- 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
Pennsylvania Health Care Providers Tell Lawmakers the State’s Rural Hospitals Are in Crisis
Pennsylvania’s rural hospitals are dealing with a shortage of physicians and mental health providers that has become dire, leaving patients in rural communities with dwindling options for care.
That was the message members of the Center for Rural Pennsylvania heard on Thursday during a hearing with hospital and health care center executives, and public health experts.
The center, a bicameral, bipartisan legislative agency, heard from hospital and health center executives, as well as public health experts about the challenges facing rural health care providers at a public hearing in Bradford.
Dr. Jill Owens, president of Upper Allegheny Health System, put it bluntly: “Rural hospitals are in crisis,” she told the panel.
Owens said that difficulty attracting and retaining health care providers, low Medicaid and Medicare reimbursement and other challenges have led to care deserts and declining health outcomes for rural Pennsylvanians. And without action to reform the struggling health care system and more funding and resources for local providers, the situation is unlikely to improve any time soon.
Attracting Providers
Jeannine McMillan, executive director of the Center for Population Health, a nonprofit focused on population and public health initiatives in rural Cambria and Somerset counties, said that both counties suffer from a lack of primary care physicians and mental health providers.
“Extreme challenges, including lack of adequate public transportation, availability of broadband, food deserts and difficulty recruiting clinicians are magnified in rural communities,” McMillan said.
While her organization has been fortunate to receive funding from philanthropic groups, McMillan said that “significant investments are needed” to improve health outcomes in rural communities.
A study conducted by the Hospital and Healthsystem Association of Pennsylvania (HAP) found that rural hospitals have struggled to fill 39% of vacant registered nurse positions. By comparison, HAP found the average vacancy rates for direct care RNs to be more than 30% statewide.
Kate Slatt, vice president of Innovative Payment and Care Delivery for the Hospital and Healthsystem Association of Pennsylvania, said that HAP supports efforts to strengthen the education and training pipeline for those pursuing health care careers and the creation of an office within Democratic Gov. Josh Shapiro’s administration to focus on “health care workforce innovation and reform,” it does not support legislative attempts to limit the staff-to-patient ratios at Pennsylvania hospitals.
In late June, the House passed HB 106, also known as the “Patient Safety Act.” The bill, co-sponsored by state Reps. Thomas Mehaffie, R-Dauphin, and Kathleen Tomlinson, R-Bucks, would outline the number of patients per-nurse required in different hospital settings.
Supporters of the legislation, including nurses who weathered unmanageable caseloads during the COVID-19 pandemic and the unions representing them, said the legislation protects patients and improves health care outcomes.
In July, the bill was referred to the Senate Health and Human Services Committee.
Maternal Health Deserts
Public health officials also warned lawmakers at the hearing about an “alarming” trend in rural health — a lack of labor and delivery services.
From January 2010 to April 2022, 30 Pennsylvania hospitals closed their doors. Many others were forced to cut specific services — such as OB/GYN — in order to remain financially viable, according to HAP.
Similarly, of Pennsylvania’s 42 rural hospitals, 60% do not have labor and delivery services, an analysis from the Center for Healthcare Quality and Payment Reform found.
“Many pregnant persons in rural areas need to drive almost 40 minutes to reach a hospital that can assist them during birth, which exceeds the recommended 30-minute travel time once a person begins labor,” Lisa Davis, director of the Pennsylvania Office of Rural Health and Outreach explained. “These challenges also contribute to increases in births outside of hospitals versus in hospitals without OB units and in preterm birth, all of which carry greater risks for both mothers and newborns.”
A 2022 report from the March of Dimes found that six of Pennsylvania’s 67 counties — Cameron, Forest, Greene, Juniata, Sullivan, and Wyoming counties — classified as “maternal health deserts” because they lacked hospitals providing obstetric care and birth centers, and had no OB/GYN or certified nurse midwives.
State Sen. Judy Schwank, D-Berks, said she was “very concerned” about the impact maternal health care deserts in rural Pennsylvania could have on the commonwealth’s maternal mortality rate.
“There are hospitals in the state that close maternity care that send persons in labor to another facility by either lifeflight helicopter or ambulance during the times when they can go but those are really expensive, or they may end up just having to deliver in the emergency department if they can’t travel,” Davis explained. “So this is something I think we really need to focus on.”
Davis offered that alternative services, such as birthing centers, may be an effective option for rural communities across the commonwealth.
