- CMS: Request for Information; Health Technology Ecosystem
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- Public Inspection: CMS: Request for Information: Health Technology Ecosystem
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
- VA: Solicitation of Nominations for the Appointment to the Advisory Committee on Tribal and Indian Affairs
- GAO Seeks New Members for Tribal and Indigenous Advisory Council
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- 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
New CMS Rule Increases Payments for Acute Care Hospitals & Advances Health Equity, Maternal Health
CMS issued a final rule for inpatient and long-term care hospitals that builds on the Biden-Harris Administration’s key priorities to advance health equity and improve maternal health outcomes. As required by statute, the fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) rule updates Medicare payments and policies for hospitals, drives high-quality, person-centered care, and promotes fiscal stewardship of the Medicare program. In addition, the rule finalizes new measures to encourage hospitals to build health equity into their core functions. These actions will improve care for people and communities who are disadvantaged or underserved by the health care system.
The rule includes three health equity-focused measures in hospital quality programs and establishes a “Birthing-Friendly” hospital designation. CMS will award this new designation to hospitals that participate in a statewide or national perinatal quality improvement collaborative program and have implemented the recommended quality interventions.
For acute care hospitals paid under the IPPS that successfully participate in the Hospital Inpatient Quality Reporting (IQR) Program and are meaningful electronic health record users, the final rule will result in an increase in operating payment rates of 4.3%. This reflects a FY 2023 projected hospital market basket update of 4.1%, reduced by a statutorily required productivity adjustment of a 0.3 percentage point and plus a 0.5 percentage point adjustment required by statute. This is the highest market basket update in the last 25 years and is primarily due to higher expected growth in compensation prices for hospital workers. Under the LTCH PPS, CMS expects payments in FY 2023 to increase by approximately 2.4% or $71 million.
“CMS is taking action to support hospitals, including updating payments to hospitals by a significantly higher rate than in the proposed IPPS rule. This final rule aligns hospital payments with CMS’ vision of ensuring access to health care for all people with Medicare and maintaining incentives for our hospital partners to operate efficiently,” said CMS Administrator Chiquita Brooks-LaSure. “It also takes important steps to advance health equity by encouraging hospitals to implement practices that reduce maternal morbidity and mortality.”
Advancing Health Equity:
Consistent with the agency’s definition of health equity, CMS is working to advance health equity by designing, implementing, and operationalizing policies and programs that support health for all the people served by our programs, eliminating avoidable differences in health outcomes experienced by people who are disadvantaged or underserved, and providing the care and support that our enrollees need to thrive.
To address health care disparities in hospital inpatient care and beyond, CMS is adopting three health equity-focused measures in the IQR Program. The first measure assesses a hospital’s commitment to establishing a culture of equity and delivering more equitable health care by capturing concrete activities across five key domains, including strategic planning, data collection, data analysis, quality improvement, and leadership engagement. The second and third measures capture screening and identification of patient-level, health-related social needs — such as food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety. By screening for and identifying such unmet needs, hospitals will be in a better position to serve patients holistically by addressing and monitoring what are often key contributors to poor physical and mental health outcomes.
In the near future, CMS is also interested in using measures focused on connecting patients with identified social needs to community resources or services. CMS sought comment on the proposed rule. In the final rule, CMS acknowledges the robust comments received on key considerations that inform our approach to improving data collection, to better measure and analyze disparities across programs and policies, and approaches for updating the Hospital Readmissions Reduction Program (HRRP) that encourage providers to improve performance for socially at-risk populations.
CMS is also discontinuing the use of proxy data for uncompensated care costs in determining uncompensated care payments for Indian Health Service and Tribal hospitals, and hospitals in Puerto Rico, and we are establishing a new supplemental payment to prevent undue long-term financial disruption for these hospitals and to promote long-term payment stability. CMS is also finalizing new flexibilities for graduate medical education for rural hospitals participating in rural track programs, which will help promote workforce development in rural areas.
