania transitioned to their own SBE platforms for 2021, thus they are not on the HealthCare.gov platform for 2021 coverage. Those two states accounted for 578,251 plan selections last year, accounting for 7% percent of all plan selections.  These enrollees’ selections will not appear in our figures until we announce the State-based Marketplace plan selections.

Definitions and details on the data are included in the glossary.

HealthCare.gov Platform Snapshot

Week 1: November 1 – 7

Plan Selections

818,365

New Consumers

173,344

Consumers Renewing Coverage

645,021

Consumers on Applications Submitted

1,461,189

Call Center Volume

510,487

Calls with Spanish Speaking Representative

41,514

HealthCare.gov Users

3,132,427

CuidadoDeSalud.gov Users

105,800

Window Shopping HealthCare.gov Users

211,633

Window Shopping CuidadoDeSalud.gov Users

10,952

Glossary

Plan Selections: The cumulative metric represents the total number of people who have submitted an application and selected a plan, net of any cancellations from a consumer or cancellations from an insurer that have occurred to date. The weekly metric represents the net change in the number of non-cancelled plan sections over the period covered by the report.

Plan selections will not include those consumers who are automatically re-enrolled into a plan.

To have their coverage effectuated, consumers generally need to pay their first month’s health plan premium. This release does not report the number of effectuated enrollments.

New Consumers: A consumer is considered to be a new consumer if they did not have 2020 Exchange coverage through December 31, 2020, and had a 2021 plan selection.

Renewing Consumers: A consumer is considered to be a renewing consumer if they have 2020 Exchange coverage through December 31, 2020, and either actively select the same plan or a new plan for 2021.

Exchange: Generally, this report refers to 36 states that use the HealthCare.gov platform for the 2021 benefit year. The states using the HealthCare.gov platform for the individual market Exchange are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

HealthCare.gov States: The 36 states that use the HealthCare.gov platform for the 2021 benefit year, including the Federally-facilitated Exchange and some State-based Exchanges.

Consumers on Applications Submitted: This includes a consumer who is on a completed application submitted to the Exchange using the HealthCare.gov platform. If determined eligible for Exchange coverage, a consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people on a submitted application (rather than the total number of submitted applications).

Enhanced direct enrollment (EDE): The pathway for consumers to enroll in health insurance coverage through the Federally-facilitated Exchange. This pathway allows CMS to partner with the private sector to provide a user-friendly enrollment experience for consumers by allowing them to apply for and enroll in an Exchange plan directly through an approved issuer or web-broker without the need to be redirected to HealthCare.gov or contact the Exchange Call Center. Applications and plan selection made through the EDE channel are included in the overall metrics presented above.

Call Center Volume: The total number of calls received by the call center for the 36 states that use the HealthCare.gov platform for the 2021 benefit year over the time period covered by the snapshot. Calls with Spanish speaking representatives are not included.

Calls with Spanish Speaking Representative: The total number of calls received by the call center for the 36 states that use the HealthCare.gov platform for the 2021 benefit year over the time period covered by the snapshot where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric.

HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users viewed or interacted with HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once.

Window Shopping HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users interacted with the window-shopping tool at HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total HealthCare.gov or CuidadoDeSalud.gov user total.

Take Action Against Diabetes

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is recognizing National Diabetes Month in November. According to the Centers for Disease Control and Prevention (CDC), an estimated 34 million people in the United States have diabetes, and 1 in 5 of them don’t know they have it. Diabetes occurs because of the body’s inability to produce insulin, the hormone that regulates blood sugar levels. If the body doesn’t make enough insulin, sugar can’t get into the cells and blood sugar levels can rise. High blood sugar can lead to health problems including heart disease, kidney disease, stroke, and blindness.

CMS has added a new “Insulin Savings” filter on Medicare Plan Finder to display plans that will offer the capped out-of-pocket costs for insulin. Beneficiaries use the Medicare Plan Finder to view plan options and look for a participating plan in their area that covers their insulin at no more than a $35 monthly copay.

