- CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- Public Inspection: CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Announcing the 2030 Census Disclosure Avoidance Research Program
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
New Report Sheds Light on Worker Displacement in Appalachia
“Worker displacement” is the separation of long-tenured workers from their employer in a way that is involuntary, permanent and independent of on-the-job performance. This issue affects all Appalachians, regardless of age, education level or industry.
In our new research report, Worker Displacement in Appalachia, we examine how displacement rates vary throughout the region, based on a number of factors, and the outcomes workers face after job loss. 📅
Using data from the most recent Displaced Worker Supplements, along with other sources, the report sheds light on the experiences of displaced workers in Appalachia and provides insights to target resources to the group.
Worker Displacement in Appalachia is online now!
300K+ New Data Points on the Appalachian Region Released
New data recently released show that Appalachia’s labor force participation continues to improve, although population growth is slower than in the nation as a whole.
This new data comes as part of our 15th annual update of The Appalachian Region: A Data Overview from the 2019-2023 American Community Survey, also known as “The Chartbook.”
The Chartbook offers a world of data on the Appalachian Region; dive in now!
More Key Takeaways From The Chartbook:
⚙️ Decrease in Unemployment
Appalachia’s unemployment rate decreased by 0.8 percentage points between 2014-2018 to 2019-2023, compared to a 0.4 percentage point decrease in the rest of the U.S.
🏠 Homeownership ️
Among occupied housing units, homeownership in the region was 6.7 percentage points higher than in the U.S. overall.
💵 Household Income
At $64,588, the median household income in Appalachia is nearly $14,000 below the U.S. average of $78,538.
💸 Cost Burdens
The share of households in Appalachia that are cost burdened — where housing costs are 30% or more of monthly income — is 6.7 percentage points lower than the U.S. average.
New CMS Innovation Center Model WISeR Launched
On June 27, CMS announced a new Innovation model called Wasteful and Inappropriate Service Reduction (WISeR). The model aims to support Original Medicare beneficiaries in receiving safe and appropriate care and protect taxpayers by testing enhanced technologies to expedite the process of reviewing medical necessity. NACHC is reviewing the model to see how it will impact CHC patients.
For more information, see the CMS WISeR Model Webpage.
New Data Available from Pennsylvania’s Health Care Containment Center!
The Pennsylvania Health Care Cost Containment Council (PHC4) has released quarter four 2024 data. This data includes facility charges and treatment information from Pennsylvania hospitals and ambulatory surgery centers. Inpatient and ambulatory/outpatient administrative and revenue Q4 2024 data files are available for purchase.
First quarter 2025 data is scheduled to be released October 2025.
For a fee, businesses, organizations, or individuals can request from PHC4’s Special Requests unit standard “ready-to-use” data or custom data that is generated based on specific populations. The data can also be linked to other data sources, such as the Pennsylvania vital statistics data from the Pennsylvania Department of Health, to provide even greater value to you. Our analysts will work with you to meet the needs of your health care study or project.
By fostering a data-driven approach to health care, PHC4 envisions a healthier, more resilient society where resources are allocated effectively, and lives are improved. PHC4 aims to continue to serve its mission of empowering Pennsylvanians through transparency and welcomes you to review its public reports at phc4.org.
PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.
For more information, visit phc4.org or contact Special Requests and click here to request data.
Media contact:
Barry D. Buckingham, Executive Director, PHC4, bbuckingham@phc4.org
Pennsylvania Managed Care Operations Memo: Dental Benefit Limit Exception Process Clarification:
The Pennsylvania Department of Human Services (DHS) Office of Medical Assistance Program (OMAP) released an operations memo on June 25 to clarify the benefit limit exception (BLE) process and to ensure that more comprehensive services are covered for those who need it. They have also included a decision flow chart to help with the process.
New Report Examines School Dental Services and Medicaid Billing in Pennsylvania
We are pleased to announce the release of a new report, “School Dental Services and Medicaid Billing in Pennsylvania.” This PCOH report examines challenges and opportunities related to children’s access to dental care. The project aimed to assess the scope of dental services currently provided in public schools, identify barriers to implementation and sustainability, support schools in serving as access points for preventive care, and advocate for policy changes that would allow Medicaid reimbursement for services delivered in school settings.
This report was made possible through the generous support of the CareQuest Institute for Oral Health. We would like to acknowledge the contributions of Corinna Culler, RDH, DrPH, a PCOH consultant who served as the lead author.