Improving Maternal Health Outcomes:
CMS is creating a new hospital designation to identify “Birthing-Friendly” hospitals and additional quality measure reporting to drive improvements in maternal health outcomes. CMS is finalizing this designation following the release of the comprehensive CMS Maternity Care Action Plan.
The Biden-Harris Administration has championed policies to improve maternal health and equity since taking office. Earlier this year, Vice President Harris convened a first-ever White House meeting with Cabinet Secretaries and agency leaders, including Secretary Becerra and CMS Administrator Chiquita Brooks-LaSure, to discuss the Administration’s whole-of-government approach to reducing maternal mortality and morbidity. In December 2021, Vice President Harris announced a historic call to action to improve health outcomes for parents and their young children in the United States. Implementing this new hospital designation is part of the Biden-Harris Administration’s continued response to that call to action, as noted in the CMS Maternity Care Action Plan.
The “Birthing-Friendly” hospital designation will provide important information to consumers about hospitals with a demonstrated commitment to reducing maternal morbidity and mortality by implementing best practices that advance health care quality and safety for pregnant and postpartum patients.
Conditions of Participation Pandemic Reporting for Hospital and Critical Access Hospitals (CAH):
CMS proposed to continue the current COVID-19 reporting requirements for hospitals and CAHs as well as establish new reporting requirements for future public health emergencies (PHE). Based on public feedback, CMS is finalizing the proposed requirements for continued COVID-19-related reporting for hospitals and CAHs with a reduced number of data categories as an off ramp to the current PHE. CMS is not finalizing the proposed reporting requirements for future PHEs.
Continued Public Reporting of Patient Safety Metrics:
CMS uses quality measures to ensure safety and quality within the health care system and to pay providers through value-based programs. For the FY 2023 Hospital-Acquired Condition (HAC) Reduction Program, CMS proposed to pause — meaning not calculate and subsequently not publicly report — the data for the PSI-90 measure, which is a composite measure that covers multiple patient safety indicators, such as pressure sores, falls, and sepsis. CMS’ proposal reflected concerns about the impact COVID-19 would have on the ability to interpret data and was also sensitive to the risks of financially penalizing hospitals for factors potentially out of their control. CMS recognizes the importance of this measure for patients and providers and is finalizing the calculation and public reporting of the CMS PSI-90 measure results. CMS will include the measure in Star Ratings in alignment with the feedback we received. Although this measure will be publicly reported, it will not be used in payment calculations in the HAC to avoid unintentional penalties related to the uneven impacts of COVID-19 across the country.
More Information:
- Final Rule fact sheet
- Maternal Health fact sheet
- Final Rule
Oral Health Workforce Report Released by Pennsylvania Oral Health Coalition
PCOH has released a workforce report that finds a major decrease in dental workforce, including a staggering decrease in dental assistants. The “Access to Oral Health Workforce Report” uncovers that many Pennsylvania counties are struggling to maintain recommended worker levels. Since the onset of the COVID-19 pandemic, rural areas and Medicaid provider networks have seen the sharpest reductions in care providers. This will result in limited access and delayed care for Pennsylvanians, especially those in rural communities. The report also evaluates education and training programs, state tax and local income losses, the impact of COVID-19 relief programs, and dental – Health Professional Shortage Areas (d-HPSAs).
The US Mental Health Hotline Network Is Expanding, but Rural Areas Still Face Care Shortages
By Kaiser Health News; reported in The Daily Yonder
On July 16, a three-digit number, 988, became the centerpiece of a nationwide effort to unify responses to Americans experiencing mental health crises. But many people, especially those in rural areas, will continue to find themselves far from help if they need more support than call operators can offer.
The National Suicide Prevention Lifeline’s 988 phone number, which launched July 16, was designed as a universal mental health support tool for callers at any time anywhere.
But the U.S. is a patchwork of resources for crisis assistance, so what comes next isn’t universal. The level of support that 988 callers receive depends on their ZIP code.