Diabetes is an important issue to CMS OMH because racial and ethnic minorities are at a higher risk of developing diabetes. Many who are diagnosed experience challenges managing their diabetes and are more likely to experience complications. Several factors including lack of access to health care, quality of care received, and socioeconomic status are all barriers to preventing diabetes and having effective diabetes management once diagnosed.

Below are several additional resources that can help health care professionals, patients, and their families manage diabetes:

Consumer Resources

Partner Resources:

To learn more about CMS OMH and to download resources, please visit https://go.cms.gov/omh or contact us at OMH@cms.hhs.gov.

What Biden’s Election Means For U.S. Health Care And Public Health

National Public Radio

As of Jan. 20, 2021 — Inauguration Day — the federal government is about to get much more involved in health care and the COVID-19 pandemic response. Exactly how much more involved, now that Joe Biden is president-elect, depends on whether Republicans keep control of the Senate. And that likely won’t be determined until early January, when Georgia’s two Senate run-off races are held.

Trump’s nearly four years as president have been marked by a scaled-back federal investment and involvement in health care in a range of ways — giving states more authority to run their own health insurance markets, for example, and leaving them to come up with their own strategies for COVID-19 testing, contact tracing and more.

Biden’s pledge during the campaign was to reverse that trend. He wants to double-down and invest in the changes the Affordable Care Act made to the country’s health care system, he says. He wants to pour trillions into a unified coronavirus strategy. And he wants to work with Congress to create a Medicare-like public insurance plan that anyone can buy into — what he’s called the “public option.”

Here’s a guide to his policy platforms and promises related to health care. Again, how much he’s able to deliver on will in some cases depend on what happens in the Senate.

Read more.

CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment

Coverage Available at No Cost to Beneficiaries Across Variety of Settings in Health Care System

CMS announced that starting November 10, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat COVID-19 with no cost-sharing during the Public Health Emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an Emergency Use Authorization (EUA) from the FDA on November 9.

“Today, CMS is announcing a historic, first-of-its kind policy that drastically expands access to COVID-19 monoclonal antibodies to beneficiaries without cost sharing,” said CMS Administrator Seema Verma. “Our timely approach means beneficiaries can receive these potentially life-saving therapies in a range of settings – such as in a doctor’s office, nursing home, infusion centers, as long as safety precautions can be met. This aggressive action and innovative approach will undoubtedly save lives.”

CMS anticipates that this monoclonal antibody product will initially be given to health care providers at no charge. Medicare will not pay for the monoclonal antibody products that providers receive for free but this action provides for reimbursement for the infusion of the product. When health care providers begin to purchase monoclonal antibody products, Medicare anticipates setting the payment rate in the same way it set the payment rates for COVID-19 vaccines, such as based on 95% of the average wholesale price for COVID-19 vaccines in many provider settings. CMS will issue billing and coding instructions for health care providers in the coming days.

CMS anticipates the announcement will allow for a broad range of providers and suppliers, including freestanding and hospital-based infusion centers, home health agencies, nursing homes, and entities with whom nursing homes contract, to administer this treatment in accordance with the EUA, and bill Medicare to administer these infusions.

Under section 6008 of the Families First Coronavirus Response Act (FFCRA), state and territorial Medicaid programs may receive a temporary 6.2 percentage point increase in the Federal Medical Assistance Percentage (FMAP), through the end of the quarter in which the COVID-19 PHE ends. A condition for receipt of this enhanced federal match is that a state or territory must cover COVID-19 testing services and treatments, including vaccines and their administration, specialized equipment, and therapies for Medicaid enrollees without cost sharing. This means that this monoclonal antibody infusion is expected to be covered when furnished to Medicaid beneficiaries, in accordance with the EUA, during this period, with limited exceptions.

View the Monoclonal Antibody COVID-19 Infusion Program Instruction.

New Cases Put 80% of Rural Counties in the Red Zone

The presidential election offers plenty of evidence that ignoring the coronavirus won’t make it go away.

