- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- 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
Rural Infections Surge Past 110,000 for the Week, Breaking Another Record
By Tim Murphy and Tim Marema
Rural counties had record-breaking numbers of new infections, for the sixth consecutive week.
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Jobs Report, September 2019-2020: Most Rural Counties Lose Jobs but Do Better than Metro
By Bill Bishop
September’s employment numbers show the pandemic is hurting rural areas less than metropolitan ones.
Read more
New Simulation Finds Max Cost for Cost-effective Health Treatments
As health care costs balloon in the U.S., experts say it may be important to analyze whether those costs translate into better population health. A new study led by a Penn State researcher analyzed existing data to find a dividing line — or “threshold — for what makes a treatment cost-effective or not.
David Vanness, professor of health policy and administration, led a team of researchers that created a simulation to consider health care treatment costs, insurance premiums, quality of life, and life expectancy to explore whether a treatment delivers enough value for its costs to be considered beneficial for population health.
According to Vanness, the term “treatment cost” in this research incorporates all the costs and savings related to a treatment. For example, the cost of a treatment to lower blood cholesterol would include how much it costs but also take into account potential savings for preventing a heart attack and its subsequent treatment.
“We know that we are spending more and more on health care in the U.S. and that we’re getting less and less for it,” Vanness said. “We do a good job of developing new treatments in this country, but we don’t do a good job of covering everybody or making sure that people have access to basic health care. We’re spending a lot on our medical treatments, but many of those treatments just don’t have a lot of value.”
Vanness added that in order to improve a population’s health without spending too much, it’s important to be able to tell whether the prices drug and device manufacturers are charging are justified by what they deliver in health improvements.
The researchers found that in their simulation, for every $10 million increase in health care expenditures, 1860 people became uninsured. This led to five deaths, 81 quality-adjusted life-years lost due to death, and 15 quality-adjusted life-years lost due to illness. In health care economics, one quality-adjusted life-year (QALY) is equal to one year of perfect health.
Vanness said these results — recently published in the Annals of Internal Medicine — suggests a cost effectiveness threshold of $104,000 per QALY.
“If a treatment is beneficial but it costs more than about $100,000 to gain one quality-adjusted life-year using that treatment, then it may not be a good deal,” Vanness said. “Because our simulation was using data estimates, we wanted to come up with a range of plausible values. So anything over a range of $100,000 to $150,000 per QALY gained is likely to actually make our population’s health fall.”
To create the simulation, Vanness said he and the other researchers used a variety of data, starting with estimates about how likely people are to drop their insurance when their premiums go up.
“We also used evidence from the public health literature on what happens to people’s health and mortality when they gain or lose health insurance,” Vanness said.
The simulation then compiled that data and estimated how much the health of a population goes down when costs increase. According to Vanness, that relationship determines the cost-effectiveness threshold — how much a treatment can cost relative to the health benefits it gives before it causes more harm than good.
The researchers said the findings could be especially important to organizations like the Institute for Clinical and Economic Review, which provides analysis to several private and public insurers to help negotiate prices with manufacturers. These organizations could use the findings as empirical evidence for what makes a treatment a good value in the United States.
“Moving forward, I think some changes could be made to national policy to make cost effectiveness analysis more commonly used,” Vanness said. “Our goal is to get that information out there with the hope that somebody is going to use it to help guide coverage or maybe get manufacturers to reduce their prices on some of these drugs.”
James Lomas at the University of York, and Hannah Ahn, a Penn State graduate student, also participated in this work.
Detailed Population Estimates Dashboard Released
The Pennsylvania State Data Center has released their Detailed Population Estimates Dashboard. Now with the latest estimates for 2019, users can access state and county level data on the total population, the change in population since 2010, and detailed characteristics like sex, age, race, and Hispanic origin.
Click here to visit the dashboard.