In particular, rural Americans, who die by suicide at a far higher rate than residents of urban areas, often have trouble accessing mental health services. While 988 can connect them to a call center close to home, they could end up being directed to far-away resources.
The new system is supposed to give people an alternative to 911, yet callers from rural areas who are experiencing a mental health crisis may still be met by law enforcement personnel, rather than mental health specialists.
More than 150 million people in the U.S. — most from rural or partially rural communities — live in places designated as mental health professional shortage areas by the federal Health Resources and Services Administration. That means their communities don’t have enough mental health providers — usually psychiatrists — to serve the population.
The Biden administration distributed about $105 million to states to help increase local crisis call center staffing for the new 988 system. But states are responsible for filling any gaps in the continuum of care that callers rely on if they need more than a phone conversation. States also shoulder most of the responsibility for staffing and funding their 988 call centers once the federal funding runs dry.
The federal Substance Abuse and Mental Health Services Administration, which runs the existing 800-273-8255 lifeline that 988 expands upon, has said that a state that launches a successful 988 program will ensure callers have a mental health professional to talk to, a mobile crisis team to respond to them, and a place to go — such as a short-term residential crisis stabilization facility — that offers diagnosis and treatment. The federal agency also intends for 988 to reduce reliance on law enforcement, expand access to mental health care, and relieve pressure on emergency rooms.
Those objectives may not play out equally in all states or communities.
House Members Ask HHS to Clarify Enforcement Plans for 96-Hour Rule
A bipartisan group of 25 House members asked Health and Human Services Secretary Xavier Becerra to clarify by September 9 whether and how the Administration plans to enforce Medicare’s 96-hour payment rule and condition of participation for critical access hospitals after the COVID-19 public health emergency.
The rule requires CAHs to certify inpatients will be discharged or transferred to another hospital within 96 hours of admission to receive payment. A related Medicare condition of participation requires CAH inpatient stays to remain below 96 hours on an annual average basis. HHS has not prioritized enforcement of the rule since 2018 due to its financial burden on hospitals and waived the condition of participation in response to the COVID-19 public health emergency.
“Even after the PHE formally ends, COVID and other respiratory diseases are likely to cause some patients to need hospitalizations lasting longer than 96 hours,” the representatives wrote. “These and other patients who can safely and effectively be treated in their local hospital deserve the option of receiving care closer to their homes, families, and usual doctors.”
HHS, DOL, and Treasury Issue Guidance Regarding Birth Control Coverage
Following President Biden’s Executive Order on ensuring access to reproductive health care, the U.S. Department of Health and Human Services (HHS), alongside the Departments of Labor and of the Treasury (Departments), took action to clarify protections for birth control coverage under the Affordable Care Act (ACA). Under the ACA, most private health plans are required to provide birth control and family planning counseling at no additional cost.
Full Press Release: https://www.cms.gov/newsroom/press-releases/hhs-dol-and-treasury-issue-guidance-regarding-birth-control-coverage
FAQs:
CMS Releases Latest Enrollment Figures for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP)
The Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.
Medicare
As of April 2022, 64,449,451 people are enrolled in Medicare. This is an increase of 88,177 since the last report.
- 34,879,219 are enrolled in Original Medicare.
- 29,570,232 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage.
- 50,011,957 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.
Over 12 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs.
Detailed enrollment data can be viewed here: https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment
Medicaid and Children’s Health Insurance Program (CHIP)
As of April 2022, 88,274,847 of people are enrolled in Medicaid and CHIP. This is an increase of 375,152 since the last report.
- 81,195,571 are enrolled in Medicaid
- 7,079,276 are enrolled in CHIP
For more information on Medicaid/CHIP enrollment, including enrollment trends, visit https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot/index.html
Every day, CMS ensures that people across the U.S. have coverage that works. See the latest coverage totals across all CMS programs at https://www.cms.gov/pillar/expand-access. This information is updated on a monthly basis. Enrollment data for CMS programs are compiled on different timelines owing to the unique nature of each program.