Last week, while most of us focused on the race for the White House, the number of Covid-19 infections in rural counties grew by 30% and set a record for the number of new cases for the seventh consecutive week. There were 144,043 new infections in rural counties last week, up from about 110,000 the week before.

Also last week, another 97 rural counties were added to the red-zone list, bringing the total to 1,599, or four out of five of all nonmetropolitan counties. (This article using nonmetropolitan counties as synonymous with rural.)

Red-zone counties have a new infection rate of 100 or more cases in one week per 100,000 residents. The Trump administration’s White House Coronavirus Task Force says that red-zone counties need to enact tougher measures to control the virus.

The current surge originated in rural areas two months ago and more recently has spread into metropolitan counties. Previously, metropolitan counties had their worst new infection rates in July. But those counties surpassed those summer peaks for the past two weeks.

Here are other facts from last week’s analysis, which covers Sunday to Saturday, November 1 to 7.

  • Rural counties had 1,873 Covid-19 related deaths last week, an increase of 20% from the previous week, and a new record. About 29% of new U.S. deaths occurred among rural residents, who constitute about 14% of the U.S. population.
  • This fall’s surge has created a new class of rural hotspots. One quarter of rural counties (479) have one-week infection rates of at least 500 new cases per 100,000 residents — five times the red-zone infection level. Fourteen percent of metropolitan counties (141) meet that criterion. As the map below shows, these hotspot counties are primarily in the Upper Midwest, Great Plains, and the Intermountain region of that includes Montana, Wyoming, and Idaho.

Read more.

COVID-19: Prevention Keeps Pennsylvania Healthy

As Pennsylvania continues to combat COVID-19 and we enter cold and flu season, the most important step in preventing sickness is following healthy habits. These best practices limit the spread of germs for yourself and others.

Download the COVID Alert PA App

The COVID Alert PA app notifies you if you have had a potential exposure to someone who has tested positive for COVID-19. The app works by using anonymous Bluetooth technology that identifies other devices with the app in your proximity. When an app user who was near you reports they have a positive COVID-19 diagnosis, you may receive an alert, depending on the date, how long you were exposed and how close you were to the other person. It does not track your location or store your personal information.

The app also includes an interactive COVID-19 symptom checker, updates on the latest public health data about COVID-19 in PA and advice for what to do if you have a potential exposure to COVID-19.

Learn more and download now. The more Pennsylvanians that download the app, the more successful we will be in stopping the spread of the virus.

Mask Up

In Pennsylvania, masks must be worn whenever anyone leaves home. Masks are mandatory in all public spaces. Members of the public should wear homemade cloth or fabric masks and save surgical masks and N95 respirators for health care workers and first responders.

Remember this saying: “My mask protects you, your mask protects me.” 

Social Distance

It’s important to keep a safe space between yourself and other people who are not from your household. To practice social or physical distancing, stay at least 6 feet from other people who are not from your household in both indoor and outdoor spaces.

Washing your hands is one of the most important steps you can take in staying healthy. When you wash, make sure you:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
  3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  4. Rinse your hands well under clean, running water.
  5. Dry your hands using a clean towel or air dry them.

Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.

Avoid Touching Your Face

Avoid touching your face with unwashed hands. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Clean Surfaces

Clean and disinfect frequently touched surfaces at home, work, or school — especially when someone is ill.

Make sure your child’s school, child care program, or college routinely cleans frequently touched objects and surfaces, and that they have a good supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes on-site.

At work, routinely clean frequently touched objects and surfaces including doorknobs, keyboards, and phones to help remove germs. Learn more about effective steps for cleaning from the CDC.

Stay Home When Sick

Stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others. It’s a good idea to build an at-home kit so you have all the items you need (food, medication, etc.) to stay inside and focus on feeling better.

Practice the healthy habits above and also do your best to get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

For the most up to date information on COVID-19 in Pennsylvania, visit the Pennsylvania Department of Health or PA Unites Against COVID and download the COVID Alert PA App.

‘No Mercy’ Chapter 7: After a Rural Town Loses Hospital, Is a Health Clinic Enough?

