A range of resources for implementing the new 988 Suicide & Crisis Lifeline is featured prominently, along with guides for financing crisis support, reaching specific populations, and much more from the National Association of State Mental Health Program Directors.

 This series of data briefs from the WWAMI Rural Health Research Center shows fewer per capita behavioral health providers in rural vs. urban counties as well as disparities in the supply of providers across rural categories and Census Divisions.  While the per capita supply of psychiatrists declined over the past decade, the supply of psychologists, psychiatric nurse practitioners, social workers, and counselors increased in both rural and urban counties.

Last week, the Centers for Medicare & Medicaid Services (CMS) released a Request for Information (RFI) seeking public input on the concept of CMS creating a directory with information on healthcare providers and services or a “National Directory of Healthcare Providers and Services” (NDH). Healthcare directories can serve as an important resource for patients, helping them locate providers who meet their individual needs and preferences and allowing them to compare health plan networks. Directories also have the ability to facilitate care coordination, health information exchange, and public health data reporting. CMS is specifically requesting public feedback on the NDH concept and potential benefit; provider types, entities, and data elements that could be included; the technical framework for an NDH; priorities for possible phased implementation;  and prerequisites and actions CMS should consider to address potential challenges and risks. Rural stakeholders may consider commenting to ensure CMS receives input on considerations for rural providers and patients.

Respond by December 6.

  Earlier this year, the U.S. Department of Transportation (DOT) released a National Roadway Safety Strategy to bring down the number of people who die in motor vehicle crashes.  One of the five key objectives of this plan is post-crash care, emergency response, and trauma care which is critical to the survivability of crashes.  Recent research has shown that nearly half of fatal crashes in the United States occur on rural roads.  The National EMS Advisory (NEMSA\

C)  Council seeks input from rural emergency medical services (EMS) on their formal submission to DOT’s National Highway Transportation and Safety Administration about the proposed plan.  There are two NEMSAC letters for your consideration: the first provides advice on major actions the DOT can take to reduce fatalities; the second calls for the adoption of the National Model EMS Clinical Guidelines (3^rd Edition) and the 2021 National Trauma Field Triage Guidelines.  Comments and questions must be submitted to NHTSA.NEMSAC@dot.gov by October 21, 2022, at 5 pm ET.

October is the month for Domestic Violence Awareness, though an estimated 10 million men and women in the United States know about it daily.  However, several characteristics of rural living make the problem difficult to see: distance and geographic location, barriers to transportation and affordable housing, the stigma of abuse, and, often, family connections with people in positions of authority. Witnessing violence in the home is recognized by researchers as a significant Adverse Childhood Experience that could lead to a lifetime of chronic health conditions such as depression, asthma, cancer, and diabetes.  In 2017, HRSA began an agency-wide Strategy to Address Intimate Partner Violence and plans an update in 2023.  Get rural-specific data and resources from the Rural Health Information Hub.  Those seeking immediate assistance should contact the Domestic Violence Hotline at 800.799.SAFE (7233).

In the United States, 54% of nurses and physicians, 60% of medical students and residents, and 61% of pharmacists have symptoms of burnout. Burnout is a long-standing issue and a fundamental barrier to professional well-being. It was further exacerbated by the COVID-19 pandemic. Health workers who find joy, fulfillment, and meaning in their work can engage on a deeper level with their patients, who are at the heart of health care. Thus, a thriving workforce is essential for delivering safe, high-quality, patient-centered care.

The National Plan for Health Workforce Well-Being is intended to inspire collective action that focuses on changes needed across the health system and at the organizational level to improve the well-being of the health workforce. As a nation, we must redesign how health is delivered so that human connection is strengthened, health equity is achieved, and trust is restored. The National Plan’s vision is that patients are cared for by a health workforce that is thriving in an environment that fosters their well-being as they improve population health, enhance the care experience, reduce costs, and advance health equity; therefore, achieving the “quintuple aim.”  Access the Plan here:  National Plan for Health Workforce Well-Being

Together, we can create a health system in which care is delivered joyfully and with meaning, by a committed team of all who work to advance health, in partnership with engaged patients and communities.

