- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- NRHA Continues Partnership to Advance Rural Oral Health
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
- Q&A: What Are the Challenges and Opportunities of Small-Town Philanthropy?
Federal Administration Seeks Input Into National Plan on Aging
The federal Administration for Community Level (ACL) is leading the charge to develop a National Plan on Aging and is seeking input from individuals and organizations who serve people of all ages, individuals who are caregivers, grandfamilies, and others. Please share this with your partners and encourage them to review the plan and submit comments at the National Plan on Aging Community Engagement Collaborative by September 15.
More information:
- Background and main page detailing the: Strategic Framework | ACL Administration for Community Living
- The StrategicFramework-NationalPlanOnAging-2024.pdf (acl.gov) document.
- Fact sheet (two-pager) on the Interagency Committee on Healthy Aging and Age-Friendly Communities ICC_FactSheet2024_508.pdf (acl.gov)
$3,600 In Spend, $600K In Savings at Pennsylvania’s WellSpan
WellSpan Health, a York, Pa.-based system with nine hospitals and more than 250 care locations, saved seven patients $600,000 in healthcare costs by allocating an extra $3,600.
The organization’s mission is to be the safest place for patients to receive care and for employees to work, according to Michael Seim, MD, chief quality officer at WellSpan. One facet of that mission is improving life expectancies and removing disparities for its 900,000 annual patients.
Within seven miles on one road in southeast Pennsylvania lies a 20-plus year difference in life expectancy, Dr. Seim told Becker’s. WellSpan works on numerous health equity programs — one of which recently won an American Hospital Association award — with many projects focused on health screening efforts.
One of these was a $3,600 salary expense for interpreters to contact Spanish-speaking patients who have delayed screenings. After successfully connecting with about half of the targeted population, WellSpan employees found seven new breast cancer cases.
“If you look at what the cost would be for delayed presentation — if they would advance one stage further [without being screened] — we calculated it would cost about $600,000,” Dr. Seim said.
That return on investment is more than a 20-fold increase.
The projected savings depend on each case, including whether patients have insurance or what type of insurance they have, he said.
Through targeted interventions, WellSpan has screened an additional 23,000 patients for breast and colorectal cancer in the last 18 months. The outcome was about 375 patients helped and 4,000 years of life added.
“Whether they’re in a value-based program or not, [with] the importance of screening and early detection, you can make a total financial argument that it’s a good place for health systems to invest,” Dr. Seim said. “And, it’s the right thing to do.”
Rural Patients’ Barriers to Care Access: 7 Notes
From Becker’s Hospital Notes
Researchers from the Huntsman Cancer Institute and the University of Utah, both based in Salt Lake City, found that 34% of rural patients said they have easy access to medical specialists.
The Community Health Assessment Survey is the first to focus on patients in rural and frontier areas, according to an Aug. 8 news release from the organizations. Rural counties have fewer than 100 people per square mile while frontier areas have seven people or fewer per square mile. More than 1,700 rural residents across five states participated in the survey.
Here are seven findings:
- About 48% of rural residents said they had seen a physician in the past year, compared to the U.S. average of 85%.
- Forty percent of rural women of the recommended age had never had a mammogram, compared to the national average of 22%.
- Nearly 88% of rural respondents said they knew little or nothing about enrolling in clinical trials.
- One-third of respondents said more telemedicine could help access to care, but only 81% have access to high-speed internet, compared to 91% of Americans nationwide. About 10% of rural areas said they did not have cell coverage.
- Sixty-eight percent people said they were not aware of programs to help pay for medical costs.
- Thirty-seven percent of respondents said they had difficulty accessing cancer screenings.
- Nearly two-thirds of respondents said increasing the number of visit specialists would improve access to care.
Bringing Health Care Back to a Rural Pennsylvania Community
Snow Shoe Township is a small, rural community of around 1,700 people in central Pennsylvania that lies approximately 30 miles north of State College. A former coal mining town, Snow Shoe has seen an economic decline over the years.
Then, in the span of one year starting in 2020, Snow Shoe lost its only grocery store, hardware store, bank, pharmacy and federally qualified health center. The only businesses left in town were a dollar store, pizza shop, post office, laundromat, and an outdoor and sporting goods store.
With the closure of the town’s health care facility and pharmacy, many of Snow Shoe’s aging residents, and others with health needs, were no longer able to access health care.
This led clinicians from the Penn State College of Medicine (PSCOM) to initiate conversations with local, state, federal, University and health system leaders to see what they could do to help area residents access basic health care needs. Through these conversations, they learned that the primary barriers to receiving health care were transportation and time constraints.
Without the ability to access basic health care services, clinicians from PSCOM and faculty members across academic colleges at Penn State collaborated to support the health and wellness of the residents in Snow Shoe and the surrounding community.
Request for Proposals: Evaluation of Migration and Population Trends in Appalachia
ARC is seeking proposals from qualified researchers to examine migration and population change in the Appalachian Region.
