The Pennsylvnia Department of Human Services (DHS) leadership announced in mid-January that they intend to implement changes to the managed care plans operating the physical health (PH) HealthChoices program effective July 1, 2022. Approximately 460,000 Medicaid consumers will be required to choose a new managed care plan or be auto-assigned into one. The remaining 2.3 million consumers in the HealthChoices program will have the option to choose a new managed care plan and will have new plan options available. This will affect dental coverage and dental providers as well.

Click here to read more on this from the PA Health Law Project.

The Pennsylvania Department of Health has published the State Health Improvement Plan Fiscal Year 2020-2021 Report.

The Healthy Pennsylvania Partnership (HPP) is a multi-sector collaboration that identifies key health challenges in Pennsylvania and works to solve them. Within the HPP, there are two major and interrelated initiatives: the State Health Assessment (SHA) and the State Health Improvement Plan (SHIP). The SHA identifies population health priorities and the populations most impacted by major health issues.
The State Health Improvement Plan (SHIP), based on the SHA, is a five-year strategic

The State Health Improvement Plan (SHIP), based on the SHA, is a five-year strategic plan developed by the Pennsylvania Department of Health (DOH) in collaboration with the HPP. The purpose of the SHIP is to describe how the health department and the community it serves will work together to improve the health of the Pennsylvania population.The community, stakeholders, and partners can use this health improvement plan to set priorities, direct the use of resources, and develop and implement projects, programs, and policies. Implementation of the plan began with its release in May 2016.

The three health priorities addressed by the SHIP are obesity, physical inactivity, and nutrition; primary care and preventive services; and mental health and substance use. For each SHIP priority, strategies, the target populations, collaborators, targets, and data sources are identified. Across these priority areas are cross-cutting themes that are key to implementing the strategies: health literacy, the public health system, health equity, social determinants of health, and integration of primary care and mental health.

During the past year, three task forces have implemented and promoted the strategic initiatives. This annual report documents progress toward the goals and the implementation of strategies. As the public health environment changes, new opportunities that may impact goals are considered by the task forces. Adjustments to the SHIP strategies are implemented by the task forces. Task forces meet quarterly throughout the year to report on progress in implementing the identified strategies, assess progress, and make recommendations for adjustments.

This report provides the health outcome measures identified in the SHIP, and implementation and progress made on strategic initiatives. It is presented to stakeholders and the public, so they may know how the commonwealth is performing on the priority issues and can prioritize based on performance results. Organizations and individuals are invited to participate. For information, email RA-ship@pa.gov.

The Rural Health Value team has released the annual update of the Catalog of Value Based Initiatives for Rural Providers.  This is your “go to” resource for staying current on CMMI payment demos that are germane for rural health care organizations and clinicians. Please share this resource as appropriate with your networks and stakeholders:

Catalog of Value Based Initiatives for Rural Providers
One-page summaries describe rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI).

Link:https://ruralhealthvalue.org/files/Catalog%20Value%20Based%20Initiatives%20for%20Rural%20Providers.pdf

On March 9, the U.S. House and Senate released the long-awaited compromise for the fiscal year (FY) 2022 appropriations package. The National Rural Health Association (NRHA) is pleased with the attention lawmakers have placed on rural providers throughout the pandemic. This week’s package continued that focus with significant provisions for supporting the rural health safety net the following provisions of note.

Support for Rural Hospitals  

• $3.45 billion for the Rural Community Facilities Program and $2 million for the Rural Hospital Technical Assistance Program thru the United States Department of Agriculture Rural Development (RD) programs. NRHA is happy to see maintained funding for these critical programs and will continue advocating for additional TA funds in FY 2023. 
• $62 million for the Medicare Rural Hospital Flexibility Grants Program, an increase of nearly $7 million over FY 2021 funding levels. The $62 million includes $21 million for the Small Rural Hospital Improvement Grant Program and $5 million to establish a Rural Emergency Hospital (REH) Technical Assistance Program. Since the REH designation was established in December 2020, NRHA has been advocating lawmakers explaining that technical assistance is needed to support providers interested in transitioning to this designation.  