Thanks to the Inflation Reduction Act, enrollees will have lower costs for insulin and free ACIP-recommended vaccines starting in 2023.  People with Medicare should review their coverage and drug and health plan options through December 7, 2022 on Medicare.gov

Medicare Open Enrollment begins tomorrow — Saturday, October 15 — and will remain open through December 7, 2022. Medicare’s Open Enrollment period gives people with Medicare the opportunity to make changes to their health plan or prescription drug plan, pick a Medicare Advantage plan, or return to Original Medicare (also referred to as Medicare Part A and Part B). Medicare plans can change their offerings and costs every year, and individuals’ health needs can change from year-to-year, too. Now is the time for people with Medicare to review their coverage options and make a choice that best meets their health care needs.

The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority. Just last month the Biden-Harris Administration announced that people with Medicare will see lower average premiums for Medicare Part B, Medicare Advantage, and Medicare Part D prescription drug plans in 2023.

This year, thanks to the Inflation Reduction Act that President Biden signed into law in August, Medicare enrollees will also see lower costs for insulin and vaccines beginning in 2023. Starting in 2023, all people with Medicare who take insulin covered by their prescription drug plan or through a traditional pump covered under Original Medicare will pay no more than $35 in cost-sharing for a month’s supply of each covered insulin product. People with Medicare also will not pay a deductible with respect to each covered insulin product. Additionally, people with Medicare drug coverage will pay nothing out-of-pocket for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) — including the shingles vaccine and Tetanus-Diphtheria-Whooping Cough vaccine. More information on the Inflation Reduction Act and these changes is available at https://www.cms.gov/newsroom/fact-sheets/inflation-reduction-act-lowers-health-care-costs-millions-americans.

“This year, more than ever, it is vital that people with Medicare review and compare their options to find the coverage that best meets their needs,” said HHS Secretary Xavier Becerra. “Thanks to the Inflation Reduction Act, we are lowering the cost of insulin and vaccines for the more than 64 million people with Medicare. The Biden-Harris Administration is unwavering in our commitment to strengthening Medicare, and we will keep doing all we can to lower costs and improve benefits.”

“We are committed to providing comprehensive and easily accessible information to support people with Medicare in their decision making,” said CMS Administrator Chiquita Brooks-LaSure. “Medicare.gov makes it easier than ever to compare coverage options and shop for plans. People can do a side-by-side comparison of plan coverage, costs, and quality ratings to help them more easily see the differences between plans.”

Since 2021, CMS has introduced a number of enhancements to Medicare.gov to optimize customer experience and create a more welcoming and user-friendly experience. Improvements include a redesigned Medicare.gov home page, the addition of pricing details to the Medigap policy comparison, streamlined landing and summary on the Medicare Plan Finder, and a redesigned “Talk to Someone” section to find additional help and contacts. All of these enhancements improve the overall experience, making it easier to navigate and access information to compare and select health and drug coverage and find providers.

The Medicare Open Enrollment period occurs every year from October 15 through December 7, with coverage changes taking effect January 1.

Things to Consider When Shopping for Medicare Coverage       

• There are two main ways to get your Medicare coverage — Original Medicare and Medicare Advantage (Medicare-approved plans from private companies). There are differences between the two that are important to understand when choosing your coverage.
• If you are selecting a Medicare Advantage plan, check with your health care providers to confirm they are in a plan’s network.
• If you are selecting a Medicare prescription drug plan, check if your prescriptions are included on a plan’s formulary.
• Remember that a low monthly premium may not always be the best overall value to meet your specific needs.
• Review a plan’s estimated total costs to you, including deductible and other out-of-pocket costs.
• If you take insulin, there is a new out-of-pocket cap on a month’s supply of each insulin product when covered by a prescription drug plan or under Original Medicare. Talk to someone for help comparing plans by calling 1-800-MEDICARE

Medicare is Here to Help

Here are four ways you can compare plans and look at savings options:

1. Go to Medicare.gov to learn the difference between Original Medicare and Medicare Advantage, and do side-by-side comparisons of costs and coverage for Medicare Advantage and prescription drug plans.
2. Call 1-800-MEDICARE. Help is available 24 hours a day, including weekends.
3. Access personalized health insurance counseling at no cost, available from State Health Insurance Assistance Program (SHIP). Visit shiphelp.org or call 1-800-MEDICARE for each SHIP’s phone number. Many SHIPs also offer virtual counseling.
4. Check eligibility for Medicare Savings Programs. If you have limited income and resources, you could qualify for Medicare Saving Programs run by your state Medicaid program. These programs could help save you money on health and prescription drug costs and/or could reduce your Part B premium from $165 to $0. For more information, contact your state Medicaid program or call 1-800-MEDICARE and ask about Medicare Savings Programs.

For more information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Help is available 24 hours a day, including weekends.