New Public Health Resource Published: Understanding Air Quality
The ongoing wildfires in Canada (including a blaze that crossed the U.S.-Canada border this past weekend) and an intense nationwide heat wave are having harmful effects on air quality–putting public health at risk. Although a decrease in air quality affects everyone, certain communities and individuals are more vulnerable to its harmful effects.
PHCC’s newest resource, Protect Your Health: Understanding Air Quality, will help you communicate about air quality and protective measures people can take to stay safe. This resource is available in English and Spanish and includes:
- The fundamentals of understanding air quality and the Air Quality Index (AQI)
- A visual guide to the major sources of air pollution
- Recommendations for protecting your health routinely and during air-quality alert days
Download and share the guide with your community to promote the importance of understanding air quality and protecting your health
CMS Releases First Round of Medicaid and CHIP Renewals Data
On July 28, 2023, the Centers for Medicare & Medicaid Services (CMS) released its first monthly data report on Medicaid and Children’s Health Insurance Program (CHIP) eligibility renewals. These data will inform the Biden-Harris Administration’s critical work to help ensure eligible people stay covered, and to help ensure people no longer eligible for Medicaid or CHIP to transition to a range of other coverage options, including affordable health insurance through HealthCare.gov and state Marketplaces.
The data detail updates from the 18 states that had completed at least one cohort of renewals by April 30, 2023, highlighting how many people kept their Medicaid and CHIP coverage, as well as the number of people who were disenrolled from coverage. CMS is also releasing data on state Medicaid call centers, including average wait times and the number of people who disconnected before speaking to a customer service representative. In addition, CMS is releasing HealthCare.gov Marketplace data on consumers who were previously enrolled in Medicaid or CHIP that came to the HealthCare.gov and applied for coverage and State-based Marketplaces (SBM) data on consumers who transitioned to SBM coverage following a Medicaid or CHIP redetermination. See a national summary of the data at a glance, or read more about the data at Medicaid.gov/unwinding-data.
CMS continues to work closely with states as people renew their Medicaid and CHIP coverage or explore other coverage options. In addition to the new data, Health and Human Services (HHS) Secretary Xavier Becerra sent a letter to Governors encouraging states to do more to adopt strategies to automatically renew coverage for people where states already have data showing the person is eligible for Medicaid or CHIP.
Immunizations Matter – National Immunization Awareness Month
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) recognizes National Immunization Awareness Month during August. Immunizations—also called vaccinations, vaccines, or shots—protect people of all ages against a wide range of diseases and conditions. Throughout August, and the rest of the year, we’re highlighting the importance of immunizations by working to advance equitable access to vaccines and encouraging all individuals served by CMS to get their routine vaccines.
Each year, the CDC recommends vaccinations like flu shots and COVID-19 vaccines as well as important, routine vaccinations based on different age groups. Despite these recommendations, fewer than 1 in 4 adults who are 19 or older got all their routinely recommended vaccines in 2019 and minority populations have even lower immunization rates. Only 15.9% of Black adults and 17.3% of Hispanic adults get their routine immunization compared to 23.7% of their White counterparts. Additionally, Black (39.0%), Hispanic (37.5%), and adults who identify as other or multiple race (41.4%) have persistently lower flu vaccine rates compared with White adults (49.3%). These racial inequities in vaccination are due to significant disparities in access and health coverage as well as a history of discrimination and distrust.
While vaccination rates for most children’s vaccines are significantly higher, kindergartener vaccination coverage has steadily declined for all vaccines over the past two school years and similar gaps in vaccination coverage exist among children in minority communities. Increasing vaccination rates for all Americans means addressing the social and health inequities that contribute to vaccine disparities.
The Inflation Reduction Act improves coverage and lowers out-of-pocket costs for recommended vaccines in Medicare, Medicaid, and the Children’s Health Insurance Program. People with Medicare drug coverage will pay nothing out-of-pocket for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) — including the shingles vaccine and Tetanus-Diphtheria-Whooping Cough vaccine. Learn more about these changes.
Health care professionals and partner organizations can encourage their communities to stay up to date on vaccines by emphasizing why immunizations matter and sharing information to help people get the vaccines they need. These resources can help those you serve learn more about recommended vaccinations and how to access them using their health care coverage.
Resources
- Find immunization resources for health care providers, partners, and patients on our Immunization and Vaccine Resources
- Learn more about the changes to coverage through the Inflation Reduction Act and find social media toolkits to share with patients in your community.
- View the Coverage to Care (C2C) Prevention Resources webpage for newly updated flyers that offer information on covered immunizations for all age groups. These resources are each available in 8 languages.
- Download the Annual Influenza Vaccination Disparities in Medicare Beneficiaries data snapshot to learn more about flu vaccines and disparities among Medicare fee-for-service enrollees.
