Rural Health Information Hub Latest News

A Small Percentage of Primary Care Physicians, Specialists Provide Most Medicaid Managed Care


Health Affairs reported on May 1, 2022, that just 25% of Medicaid managed care network primary care physicians provide 86% of primary care to Medicaid beneficiaries, according to a study of four states. Additionally, 25% of specialists provide 75% of specialty care. The results suggest that “current network adequacy standards might not reflect actual access,” the study said. Read More.

Discrimination’s Impact on Health Care for Older Adults

Racial and ethnic discrimination in the U.S. health care system is taking a toll on older Americans, even preventing some from getting needed care, a Commonwealth Fund study finds. One in four older adults of color surveyed said that healthcare professionals have treated them unfairly or ignored health concerns because of their race or ethnicity. Among those who reported being discriminated against, more than a quarter said that they did not get the care they needed because of that discrimination. Read more here.

Pennsylvania Department of State Alerts that Health Professional Licensure Pandemic Waivers Are Expiring

The PA Department of State (DOS), under which all of Pennsylvania’s health professional licensure boards rest, has issued a notice that DOS’s professional licensing waivers issued under the COVID-19 disaster declaration will begin expiring in phases starting May 23. All waivers will expire by June 30. The legislature ended the COVID-19 disaster declaration in June 2021, extending some license waivers. Without a disaster declaration, the governor and DOS cannot further extend the waivers. Legislative action is necessary to develop any active waiver. Under Act 14 of 2022, all waived and suspended regulations initiated because of the COVID-19 disaster emergency would expire June 30, 2022, unless terminated earlier. Licensed professionals and other individuals affected by these waivers should make every effort to return to compliance based on the pending expiration. A list of all waivers and scheduled expiration dates is available on the Department of State website.


HHS Launches Pledge Initiative to Mobilize Health Care Sector to Reduce Emissions

June event hosted by the White House will highlight private sector commitments

Today, the Department of Health and Human Services (HHS), in partnership with the White House, is issuing a call to action for health care stakeholders to commit to tackling the climate crisis through a new initiative aimed at reducing emissions across the health care sector.

Climate change exacerbates health disparities and private health care stakeholders have an opportunity to reduce their greenhouse gas emissions and mitigate future damage. Federal Health systems are already taking actions to reduce emissions under the leadership of the Biden Administration. This new initiative challenges private health systems to match or exceed these goals and to build climate considerations into the future of health care.

U.S. hospitals, health systems, suppliers, pharmaceutical companies and other industry stakeholders are invited to submit pledges to reduce greenhouse gas emissions and increase their climate resilience. The White House plans to host a convening in June to highlight health care sector progress in promoting climate actions.

“We need all players on the field confronting the climate crisis; sitting on the sidelines is not an option.” said HHS Secretary Xavier Becerra. “Every stakeholder group in America must step up, and collaboration across the public and private sector is key. At HHS, we stand ready to partner with as many players as possible. Reducing emissions and fighting climate change’s catastrophic and chronic impact on vulnerable people is key to building a healthier nation.”

The voluntary pledge asks signees to, at a minimum, commit to: (1) reducing their organization’s emissions (by 50% by 2030 and to net zero by 2050) and publicly reporting on their progress; (2) completing an inventory of Scope 3 (supply chain) emissions; and (3) developing climate resilience plans for their facilities and communities. It also asks them to designate an executive lead for this work.

“We are encouraged by the bold and specific commitments to decarbonization that many organizations across the country have already made,” Admiral Rachel Levine, Assistant Secretary for Health, said. “It is time for us to both celebrate those commitments and galvanize others to take this critical step.”

“The health care sector contributes 8.5% of total U.S. emissions, so they have a big role to play,” National Climate Advisor Gina McCarthy said. “We are excited for health care leaders across the country willing to step up, reduce emissions, and help us reach the President’s bold climate goals.”

Starting with the establishment of the Office of Climate Change and Health Equity (OCCHE) in August of 2021, HHS is taking a more active role to address the challenges climate poses to health. This includes the Administration’s commitment at last November’s United Nations Climate Conference  to creating a low-carbon health system. It also includes co-chairing the National Academy of Medicine Action Collaborative on Decarbonizing the U.S. Health Sector , a public-private partnership of leaders from across the health system committed to addressing the sector’s environmental impact while strengthening its sustainability and resilience.

The Department expects to make more climate-readiness resources and technical assistance supports available to health care providers in the coming months.

Pledge signers can download forms and find more information on the submission process here. Forms will be due by June 3, 2022.

President Biden Announces Additional Steps to Address Infant Formula Shortage

President Biden has directed his administration to work urgently to ensure that during the Abbott Nutrition voluntary recall, infant formula is safe and available for families across the country. Today, President Biden spoke with retailers and manufacturers, including Wal-Mart, Target, Reckitt, and Gerber, to discuss ways we can all work together to do more to help families access infant formula.

On February 17, the largest infant formula manufacturer in the country—Abbott Nutrition—initiated a voluntary recall of several lines of powdered formula. This came after concerns about bacterial contamination at Abbott’s Sturgis, Michigan, facility after four infants fell ill and two died. The federal government—including the Food and Drug Administration (FDA), Department of Agriculture (USDA), Department of Justice (DOJ), Department of Transportation (DOT), U.S. Trade Representative (USTR), Department of Homeland Security (DHS), Department of Commerce (DOC), and the White House—has worked diligently over the last few months to address the shortfall in infant formula production while the Sturgis plant remains offline, including working with other infant formula manufacturers to increase production, expediting the import of infant formula from abroad, and calling on both online and in store retailers to establish purchasing limits to prevent the possibility of hoarding. As a result, more infant formula has been produced in the last four weeks than in the four weeks preceding the recall — despite one of the largest infant formula production facilities in the U.S. being offline.