The research will incorporate a variety of datasets, tools, and methodologies to provide an overview of migration and population trends in the region, highlighting how current trends differ from those in the past. Analysis should provide a high-level look at trends dating back to at least 1960, as well as an in-depth examination of trends over the past decade.
The contractor will deliver a final report, executive summary, and state-level fact sheets that help answer the following questions:
- What are the migration and population trends throughout the Region? How have these trends changed over time?
- What are the characteristics of the places that are gaining/losing population? What are the characteristics of people who are migrating?
- How has migration changed the demographic profiles of communities throughout Appalachia?
- How have these demographic changes impacted the places gaining/losing population?
Key dates are outlined below. If you have any questions, please reach out to ARC’s economist Logan Thomas.
RFP open date: August 7, 2024
Questions due: September 4, 2024
Answers posted on arc.gov: September 11, 2024
Proposal due date: October 2, 2024
Interviews: October 21 – November 20, 2024
Selection date: December 11, 2024
Contract period: January – September 2025
Small-Town Patients Face Big Hurdles as Rural Hospitals Cut Cancer Care
The night before her chemotherapy, Herlinda Sanchez sets out her clothes and checks that she has everything she needs: a blanket, medications, an iPad and chargers, a small Bible and rosary, fuzzy socks, and snacks for the road.
After the 36-year-old was diagnosed with stage 3 breast cancer in December, she learned that there weren’t any cancer services in her community of Del Rio, a town of 35,000 near the Texas-Mexico border.
To get treatment, she and her husband, Manuel, must drive nearly three hours east to San Antonio. So they set an alarm for 4 a.m., which allows for just enough time to roll out of bed, brush their teeth, and begin the long drive navigating dark roads while watching for deer.
About an hour before they arrive at the cancer clinic, the couple pulls over to quickly eat fast food in the car. The break gives Herlinda time to apply ointment on the port where the needle for her chemotherapy will be inserted.
“It numbs the area, so when I get to the infusion room the needle won’t hurt,” she said.
For rural patients, getting cancer treatment close to home has always been difficult. But in recent years, chemotherapy deserts have expanded across the United States, with 382 rural hospitals halting services from 2014 to 2022, according to a report published this year by Chartis, a health analytics and consulting firm.
After Hitting Record Low, Uninsured Rates Climb: CDC
From Beckers
After hitting record lows in 2023, uninsured rates are beginning to rise again, according to new CDC data.
According to CDC estimates published August 5, 8.2% of Americans were uninsured in the first quarter of 2024, up from 7.7% in the fourth quarter of 2023.
In the second quarter of 2023, the CDC recorded a record-low uninsured rate of 7.2%. Government estimates predict the uninsured rate will rise over the next decade, driven by Medicaid disenrollment and the expiration of ACA subsidies.
The CDC also said 27.1 million people were uninsured in the first quarter of 2024, up from 25.5 million in the fourth quarter of 2023.
The number of people under 65 with public coverage declined from 75.9 million in the fourth quarter of 2023 to 73.5 million in the first quarter of 2024. Federal agencies estimated insured rates would drop as states began disenrolling Medicaid enrollees for the first time since 2020.
Continuous coverage requirements in place during the COVID-19 pandemic helped drive uninsured rates to new lows. At least 24.8 million people have been disenrolled from Medicaid since March 2023, according to KFF.
Though the number of people with public coverage has decreased, the number of adults under 65 with private insurance was the same between the last quarter of 2023 and the first quarter of 2024, at 176.7 million.
ACA exchange enrollment increased to 16.6 million in the first quarter of 2024, up from 13.3 million in the last quarter of 2023. Federal agencies have worked to steer individuals losing Medicaid coverage to exchange plans.
Enhanced subsidies that offset the premiums for marketplace plans are set to expire at the end of 2025, unless Congress chooses to extend them.
Estimates from the Congressional Budget Office in June projected the uninsured rate will hit 8.9% by 2034.
CMS Launches Oral Health Cross Cutting Initiative
The Centers for Medicare and Medicaid Services (CMS) released the inaugural Oral Health Cross Cutting Initiative (CCI) fact sheet. This initiative is committed to ensuring equitable access to oral health care, eliminating disparities, expanding oral health service availability, and effectively engaging stakeholders. It aims to improve the oral health and wellness of individuals who have Medicare, Medicaid, and Marketplace coverage.
Quality Measures of Oral Health Care for Children Released
The Consortium for Oral Health Systems Integration and Improvement released “Selected Quality Measures of Oral Health Care for Children.” The new brief provides a national summary of selected oral health care quality measures for children including oral evaluation, dental services, topical fluoride for children, and sealant receipt on permanent first molars.
Oral Health Resources for Older Adults Available
PCOH has added two new resources on oral health care for older adults to their Request Materials page. “Oral Health Care Tips for Older Adults” is a resource with tips for oral health care for older adults including the importance of regular dental care and dental access. “Oral Care for Long-Term Care Residents” is a tri-fold brochure with tips providers need to know for treating adults in long-term care facilities. Topics include dry mouth, denture care, and gum disease. These resources, and many others, are available to download or ship for free from the Request Materials page.