- Share CDC’s Adult Vaccine Assessment Tool to help those you serve learn more about which immunizations they should receive.
- Visit CDC’s Vaccine Information for Adults webpage and review the Adult Immunization Schedule for details on recommended vaccinations in adulthood. Additionally, view the Vaccines for Your Children webpage and Child & Adolescent Immunization Schedule for details about vaccines for children. Visit the CDC “Back-to-School” Campaign for downloadable resources and additional materials.
- Explore CDC’s Resources to Encourage Routine Childhood Vaccinations webpage to access materials to help both health care providers and parents contribute to efforts to increase routine vaccination coverage.
- Utilize and share the CMS Flu Vaccine Partner Toolkit which provides the most up-to-date information from CMS, CDC, and HHS on the importance of receiving the flu vaccine.
- Find the latest information on the COVID-19 vaccine and guidance on how to get vaccinated on the CDC Vaccines for COVID-19.
Calling All Western Pennsylvania Providers: Your Help is Needed!
Are you a provider in Western Pennsylvania? Remote Area Medical® (RAM) needs your help at the upcoming clinic in Butler on November 11 and 12. The clinic will offer free dental care to underserved and uninsured individuals in the area. Volunteers are still needed to join in providing much-needed dental care to the community. Signing up to volunteer is simple – visit this link, select “Volunteer” at the top right of the page, and select “USA: Pennsylvania” and “Butler” when registering. You can also check out a video about volunteering for the upcoming Butler clinic.
Click here to watch the video.
Click here to view the volunteer flyer.
Click here for more information.
Oral Health Kids Resource Now Available in Swahili
Good news! The popular resource, “What Should Kids Drink” is now available in Swahili on the PCOH Request Materials Page!
This resource, created with the Pennsylvania Chapter of the American Academy of Pediatrics, is intended to help parents and guardians understand the amount of water, milk, and juice that is appropriate for young children from birth to age 5. Please note this resource has previously been translated to Spanish as well. You can order this resource and more on the PCOH Request Materials Page.
Click here to view the resource.
Click here to visit the Request Materials Page.
Input Needed: Pennsylvania Master Plan for Older Adults
The Pennsylvania Department of Aging is gathering input on Pennsylvania’s Master Plan for Older Adults, a 10-year, state-led and stakeholder-driven strategic plan designed to help transform the infrastructure and coordination of services for older Pennsylvanians. Individuals can submit input on the plan via email to AgingPlan@pa.gov or via online form.
Click here for more information.
Click here to submit input online.
FORHP Invests $11 Million to Expand Medical Residencies in Rural Communities
The Federal Office of Rural Health Policy (FORHP) awarded nearly $11 million to 15 award recipients to strengthen the rural health workforce through the Rural Residency Planning and Development (RRPD) Program. The RRPD program supports the establishment of new rural residency programs or rural track programs in family medicine, internal medicine, preventive medicine, psychiatry, general surgery, and obstetrics-gynecology. Over a three-year grant period, the award recipients will spend up to $750,000 in start-up funding to build the program infrastructure (faculty, curriculum, etc.) needed to deliver rural residency training. Based in 13 states and one U.S. territory, the new awardees include three family medicine programs with enhanced obstetrical training, our first rural preventive medicine program, and two multi-specialty programs.
The programs supported by RRPD funds allow rural communities to build a strong and sustainable rural physician workforce through a “grow-your-own” approach, preparing the next generation of physicians to learn and eventually practice in rural settings. Research has shown that physicians from a rural background and those trained in rural settings are more likely to continue practicing in rural areas after completing their residencies. This newest RRPD cohort will continue to counter persistent workforce shortages by laying and maintaining the infrastructure needed to train physicians in rural communities.
Throughout the duration of their grant, award recipients will have access to one-on-one advisor support, tools, and resources provided by the HRSA-funded RRPD Technical Assistance Center to navigate the various stages of program development. The RRPD Technical Assistance Center also has free resources for other organizations interested in rural residency programs.
These 15 new awards join the 58 organizations across 32 states and five medicine disciplines that are developing new residency programs thanks to the $43.4 million FORHP awarded between 2019 and 2022. So far, these critical investments in the rural health workforce have created 38 new accredited rural residency programs or rural track programs with approximately 503 new residency positions. Other programs are making progress towards achieving accreditation by the end of their grant period. Accredited RRPD-funded programs are already training over 300 resident physicians in family medicine, internal medicine, psychiatry, and general surgery. To learn more about what rural residency programs are doing in your states, please read the latest RRPD program summaries.
