HRSA’s Bureau of Health Workforce has released the current list of Health Professional Shortage Areas (HPSAs) – which can be geographic areas, populations, or facilities – that have a shortage of primary, dental, or mental health care providers.  The designations are used to determine eligibility for federal programs that support the health workforce, such as the National Health Service Corps, as well as safety net programs such as HRSA’s Health Centers and CMS’s Rural Health Clinics. For more details on the information used to determine HPSAs, visit the HRSA Data Warehouse.

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Kevin Stansbury, the CEO of Lincoln Community Hospital in the 800-person town of Hugo, Colorado, is facing a classic Catch-22: He could boost his rural hospital’s revenues by offering hip replacements and shoulder surgeries, but the 64-year-old hospital needs more money to be able to expand its operating room to do those procedures.

“I’ve got a surgeon that’s willing to do it. My facility isn’t big enough,” Stansbury said. “And urgent services like obstetrics I can’t do in my hospital, because my facility won’t meet code.”

Rural hospitals throughout the nation are facing a similar conundrum. An increase in costs amid lower payments from insurance plans makes it harder for small hospitals to fund large capital improvement projects. And high inflation and rising interest rates coming out of the pandemic are making it tougher for aging facilities to qualify for loans or other types of financing to upgrade their facilities to meet the ever-changing standards of medical care.

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The proposed rule from the Centers for Medicare & Medicaid Services (CMS) is in response to a federal court ruling that affects Medicare beneficiaries who received “observation services” in a hospital as outpatients.  The case of Alexander v. Azar in the U.S. District Court of Connecticut was decided by a federal judge in March 2020 and requires that beneficiaries who are initially admitted as hospital inpatients, but are subsequently reclassified as outpatients (resulting in a denial of coverage for the hospital stay under Medicare Part A), are entitled to an appeals process if they meet other eligibility criteria. CMS is requesting comment from the public on this proposal to create a standardized notice advising beneficiaries of their rights to three types of appeal – expedited, standard, or retrospective – depending on the patient’s current status.

Comment by February 22

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In compliance with the Inflation Reduction Act, the Centers for Medicare & Medicaid Services’ Low-Income Subsidy Program (also known as Extra Help) will provide full financial assistance to beneficiaries enrolled in the Medicare Part D program with incomes up to 150% of the federal poverty level. Medicare beneficiaries who are eligible and enroll in Medicare Savings Programs are automatically eligible for full low-income subsidies, the payment of Medicare Parts A and B premiums, and cost-sharing. Other Medicare beneficiaries must apply for the Extra Help program via the Social Security Administration to obtain these subsidies.

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The plan sets the stage for structural changes – from the federal to state and community levels, both inside and outside of government – that are meant to address the social needs affecting health outcomes and hindering health equity.  Three pillars would form the initial scaffolding for a nationwide effort: 1) data gathering and sharing; 2) flexible funding for social needs; and 3) support for community-based organizations. Among the federal-level contributions is a collaboration between the Centers for Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation that began in 2015.  PLACES – Population-level Analysis and Community Estimates of Health – is the first initiative to connect county, place, and Census tract data with the CDC’s surveillance data to develop and implement targeted preventions.

Read the full plan here.