‘No Mercy’ is Season One of ‘Where It Hurts,’ a podcast about overlooked parts of the country where cracks in the health system leave people without the care they need. Our first destination is Fort Scott, Kansas.

 

Family physician Maxwell Self is doing his same old job for a new employer. For two decades he was a doctor with Mercy Hospital. But when Mercy packed up and left, a federally qualified health center moved to town — into the hospital building itself — and hired Dr. Self.

The Community Health Center of Southeast Kansas does things differently.

“What CHC says really has teeth and they’re solid,” Self said. “There’s real follow-through. And I have a lot more, I feel like, freedom to take care of people the way I want to and to get them what they need.”

With nutrition counseling and mental health and addiction services, and even things like arranging rides for patients, the center offers people what they need to be healthy, clinic executives said — not only health care for when they’re sick.

In the final chapter of the podcast, we also meet Sherise Beckham, 31, who lost work as a dietitian at Mercy when the hospital closed — just as she was expecting her second child.

“Initially, I cried a lot because I would be losing my job as well as losing a place to have my baby,” Beckham said.

Beckham helps explain how much more difficult it can be to have a baby when a town loses full-service maternity care. Then, later when she gets a job at — where else? — the new CHC clinic, Beckham gives us a front-row seat to the new vision for health care in Fort Scott.

Read more and access the podcast.

CMS COVID-19 Stakeholder Engagement Calls – November

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

 Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

  • Increase Hospital Capacity – CMS Hospitals Without Walls;
  • Rapidly Expand the Healthcare Workforce;
  • Put Patients Over Paperwork; and
  • Further Promote Telehealth in Medicare

Next Office Hours:

Tuesday, November 17th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2491556

Audio Webcast link: https://engage.vevent.com/index.jsp?eid=5779&seid=2617

Weekly COVID-19 Care Site-Specific Calls  

CMS hosts calls for certain types of organizations on an intermittent basis to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

 Next Nursing Homes

Wednesday, November 18th at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1335116 Audio Webcast Link: https://engage.vevent.com/index.jsp?eid=5779&seid=2721

For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.

 

Pennsylvania Governor’s Administration Highlights Ag Apprenticeships Providing Hands-on, Paid Training for Jobs in Demand Among Pennsylvania Employers

Pennsylvania Agriculture Secretary Russell Redding and Labor & Industry Deputy Secretary for Workforce Development Sheila Ireland will host a live panel discussion today on agriculture job training options through Pennsylvania’s three agriculture apprenticeship programs. The discussion will be livestreamed on the Department of Agriculture’s Facebook page today at 2:00 PM.

“Pennsylvania’s $135 billion agriculture and food industry needs 75,000 skilled workers over the next decade,” Redding said. “The jobs are real, and an apprenticeship removes one barrier for jobseekers by allowing them to earn as they learn. The hope is that apprentices will continue to grow in the field and move up the ladder to other in-demand jobs.”

The virtual panel is being held in recognition of the U.S. Department of Labor’s National Apprenticeship Week, November 8-14, to share this unique way Pennsylvanians can acquire the career skills that employers seek.

“The COVID-19 pandemic caused rapid changes to our economy and workforce needs. Apprenticeships are a key tool that we need to use to rebuild our workforce to accommodate these changes,” Ireland said. “Apprenticeships allow Pennsylvanians to earn while they learn, helping them earn a paycheck while making a career change that will benefit their family for the long term. And, apprenticeships help businesses get the specialized workers they need to grow and succeed. We encourage any business interested in exploring an apprenticeship program to reach out to us for more information on this great opportunity.”

While apprenticeships have been common in trades such as plumber, electrician and carpenter, the model of learning specialized skills on the job from industry experts fits other career paths. It is an especially good fit for some agricultural jobs which do not require a college degree but are hands on and require unique skills. These are jobs with family-sustaining wages such as meat cutter, landscaper, logger or traditional farmer.

The food production and agriculture industry projects a need for 75,000 qualified workers over the next 10 years and apprenticeships are a good way to prepare a new workforce to fill those jobs. With a perpetual need for food, we will always need more agriculture workers.