Families across the country remain concerned about the availability of infant formula—especially families that depend on specialty formulas for which the Sturgis facility is a key supplier. These 20 specialty formulas are used by about 5,000 infants as well as some older children and adults with rare metabolic diseases, and Abbott Nutrition is the only supplier for some of these formulas.

Today, President Biden is announcing additional steps to bolster our work to get infant formula onto store shelves as quickly as possible without compromising safety. These steps include:

  • Cutting Red Tape to Get More Infant Formula to Store Shelves Quicker: Manufacturers typically produce many different sizes of the same type of infant formula. Simplifying product offerings allows manufacturers to increase the speed and scale of their infant formula production, stabilizing the overall volume of formula available in the market. The type of formula that companies make and distribute is impacted by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), administered by USDA. About half of infant formula nationwide is purchased by participants using WIC benefits, based on both federal requirements and additional rules set by individual states that have a large effect on the availability and distribution of infant formula in a given state.

To help further increase manufacturers’ ability to meet demand and distribute formula, USDA is working with states to make it easier for vulnerable families to purchase the formula they need with their WIC benefits. USDA is urging states to allow WIC recipients to use their WIC benefits on a wider variety of products so that if certain sizes or types of formula are out of stock, they can use their benefits on those that are in stock. And, USDA is urging states to relax their requirements that stores keep a certain amount of formula in stock. This will offer relief to retailers and allow companies to manage inventories to meet demand. Some states are already doing this. All fifty states should. These actions will make it easier for vulnerable families to get the necessary nutritional support for their infants.

  • Calling on the FTC and State Attorneys General to Crack Down on Any Price Gouging or Unfair Market Practices Related to Sales of Infant Formula: Parents looking to feed their child should not be taken advantage of by unscrupulous retailers unfairly jacking up prices. There have been several reports that actors are purchasing formula at retail stores and reselling it online at a markup several times the retail price, especially specialty brands of formula that have experienced the most disruption. These actions not only are costing families hundreds of dollars for formula they need, but drive scarcity on the market. Since February, the FDA has worked with companies, calling on them to issue purchasing limits to help limit such predatory behavior. Many responsible retailers have responded to that call. Now, DOJ is engaging with state attorneys general to encourage them to use their powers to monitor and address price gouging in the infant formula market, and urging them to devote more resources to monitoring predatory behavior in the market for infant formula. And, the President today asked the Federal Trade Commission to use all its available tools to monitor and investigate reports of illegal and predatory conduct.
  • Increasing the Supply of Formula Through Increased Imports: The U.S. normally produces 98% percent of the infant formula it consumes, and trading partners in Mexico, Chile, Ireland, and the Netherlands are key sources of imports. But given the production and distribution issues leading to local short supplies of infant formula, the FDA will, in the coming days, announce specific new steps it is taking concerning importing certain infant formula products from abroad.

More information on actions that the FDA announced earlier this week to address the shortage of infant formula can be found here. The Biden-Harris Administration will continue to monitor the situation and identify other ways it can support the safe and rapid increase in the production and distribution of baby formula.

FACT SHEET: President Biden Announces Additional Steps to Address Infant Formula Shortage

No-cost Naloxone for Pennsylvanians

Naloxone saves lives by reversing opioid overdoses. In addition to efforts like expanding access to treatment, services, and supports for people with substance use disorder (SUD), naloxone is a critical tool in Pennsylvania’s efforts to address the opioid epidemic.

Since 2017, Pennsylvania Governor Wolf’s administration has taken a number of steps to increase naloxone access for people and communities across Pennsylvania who need it the most. As we continue to deal with the mental and behavioral health impacts brought on by the COVID-19 pandemic, we realize the fight is far from over. We are again seeing an uptick in drug overdose deaths, and the vast majority of these deaths are opioid- and fentanyl-related.

Pennsylvanians can play an important role in addressing this public health crisis. By being prepared, learning the signs of overdose and how to respond, and getting naloxone, you can help save lives. As a commonwealth we are anticipating a significant supply of naloxone in the coming months. The Department of Drug and Alcohol Programs encourages you to learn about the ways individuals, organizations, and agencies can access naloxone.  Please see the attached one-page PDF for resources to access no-cost naloxone in Pennsylvania.

Naloxone Program Overview


Oral Health, Mental Health, and Substance Use Treatment Toolkit Released

The National Council for Mental Wellbeing developed a new toolkit, “Oral Health, Mental Health and Substance Use Treatment: A Framework for Increased Coordination and Integration.” The toolkit provides a guide for health professionals to increase coordination and integration efforts across oral, mental, and substance use treatment settings. The toolkit includes suggestions, strategies, and examples for implementation of new care models across health systems.

Click here to view the toolkit.

CMS Announces Health Insurance Marketplace Policies for 2023

Last week, the Centers for Medicare & Medicaid Services (CMS)issued the Notice of Benefit and Payment Parameters for 2023 Final Rule to finalize standards for issuers and Marketplaces, as well as requirements for agents, brokers, web-brokers, and issuers assisting consumers with enrollment through Marketplaces that use the federal platform. The final rule includes policies pertaining to plan options, network adequacy, health equity, risk adjustment, and consumer experience. Recent rural-centric research on health insurance marketplaces is available on the Rural Health Research Gateway.