The Pennsylvania Health Care Cost Containment Council (PHC4) released a new set of County-Level Utilization Reports and County-Level Condition-Specific Reports today.

The County-Level Utilization Reports display the total number of ambulatory/outpatient cases and inpatient hospitalizations for Pennsylvania residents from October 1 through December 31, 2025, (Q4 of 2025). Each report separates the information into inpatient and outpatient utilization. Inpatient data are further categorized by age, payer type, and sex. Outpatient data include those same categories, with an additional breakdown by facility type.

The County-Level Condition-Specific Reports shed light on key health care conditions, by offering volume data at the county level. These PHC4 reports focus on eight conditions, containing raw counts and rates for each. The reporting covers data from January 1 through December 31, 2025.

Producing comprehensive sets of County-Level Health Care Utilization Reports and County-Level Condition-Specific Reports directly support PHC4’s mission.

PHC4 invites all stakeholders to review these reports, available now at County-Level Health Care Reports – PHC4. Recognizing these data is key in supporting research, business, and health care communities, PHC4 regularly connects with professionals seeking standard or custom data. Questions can be directed to general@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 access the reports here.

Rural healthcare organizations face growing pressure to succeed in value-based care while maintaining local control and financial sustainability. To support that journey, the Rural Health Value  team is pleased to share two new resources designed to help rural leaders assess readiness, build infrastructure, and advance clinically integrated network (CIN) strategies.

Collaboration to Contracting: A Guide to Rural Clinically Integrated Networks
A practical roadmap for developing and operating a rural CIN, including guidance on governance, clinical integration, data infrastructure, financial sustainability, and payer contracting.

Rural Clinically Integrated Network Readiness Assessment Tool
A companion to Collaboration to Contracting: A Guide to Rural Clinically Integrated Networks, this self-assessment helps organizations evaluate readiness, identify opportunities, and spark strategic conversations about CIN participation and value-based care.

Looking for the Basics?

Introduction to Rural Clinically Integrated Networks
If you’re new to CINs, this companion resource provides a concise overview of what CINs are, why they matter, and how they can help rural organizations achieve greater scale while maintaining independence.

Why Explore These Resources?

These resources can help your organization:

• Assess readiness for value-based care and clinical integration.
• Strengthen care coordination and population health capabilities.
• Build the governance, data, and operational infrastructure needed for success.
• Achieve greater scale through collaboration while preserving local decision-making.
• Prepare for future value-based payment and contracting opportunities.

For more information, contact Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu.

Rural Health Value facilitates the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Visit www.ruralhealthvalue.org

Research Brief Highlights Updated ADI

The Area Deprivation Index (ADI) from the Neighborhood Atlas has been updated with the American Community Survey’s 2020-2024 5-Year Estimates. The ADI ranks block groups nationwide from least to most disadvantaged using education, employment, income, poverty, and housing data, and is widely used to study the social determinants of health.

Our latest brief examines how Pennsylvania’s block groups compare, measuring the share of each county’s population living in the bottom and top 30 percent of national rankings.

Key Findings from the Report:

• About 34.4 percent of Pennsylvania’s population lived in the most disadvantaged block groups. Twenty counties had at least 75 percent of their population in these areas.
• About 14.4 percent of Pennsylvania’s population lived in the least disadvantaged block groups. Two-thirds of counties had no residents in these areas.

Read the full Pennsylvania ADI brief.

Households Without Air Conditioning

The Local Air Conditioning Estimates (LACE) dataset shows how many households have air conditioning (AC), from the national level down to individual neighborhoods. Approximately 5.7 percent of households in Pennsylvania live without AC.

Most counties with a high share of households without AC are located in the northern tier of Pennsylvania, with the highest percentage found in Cameron (32.0%).

Counties where nearly all households have AC are primarily clustered in the southeastern and south-central regions of the state, including York and Chester, which are tied for the lowest share without AC (0.3%).

Visit the interactive map for more data.

A Road Trip Across the Vacation Economy

The Census Bureau rang in the summer with a travel statistics road map. Take a look at the vacation economy road trip.

Wealth of Households: 2024

A brief examining household wealth in 2024 using the 2025 Survey of Income and Program Participation (SIPP). Read more about household wealth in 2024.

Net International Migration Down in Every State, Most Counties

Net international migration declined in every state and 90 percent of U.S. counties between 2024 and 2025. Explore the net international migration data.

Insurers denied at least 1 in 8 standard requests for prior authorization in 2025 across three major markets – Medicare Advantage (12%), Medicaid managed care (14%), and the Affordable Care Act Marketplaces (18%), finds a new KFF analysis of publicly available data.

Insurers require prior authorization for certain procedures and treatments as a way to reduce unnecessary care and contain costs. The practice has received increased attention in recent years as it can lead to delays or denials in receiving care and creates administrative burdens for patients and providers.

KFF’s analysis examines data about insurers’ prior authorization use that plans are required to post publicly as part of a 2024 final rule from the Centers for Medicare and Medicaid Services aimed at streamlining and automating the prior authorization process. The analysis assessed data from 14 large insurers with the largest enrollment in each market.

Among Medicare Advantage insurers, the denial rate for standard requests ranged from 5% for Elevance to 17% for United Health Group. In Medicaid Managed Care, the range went from 2% for L.A. Care Health Plan to 23% for Independence Health Group. In the ACA Marketplace, the range went from 3% for GuideWell to 25% for Centene.

Other findings include:

• When prior authorization denials are appealed, the original decision is often overturned across the three markets – two-thirds (67%) of the time in the Medicare Advantage market, nearly half (47%) of the time for Medicaid managed care, and 43% of the time in the ACA Marketplaces.
• Median response times in all markets were about one day for standard prior authorization requests. For expedited requests, the typical response time was half a day for Medicare Advantage and about a day for Medicaid managed care and the ACA Marketplace.  The short median response times may stem from the growing use of artificial intelligence and electronic systems to help process requests.

The analysis also highlights several limitations in the publicly reported data that reduce their usefulness for consumers.

Small businesses drive local economies, yet those in Delaware, New Jersey, and Pennsylvania faced major financial difficulties in 2025, according to the Fed’s Small Business Credit Survey.

Below are some key findings:

• Most firms in the three states described their financial condition as poor or fair. Debt levels held relatively steady, with over one-third of firms seeking loans or credit lines.
• Small businesses in the region continued to face challenges with rising costs, paying operating expenses, and weak sales. Nearly half reported issues with uneven cash flows and tariff-related costs.
• New Jersey firms are struggling compared with Pennsylvania firms. They were more likely to report poor or fair financial health, dip into personal funds to stay afloat, and face challenges with operating expenses and weak sales.

Interact with survey data and learn more about regional trends in this article.