- 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
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research 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
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
PA Senator Bob Casey Examines Ways to Strengthen Community Supports for Seniors and People with Disabilities Living in Rural Areas
Washington, D.C. – On February 12, 2020, U.S. Senator Bob Casey (D-PA), Ranking Member of the U.S. Senate Special Committee on Aging, held a hearing entitled, “There’s No Place Like Home: Home Health Care in Rural America.” During the hearing, Senator Casey highlighted his bill, the Home and Community-Based Services (HCBS) Infrastructure Improvement Act, which would invest in community supports for older adults and people with disabilities in rural areas through increased Medicaid funding for states.
“In Pennsylvania, there are more than 13,000 older adults and people with disabilities waiting for home care and support services. My bill, the Home and Community-Based Services Infrastructure Improvement Act, aims to change that–to make home-based care and services a reality for all who need it. An investment in home health care is an investment in the future of rural America. It is an investment in access to care, an investment in the direct support workforce and an investment in the economy,” said Senator Casey.
Senator Casey invited Francis Adams, a home care worker from Washington, PA, to testify about the barriers to improving home care jobs. “We can’t truly improve the long-term care that seniors and people with disabilities rely on unless we tackle the major obstacles that are holding working people back, including low wages, lack of benefits and basic worker protections and inadequate training,” said Mr. Adams. “It isn’t that we don’t have enough people to do this work that creates a workforce shortage, it is that our country, as a whole, undervalues this work and so nobody wants to fill the positions. We have to fix this. We have to invest in long-term care for all and we have to finally respect the work home care workers do.”
Read more about the HCBS Infrastructure Improvement Act here.
Dental Public Health Resource
The Association of State and Territorial Dental Directors (ASTDD) released a “Dental Public Health 101” learning module. Dental Public Health focuses on dental and oral health issues in communities and populations rather than individuals.
2020’s Healthiest & Unhealthiest Cities in America – WalletHub Study
With health care costs rising and U.S. life expectancy declining for three consecutive years, the personal-finance website WalletHub today released its report on 2020’s Healthiest & Unhealthiest Cities in America as well as accompanying videos.
To identify the places where health is a priority, WalletHub compared more than 170 of the largest U.S. cities across 43 key metrics. The data set ranges from cost of medical visit to fruit and vegetable consumption to fitness clubs per capita.
Healthiest Cities |
Unhealthiest Cities |
1. San Francisco, CA | 165. Detroit, MI |
2. Seattle, WA | 166. Fort Smith, AR |
3. San Diego, CA | 167. Augusta, GA |
4. Portland, OR | 168. Huntington, WV |
5. Washington, DC | 169. Montgomery, AL |
6. New York, NY | 170. Memphis, TN |
7. Denver, CO | 171. Shreveport, LA |
8. Irvine, CA | 172. Gulfport, MS |
9. Scottsdale, AZ | 173. Laredo, TX |
10. Chicago, IL | 174. Brownsville, TX |
Key Stats
- Overland Park, Kansas, has the lowest share of physically unhealthy adults, 7.60 percent, which is 2.5 times lower than in Detroit, the city with the highest at 19.20 percent.
- Laredo, Texas, has the lowest cost per doctor’s visit, $58.33, which is 3.3 times less expensive than in Boston, the city with the highest at $191.62.
- Portland, Maine, has the lowest share of adults eating fruit less than once daily, 28.20 percent, which is 1.8 times lower than in Gulfport, Mississippi, the city with the highest at 51.80 percent.
- Amarillo, Texas, has the lowest average monthly cost for a fitness-club membership, $10.17, which is 8.1 times less expensive than in San Francisco, the city with the highest at $82.83.
To view the full report and your city’s rank, please visit:
https://wallethub.com/edu/healthiest-cities/31072/
Pennsylvania Department of Health Releases 2020-2023 Strategic Plan
The Pennsylvania Department of Health has released it’s 2020-2023 Strategic Plan. A tremendous effort went into creating this strategic plan, from community partners and employee surveys to workshops, interviews, and data analysis. This plan is the Department’s roadmap for pursuing the greatest public health challenges faced by Pennsylvanians and illustrates their commitment to health equity, collaboration, continuous quality improvement and evidence-based decision making. The Department will build upon the great work already being done to promote healthy behaviors, prevent injury and disease, and to assure the safe delivery of quality health care for all people in Pennsylvania.
This plan sets the course to achieve five overarching strategies that we will work toward accomplishing over the next three years:
- Maintain and enhance emergency services and public health preparedness
- Continually develop our talents to significantly advance public health in PA
- Promote public health with awareness, prevention, and improvement of outcomes where the need is greatest
- Use data, measures, and technology to enable public health performance
- Improve staff, customer and partner experience with consistent, efficient and effective services and work processes
Exploring Alternative Payment Models for Oral Health Care
In January 2020, the DentaQuest Partnership published an article in Decisions in Dentistry that evaluated Medicaid claims of alternative payment models (APMs) and fee for service (FFS). Key takeaways from the their study demonstrated that:
- In 2016, the Center for Health Care Strategies noted “states may be able to use their purchasing power to encourage better access, quality and accountability in oral health care for children in Medicaid — particularly through contracting with dental plans.”
