On November 2, the Centers for Medicare & Medicaid Services (CMS) finalized calendar year 2024 (CY 2024) policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues. Under CY 2024 PFS, pay rates will be reduced by 1.25 percent and the PFS conversion factor will decrease by 3.4 percent to $32.74. CMS is also finalizing significant increases in payment for primary care and other kinds of direct patient care. Marriage and family therapists (MFTs) along with mental health counselors are eligible to receive payment for mental health services and substance abuse treatment, including services furnished in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Payment for telehealth services furnished in RHCs and FQHCs is extended until December 31, 2024. In addition, CMS has created two new billing codes to describe services performed by auxiliary personnel including community health workers (CHWs) under the general supervision of the billing practitioner. The final rule is effective January 1, 2024.

Last week, the Centers for Medicare & Medicaid Services (CMS) finalized calendar year 2024 payment rates and policy changes for hospital outpatient facilities and Ambulatory Surgical Centers.  In addition to increasing pay rates by 3.1 percent, this rule establishes an intensive outpatient program to serve beneficiaries who require more intense mental and behavioral services than traditional outpatient therapy but less than inpatient-level care. Hospital outpatient departments, as well as federally designated Community Mental Health Centers, Federally Qualified Health Centers, Rural Health Clinics,  or Opioid Treatment Programs may provide these services.  The rule also finalized the adoption of four measures for the Rural Emergency Hospital (REH) Quality Reporting program and a policy that Indian Health Service and Tribal facilities that become REHs will be paid for hospital outpatient services using their current all-inclusive rate. These facilities will also receive the REH monthly facility payment.  Finally, this rule updates Hospital Price Transparency requirements to increase standardization of the data files, clarify how to find the files online, and add provisions on how compliance will be enforced. The final rule is effective January 1, 2024.

 The Economic Research Service at the U.S. Department of Agriculture (USDA) published a new report analyzing the areas and populations served by three USDA rural broadband programs: 10 the Broadband Initiatives Program (BIP), 2) the Community Connect grant program, and 3) the ReConnect program. The study reported the populations served by all three programs were found to be more rural, less educated, poorer, and older than those in areas not served or ineligible. In 2021, 41 percent of households in nonmetropolitan (nonmetro) areas lacked wired high-speed internet service in their homes, compared to 27 percent of metropolitan (metro) households. In addition, a 2020 study published by the Federal Bank entitled Bringing Broadband to Rural, demonstrated broadband access and adoption in rural areas is linked to increased job and population growth, higher rates of new business formation and home values, and lower unemployment rates. For rural healthcare facilities, broadband assists in increasing access and quality services through creating infrastructure to send electronic files, support patient portals, and complete telehealth visits.

The U.S. Department of Labor has published a comprehensive “profile” of the job of a Community Health Worker (CHW.) The profile, which was developed with input from the Health Resources and Services Administration (HRSA), includes: a standard job description; wage information for numerous states and localities; and training and education requirements.

Penn Medicine and Independence Blue Cross have been studying a new billing code created to help healthcare providers address mental health issues since 2018. Their work previously showed that linking primary care and mental health services increased the number of patients receiving needed behavioral health care and led to mental health improvements. Their new research shows it doesn’t add costs. Read more.

More than a third of schools nationwide don’t have a full-time nurse on-site, according to a 2021 survey by the National Association of School Nurses. Meanwhile, the nation is facing high rates of chronic illnesses among K-12 students, such as diabetes and asthma, along with an unprecedented mental health crisis among youth. Read more.

The average cost of workplace health insurance premiums for family coverage reached nearly $24,000 this year, jumping 7% from 2022, according to the latest annual Kaiser Family Foundation survey of employer-sponsored coverage. Workers on average contributed $6,575 toward the cost of family coverage — up about $500 from last year — while employers kicked in $17,393, according to the KFF survey of over 2,000 firms. “It’s just an incredible amount of money to spend on health insurance every year,” according to KFF health insurance expert Matthew Rae, a co-author of the report. Higher expenses for healthcare providers increase health costs for employers, which is leading to higher premiums. Average deductibles stayed largely the same in recent years, hovering around $1,735 and continuing five years of relatively flat deductible growth following years of steady hikes. Read more.