New Pennsylvania Cancer Coalition Website Launched
The Pennsylvania Cancer Coalition (PCC) is excited to announce the launch of their new website.
One of the long-standing goals is to robustly support comprehensive cancer prevention and control activities through the implementation of the Pennsylvania Cancer Control Plan. The PCC strives to increase inclusive and diverse membership of the Coalition that represents all issues related to reduction of the cancer burden in Pennsylvania. This website is a key resource to highlight cancer prevention and control activities, provide updates on the work of the workgroups and subcommittees, and share information with stakeholders across our state.
The website offers several new features, including:
- A fresh and modern Homepage that highlights key cancer-related resources that can be further explored in greater detail.
- A robust News section that can accommodate a higher volume of articles.
- A searchable and comprehensive Resources section that organizes items by specific Health Topics and File Types.
- A new section that addresses Health Equity and the policies, systems, and environmental strategies to reduce cancer health disparities.
Take a look at the new website using the following link:
Geisinger Names Dr. Susan Parisi as 1st Chief Wellness Officer
Danville, Pa.- based Geisinger has selected Susan Parisi, MD, to serve as its inaugural chief wellness officer — a role in which she will lead the implementation of a “systemwide strategy” to improve employees’ personal and professional well-being, according to a July 28 news release sent to Becker’s.
Dr. Parisi, an OB-GYN, has three decades of healthcare experience. Most recently, she was the director of well-being at Nuvance Health in Danbury, Conn., where she crafted a well-being program that was implemented across seven hospitals and supported 2,500 physicians. In 2019, she completed the chief wellness officer executive training program at Stanford University in California.
“The crisis of emotional exhaustion and burnout on the healthcare workforce is more important than ever — and it deserves our full attention. I’m thrilled to join Geisinger in this new role and partner with our Geisinger family to find new and better ways to build a culture that supports the well-being of everyone who commits their lives to this work,” Dr. Parisi said in a news release.
Kittanning, PA: You Can Get Fancy Coffee in Small Towns, Too
Ispirare, a high-end coffee shop in Kittanning, Pennsylvania, is introducing espresso culture to the community, and bringing people back to downtown.
Visitors to the downtown storefront of Ispirare Coffee in Kittanning, Pennsylvania (population 3,800), choose from a wide selection of basic and innovative drinks. Seasonal offerings are a big draw. This summer, a hibiscus berry lemonade, a white mocha with local maple syrup, and a vanilla strawberry brown sugar latte are bringing in curious customers, some who return to try them all.
Many people choose a baked good to accompany their drink. A full selection includes muffins, cookies, granola bars, scones, and croissants. People of all ages meet up here and often remark on the wide array of delicious treats.
Ispirare Coffee is the first high-end coffee shop the county has ever had, and some other specialty items like organic juice can’t be found anywhere else. In recognition that many locals, an older demographic, might not be familiar with espresso culture, a graphic on the wall shows the components of each drink.
Updated Resources from Rural Health Value Announced!
The Rural Health Value team recently released two updated resources:
- Engaging Your Board and Community in Value-Based Care Conversations
Board and community engagement is critical to value-based care and payment success. Healthcare organization leaders can use Rural Health Value’s discussion questions to inspire lively board and community conversations that both enlighten participants and advance value-based care. - State Innovation Model Testing Awards: Highlighting Rural Focus
Learn about activities and early accomplishments from eleven states that used their State Innovation Model (SIM) awards from the Center for Medicare & Medicaid Innovation (CMMI) to impact healthcare delivery in rural areas.
Related resources on the Rural Health Value website:
Catalog of Value Based Initiatives for Rural Providers
One-page summaries describe rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI).
This tool helps a rural healthcare organization assess readiness for the shift of payments from volume to value. The resulting report may be used to guide the development of action plans.
Contact information:
Clint MacKinney, MD, MS, Co-Principal Investigator; clint-mackinney@uiowa.edu