Continuation of Core Rural Health Care Programs 

• $12.5 million for State Offices of Rural Health 
• $135 million for the Rural Communities Opioid Response Program  
• $10.5 million for the Rural Residency Development Program 
• $122 million for the National Health Service Corps  
• $6 million for the Rural Maternity and Obstetrics Management Strategies (RMOMS) program, including an increase of $1 million over FY 2021 included in this package.  

Supplemental Public Health Provisions  

As an omnibus package, non-appropriations related provisions will pass along with it, including several that NRHA advocated for.  

• Legislative text to ensure providers maintain their 340B status by waiving the DSH percentage qualification requirement during COVID-19 cost report years. We have heard tremendous concerns from providers on this issue. Congress taking this action is a tremendous victory to upholding the integrity of the program. In February, NRHA sent this letter to HHS Secretary Becerra outlining our concerns with attacks on the 340B program, and the need for this fix.  
• Substantive maternal health legislative language. This includes training grants for health care providers in the maternal health lens, support for pregnant women to understand the true benefit of the COVID-19 vaccine, and additional support for post-partum care. Also included is the NRHA developed Rural Maternal and Obstetric Modernization of Services (Rural MOMS) Act to:  
  • Improve rural maternal and obstetric care data;  
  • Create rural obstetric network grants (authorization of FORHP’s current program); 
  • Adds rural obstetric care to the telehealth programs at HRSA; 
  • Creates a rural maternal and obstetric care training demonstration on workforce specific to rural communities.  
• Extension of telehealth flexibilities beyond the duration of the public health emergency (PHE), including allowance for rural health clinics (RHC) and Federally Qualified Health Centers (FQHC) at their current reimbursement methodology and furnishment of audio-only telehealth services. The bill continues current Coronavirus Aid, Relief, and Economic Security (CARES) Act telehealth provisions as currently written for 151 days beyond the duration of the PHE, which is anticipated to end in July 2022. This timeframe will allow for telehealth to be continued until mid-December, where they will have another opportunity to address this issue.  

NRHA is thrilled with the number of our advocacy priorities included in this package as outlined above. They will continue advocating for delay reinstatement of Medicare sequestration, tools rural providers need to combat the remainder of the pandemic, and creation of a quality reporting program for provider-based RHCs in exchange for cost-based reimbursement moving forward.  

NRHA expects consideration of this package in the House and Senate before the deadline of March 11, with the President expected to sign it into law soon after. They will keep members apprised of developments on this important package and work we’re doing to continue improving the rural health safety net.  

An article in Dr. BiCuspid shares information from a recent presenter at the Chicago Dental Society’s midwinter meeting who presented on how to treat dental patients who use marijuana. Smoking or ingesting marijuana can wreak havoc on the oral cavity, exacerbating gum disease and causing dry mouth, and can be life-threatening when mixed with some anesthetics. Read more.

Quality Insights has released its 2022 Medication Adherence Practice Module. This newly updated resource is designed to assist in promoting and improving your quality improvement efforts, specifically related to medication management and adherence across patient populations living with high blood pressure, hypercholesterolemia, prediabetes, and diabetes. Updates include Medication Adherence Office Protocol, enhanced care team and patient communication resources, and tips for assessing health literacy, cultural competency, and potential language barriers. Download the 2022 Medication Adherence Practice Module and Workflow Modification Guide as well as a brief module overview recording.

Pennsylvania’s health information exchange network now has a new health information organization (HIO). The Lehigh Valley Health Network has successfully completed the requirements for certification as a Pennsylvania eHealth Partnership Uniform Participant in the Pennsylvania Patient and Provider Network, or P3N. Read more.

Duquesne University in Pittsburgh broke ground for the new Duquesne College of Osteopathic Medicine (DCOM) on March 1. Among the speakers was Jerome Gloster, MD, CEO of FQHC Primary Care Health Services (PCHS). Dr. Gloster spoke about how PCHS has experienced Duquesne’s dedication to serving the community through their partnership with the university’s Duquesne Center for Integrated Health asthma program for children and teenagers. PCHS, East Liberty Family Health Care Center, and North Side Christian Health Center are among the healthcare organizations that will partner with DCOM to provide rotations for third- and fourth-year medical students. John Kauffman, DO, the founding dean of DCOM, said an emphasis will be placed on serving underserved communities. He anticipates that 50% of each class of residents will go into primary care. The $151 million projects is projected to take two years with the first class of students starting in 2024.