In FY 2024, FORHP anticipates investing approximately $11.25 million in RRPD awards contingent on available funding. For more information, visit the forecast on grants.gov or email RuralResidency@hrsa.gov.
CMS Releases First Round of Medicaid and CHIP Renewals Data
On July 28, the Centers for Medicare & Medicaid Services (CMS) released its first monthly data report on Medicaid and Children’s Health Insurance Program (CHIP) eligibility renewals. These data will inform the Biden-Harris Administration’s critical work to help ensure eligible people stay covered, and to help ensure people no longer eligible for Medicaid or CHIP to transition to a range of other coverage options, including affordable health insurance through HealthCare.gov and state Marketplaces.
The data detail updates from the 18 states that had completed at least one cohort of renewals by April 30, 2023, highlighting how many people kept their Medicaid and CHIP coverage, as well as the number of people who were disenrolled from coverage. CMS is also releasing data on state Medicaid call centers, including average wait times and the number of people who disconnected before speaking to a customer service representative. In addition, CMS is releasing HealthCare.gov Marketplace data on consumers who were previously enrolled in Medicaid or CHIP that came to the HealthCare.gov and applied for coverage and State-based Marketplaces (SBM) data on consumers who transitioned to SBM coverage following a Medicaid or CHIP redetermination. See a national summary of the data at a glance, or read more about the data at Medicaid.gov/unwinding-data
CMS continues to work closely with states as people renew their Medicaid and CHIP coverage or explore other coverage options. In addition to the new data, Health and Human Services (HHS) Secretary Xavier Becerra sent a letter to Governors encouraging states to do more to adopt strategies to automatically renew coverage for people where states already have data showing the person is eligible for Medicaid or CHIP.
HRSA’S Rural Communities Opioid Response Program Team Wins 2023 Samuel J. Heyman Service to America Medals People’s Choice Award
The Health Resources and Services Administration (HRSA) is proud to announce that today the team of Megan Meacham, Allison Hutchings, and Sarah O’Donnell from the HRSA Federal Office of Rural Health Policy was named the winner of the 2023 Samuel J. Heyman Service to America Medals People’s Choice Award by the Partnership for Public Service. This team established the HRSA Rural Communities Opioid Response Program (RCORP), which has helped millions of people in rural communities across the country receive opioid use disorder prevention, treatment, and recovery support services.
The Service to America Medals, known as the Sammies, are often called the “Oscars” of public service and represent the very best of the federal government. The People’s Choice Award grants special recognition to the team that receives the most votes from the general public, highlighting how the work of the federal government resonates in communities. HRSA, an agency of the Department of Health and Human Services (HHS), provides health care to the nation’s highest need communities and supports training and growing the health care workforce. HRSA programs include support for rural communities, historically underserved communities, people with low incomes, people with HIV, infants, children, and new parents.
“I’m thrilled that the work of the HRSA Rural Communities Opioid Response Program team resonated most with the American public,” said HHS Secretary Xavier Becerra. “The work to reduce the dangers of substance use disorder in high-risk rural communities is critically important. Thank you to the Partnership for Public Service for recognizing this excellent, life-saving work.”
“Our government is powered by dedicated public servants like Megan Meacham, Allison Hutchings, Sarah O’Donnell, and the members of the HRSA Rural Communities Opioid Response Program team,” said HHS Deputy Secretary Andrea Palm. “This award recognizes their important work on behalf of the American people and serves as a reminder of what government can achieve.”
“Megan, Allison, Sarah, and the entire HRSA Rural Communities Opioid Response Program Team represent the best of government service and – like all of our work at HRSA – they are driving change by helping communities get the health care services and supports they need,” said HRSA Administrator Carole Johnson. “Their work to prevent and respond to the opioid crisis is making a real difference on the ground as rural communities have expanded treatment sites, grown their prevention strategies, and built and sustained pathways to recovery. Our People’s Choice Award winning team is an incredible example of the work being done every day at HRSA to make a difference in the lives of people across the country who need health care services. We are very proud of their leadership and their embodiment of the HRSA mission.”
To help tackle the public health crisis of opioid use disorder in rural communities, Meacham, Hutchings, and O’Donnell created the Rural Communities Opioid Response Program. The funding provided through the program allows grant recipients to provide services tailored to the needs of their communities and pilot innovative practices.
To date, the program has invested over $500 million and served more than 4 million rural individuals in over 1,800 rural counties across 47 states and two territories. Through RCORP, HRSA has supported training approximately 634,000 service providers, paraprofessional staff and community members.