Employers play a vital role in apprenticeships by sponsoring programs and teaching participants career skills.

The departments of Agriculture and Labor & Industry are working with Pennsylvania employers to develop agriculture-related apprenticeships and would welcome discussing other proposed programs with employers.

Pennsylvania’s three current agriculture apprenticeships are:

  • Northeast Equipment Dealerships Association sponsors the Ag Equipment Technician Apprenticeship. In this program, participants learn how to repair today’s complex farm equipment such as tractors and combines. In the next 10 years Pennsylvania employers predict more than 1,000 job openings in this field as current farm equipment mechanics and service technicians retire.
  • PASA Sustainable Agriculture sponsors the Diversified Vegetable Apprenticeship, which trains apprentices in core competencies to operate a vegetable farm, from soil fertility and irrigation, to marketing and business administration. Apprentices receive more than 2,700 hours of on-the-job training at an established farm and complete more than 200 hours of related technical instruction over the course of two seasons. Apprentices are paid an increasing hourly wage as their skills advance. The program teaches new farmers while providing teaching farms with reliable workers.
  • The PASA-sponsored Dairy Grazing Apprenticeship is a two-year program that pairs beginning farmers with mentors to provide experiences and skills toward operating a pastured dairy farm. The Dairy Grazing Apprenticeship combines paid, on-the-job training with related technical coursework.

Employers and job seekers may learn more about apprenticeships online at https://www.dli.pa.gov/Individuals/Workforce-Development/apprenticeship/Pages/default.aspx

Pennsylvania Governor’s Administration Tours Veteran-Owned Farms Supported by State’s $10 Million Fresh Food Financing Initiative 

Pennsylvania Agriculture Secretary Russell Redding and Anthony J. Carrelli, Pennsylvania’s adjutant general and head of the Department of Military and Veterans Affairs, toured U.S. Navy Veteran James Cornwell’s Nine Pines Farm in York, and U.S. Marine Corps Veteran Daniel Hubbard’s Hubbard Family Ranch in Gardners, Adams County on Friday, November 6, to highlight state support of veterans and engender consumer support for veteran-owned farms. Both farms received grants in September through the state’s $10 million Fresh Food Financing Initiative COVID-19 Relief Fund to expand access to fresh food in low-income communities during the pandemic.

“These men and their families have served their country well,” Redding said. “And they continue to serve their neighbors who struggle to access fresh, nutritious food. For both, these veteran-farmers deserve our thanks today, as we approach Veteran’s Day and Thanksgiving, and every single day of the year. They are truly heroes.”

“These proud veterans and their families sacrificed much to protect our freedoms while in uniform and now are working just as hard as farm families feeding our nation,” said Carrelli. “We thank the departments of Agriculture and Community and Economic Development, who looked deep into our communities and selected these two deserving veteran-owned businesses for the grants. These great veteran farm families are now better equipped to increase food production so that Pennsylvanians have more reliable access to food despite the disruptions of COVID-19.”

Nine Pines Farm received a $90,000 grant from the Department of Community and Economic Development’s Fresh Food Financing Initiative to expand its poultry operation and make more fresh turkey and chicken available to consumers, particularly in nearby low-income areas.

“With the onset of the COVID-19 pandemic, it is now more apparent than ever, the need for strong, local food producers in and around areas where food security is a daily struggle,” Cornwell said in his grant application. “We will be using funds to assist in accommodating the room needed to raise and store more chicken so that it can be brought to market, specifically to those in need in our nearby food desert.”

The Hubbard Family Ranch received $15,000 through the initiative to support their poultry and non-GMO feed operation.

The tour was hosted by PA Veteran Farming Project, which connects military veterans to programs and resources, including those available through the state. One example is the PA Preferred® Homegrown by Heroes program, which helps consumers easily identify and purchase products made and grown by Pennsylvania veterans.

The PA Department of Military and Veterans Affairs connects veterans to resources through the Pennsylvania Veterans Registry, an online application that allows veterans, family members and people who work with veterans to connect with DMVA to request information related to the valuable state benefits, programs and services offered.