In 2023, the Pennsylvania Insurance Department partnered with Texas A&M University and the Robert Wood Johnson Foundation to study barriers to accessing healthcare. The study found that only 13% of the provider listings had accurate contact information, and up to 44% of providers were unreachable because of incorrect information. The most common inaccuracies involved outdated contact information and incorrect specialty listings, which could mislead patients and lead to care delays and unexpected charges. The secret shopper survey of almost 7,000 providers listed in provider directories for Pennsylvania’s ACA Marketplace plans indicates that inaccuracies often persist for long periods of time and beyond the requirements set by recent federal law.

The Advisory Commission on Additional Licensing Models has released draft preliminary recommendations for public comment. The recommendations are intended for state medical boards, state legislators, policymakers, and interested stakeholders to help inform those jurisdictions interested in developing or modifying additional licensing pathways for physicians who have completed training internationally. The Advisory Commission compiled the draft preliminary recommendations in response to a growing number of U.S. state and territorial legislatures interested in modifying traditional post-graduate training requirements for medical licensure of physicians who have completed training internationally by eliminating the traditional requirement for completion of ACGME-accredited graduate medical education in the U.S. All interested parties should submit comments about the draft recommendations by Dec. 6, 2024.

The Jewish Healthcare Foundation and Health Career Futures are proud to announce the 2025 Death and Dying Fellowship. Over the course of nine sessions, fellows will learn critical skills and concepts in serious illness care as part of a multidisciplinary group. The program features opportunities to engage with experts, participate in site visits, and practice conversation skills in a low-pressure environment.

The Substance Abuse and Mental health Services Administration (SAMHSA) released the 2023 National Survey on Drug Use and Health results, including two infographics highlighting overall findings and findings by race and ethnicity. The data showed that in the past year, 23% of adults had a mental illness, 3% of people misused opioids, and 32% of adolescents received mental health treatment. Visit SAMHSA’s website for the data, infographics, and more.

Drugmaker Eli Lilly revealed that it had planned to impose a 340B rebate model on all covered entities (including CHCs) for all Lilly drugs, effective in Nov., and had communicated their plans to HRSA over the summer. However, after HRSA threatened to remove Johnson & Johnson’s access to the Medicaid and Medicare Part B markets if they implemented their own limited 340B rebate model, Lilly decided to put its rebate plans on-hold. Eli Lilly’s plans became public when they filed a lawsuit against HRSA, claiming that the agency exceeded its authority by seeking to block the rebate model. A similar suit was filed two days earlier by J&J. Lilly was the first manufacturer to impose contract pharmacy restrictions, so it is not surprising that they would seek to be an “early adopter” of a rebate model. While both lawsuits name the current HHS Secretary and HRSA Administrator as defendants, these individuals will soon be replaced by Trump appointees. Currently, there is no reliable information about how the Trump Administration will respond to the drugmakers’ arguments.

This policy brief from the Administration for Children and Families (ACF) examines the results of a demonstration project created by ACF’s Office on Trafficking in Persons for Native Communities.  Analysts describe how six communities chosen for the project used culture as a resource to integrate values, beliefs, traditions, and activities into various project strategies and services offered.

A new feature article in The Rural Monitor provides a historical review of graduate medical education funding and its relationship to the supply of rural physicians.

Rural Health Value is an initiative funded by the Federal Office of Rural Health Policy to provide analysis, technical assistance, and strategy for rural health care delivery.  Along with a new website and logo, they’ve launched two new resources to help rural healthcare organizations, payers, and communities make the transition from volume-based to value-based health care and payment models:

• Rural Value-Based Care – The Payer Perspective, Rural Health Value Summit Report
• A one-page summary of CMS’s Transforming Episode Accountability Model (TEAM) (p.30)

The Centers for Medicare & Medicaid Services (CMS) has an updated factsheet for its Frontier Community Health Integration Project (FCHIP) Demonstration. The model tests new models of health care delivery in the most sparsely populated rural counties by waiving certain Medicare requirements regarding skilled nursing facility beds, telehealth, and ambulance services.  In the initial demonstration period (August 2016 through July 2019), CMS received applications from Critical Access Hospitals (CAHs) in Montana, Nevada, and North Dakota (though eligible to apply, CAHs in Alaska and Wyoming did not apply). The Consolidated Appropriations Act of 2021 extended FCHIP.  Five CAHs in Montana and Nevada are continuing their participation with the goal of improving health and reducing Medicare expenditures.

– Effective January 1, 2025. On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule updating payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services for Medicare beneficiaries. This rule includes updates to base payment rates, a modified low volume payment adjustment, new inclusion of oral-only dialysis drugs in bundled payments, and coverage for home dialysis services for beneficiaries with acute kidney injury.