- This analysis of a national sample of Medicaid dental claims found an approximate 6% increase (from 27% to 33%) in dental claims associated with APMs from 2013 to 2017.
- The costs over the lifespan for APMs were lower than traditional FFS models, while utilization was better in the APM plans.
- Dental utilization in this sampling was highest during pediatric care and sharply declines within the 20s, before remaining low for the rest of the lifespan.
CMS Requests Review and Comment on Rural Maternal Health Care
On February 13, 2020, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma announced a Request for Information (RFI) to seek public comments regarding rural maternal and infant health care.
Through CMS’ Office of Minority Health, the agency is seeking information related to opportunities to improve access, quality, and outcomes before, during, and after pregnancy, and to develop and refine programs and policies that ensure all rural women have access to high quality maternal health care that results in optimal health.
To review the RFI, please visit go.cms.gov/ruralhealth.
Responses to this RFI will be used to inform future discussions among stakeholders and future work by CMS toward the development and refinement of programs and policies that ensure rural women have access to high quality maternal health care that results in optimal health outcomes.
CMS encourages all stakeholders to review the RFI at go.cms.gov/ruralhealth and submit comments to RuralMaternalRFI@cms.hhs.gov. Comments will be collected starting Wednesday February 12 through Sunday, April 12 at 11:59pm ET.
For more information and updates about this RFI, please visit the CMS Rural Health website at go.cms.gov/ruralhealth or email questions to RuralMaternalRFI@cms.hhs.gov.
Oral Health Coalition Releases 2019 Annual Report
The Pennsylvania Coalition for Oral Health (PCOH) has released their annual report for 2019 detailing accomplishments for the year. They extend a heartfelt thank you to their 2019 stakeholders, sponsors, and financial partners!
Pennsylvania Launches Reach Out PA: Your Mental Health Matters
In January 2020, Pennsylvania Governor Tom Wolf announced a focused all-agency effort and anti-stigma campaign, ‘Reach Out PA: Your Mental Health Matters,’ aimed at expanding resources and the state’s comprehensive support of mental health and related health care priorities in Pennsylvania.
The governor announced several initiatives and reviews the administration will undertake for commonwealth agencies to bolster the effort. Furthermore, over the coming weeks, agencies will announce additional initiatives. The governor was joined by mental health advocates, social workers, educators, military veterans, and cabinet secretaries in making the announcement.
“For those struggling with their mental health, we have one message: Your mental health matters and it’s okay to reach out for help,” Gov. Wolf said. “We are stepping up our efforts to ensure every Pennsylvanian can access mental health care and more agencies can respond to the challenges facing Pennsylvanians struggling with their mental health. The act of reaching out for help – or to help – can make a huge difference for someone struggling.”
According to a 2017 study from the University of Southern California, approximately 1 million adult Pennsylvanians struggled with serious psychological distress at least once in 2015. Of those adults, more than 27 percent had an unmet need for mental health care. That population includes 42 percent who did not receive mental health care because they could not afford it.
Strengthening Mental Health Care Access
The Department of Human Services will take steps to incentivize the integration of physical and behavioral health services to remove barriers to coordinating care and treatment. DHS will create financial incentives to encourage managed care organizations that provide Medical Assistance benefits to create, maintain, and continuously improve collaboration between the entities and providers that coordinate and deliver physical health benefits and mental health benefits.
These steps will mark the beginning of a large-scale effort to combat mental health issues in Pennsylvania. Reach Out PA, the Suicide Prevention Task Force, and other Wolf Administration focuses will continue to bust the stigma surrounding mental health, and work together in a multi-pronged push.
Monitoring the Future Survey Results Released
The 2019 Monitoring the Future Survey results were released in December 2019. Tracking annual drug use and attitudes among 8th, 10th, and 12th grade students, the survey noted encouraging trends such as prescription opioid misuse among teens continuing to decline and cigarette use down by approx. 20-30 percent compared to the mid- 1990’s. However, survey results show a continued dramatic increase in vaping. Learn more and view the infographics here.
Family First Transition Act a Win for Pennsylvania Foster Youth
The Family First Transition Act (FFTA), which was signed into law on December 20, 2019, aids states in implementing the Family First Prevention Services Act of 2018 (FFPSA). The FFPSA is landmark legislation, so implementing its changes at the state level have and will continue to be a heavy lift for administrators. With the magnitude of those changes in mind, the recently passed FFTA provides new reforms to promote services for children at imminent risk of out-of-home placement and family-based placement for those children who do enter foster care. It helps states, tribes and territories take advantage of the opportunities contained in FFPSA, so that every child has the opportunity to grow up in a safe and loving family. PPC is proud to have joined other local and national organizations in support of this legislation.
FFTA also provides transition funding to states for the implementation of the FFPSA in three very important ways:
- Provide one-time, flexible funding to support implementation and reduce adverse fiscal impacts.
- Delay the phase-in of the FFPSA’s 50 percent “well-supported requirement” for prevention services funding.
- Provide short-term funding for states with expiring waivers.
The FFTA also contains funding for kinship navigator programs, like Pennsylvania’s Kin Connector Program. As the commonwealth plans to opt-in to the FFPSA by October 2020, PPC continues to take an active role in Pennsylvania’s implementation of the federal law and will continue to provide updates.