COVID-19 Oral Health Resources for School Nurses Available
During the current COVID-19 pandemic, school nurses may be the only avenue for assuring that children receive oral health screenings and referrals. The Association of State and Territorial Dental Directors (ASTDD) and the National Association of School Nurses have collaborated to develop resources for school nurses: “Considerations for School Nurses in Return to School: Dental Screenings” and “School Nurses: The Key to Good Oral Health During COVID-19 Infographic.” Please share with any school nurses you know.
Click here to download “Considerations” document.
Click here to download the infographic.
Parent Handouts on COVID-19 and Oral Health Available
The National Maternal and Child Oral Health Resource Center (OHRC) released two new resources for parents of young children from the Office of Head Start’s National Center on Early Childhood Health and Wellness (NCECHW). The handouts provide clear messages with photos about healthy eating and oral hygiene practices at home and about changes to dental offices to promote the safety of staff and patients during COVID-19. The colorful handouts are available in English and Spanish.
Click here to download the English version.
Click here to download the Spanish Version.
A Three Domain Framework to Innovating Oral Health Care Announced
Change in oral health is long overdue and COVID-19 has brought the system’s issues to the forefront. Now is the time for change. PCOH joins more than 110 oral health leaders in support of a new approach developed by the DentaQuest Partnership for Oral Health Advancement. “A Three Domain Framework to Innovating Oral Health Care” emphasizes overall health as an outcome and is more cost-effective, efficient, and equitable.
Nicotine Dependence and Oral Health Professionals
Have you taken the “Nicotine Dependence Treatment Strategies for Oral Health Professionals” course? PCOH’s newly updated course portal makes it easier than ever! Free CEUs are available. Also, if you would like to get connected to the tobacco coalition in your county/region, please reach out to Paula Di Gregory of Nicotine Free Northwest PA for an introduction. You can also look up your regional tobacco use and prevention cessation primary contractor for the Department of Health below.
Click here to take the course.
Click here to contact Paula Di Gregory.
Click here to look up your regional primary contractor.
Updated Pennsylvania Oral Health Coalition Website Launched
PCOH is excited to share our updated website! While parts of the site may look familiar, there are cool improvements. The new resource page is searchable and has advanced filters so that you can find exactly what you are looking for. The updated course portal provides a more user-friendly continuing education experience. Don’t just take our word for it, check it out!
Regional Response Health Collaboratives in Pennsylvania Strengthen Support for Long-Term Care Facilities
As Pennsylvania Governor Wolf’s administration continues to focus on keeping Pennsylvanians safe, programs have been put in place to protect those most vulnerable including the Regional Response Health Collaborative (RRHC) program. RRHC is a statewide program providing clinical, operational, and educational support to long-term care facilities preparing for or facing outbreaks of COVID-19 at their facility.
COVID-19 can be dangerous in congregate care settings, particularly in settings that serve people who are medically fragile or have other health vulnerabilities that make them more likely to experience additional complications from COVID-19, as often is the case for residents of long-term care facilities. The RRHC Program is a crucial part of catching and responding to outbreaks when they occur, saving lives.
The RRHCs work to assist in ensuring facilities have the resources they need to respond to COVID-19 in these vulnerable settings. As we are in the midst of a fall resurgence, the RRHCs will become even more important.
Pennsylvania’s long-term care system serves more than 127,000 people living in nursing homes, personal care homes, assisted living residences, and private intermediate care facilities. Due to the congregate nature and because they often serve individuals who are older or have co-occurring medical conditions that make them more vulnerable to an acute case of or complications from COVID-19, constant vigilance is necessary to avoid a serious outbreak at these facilities.
RRHC Program Structure
Launched in late July, the RRHC program was established to provide clinical support, technical assistance, and education to long-term care facilities as they work to prevent and mitigate spread of COVID-19. The RRHCs are available 24/7 to support the nearly 2,000 nursing facilities, personal care homes, assisted living residences, and private intermediate care facilities in Pennsylvania and the residents they serve. Eleven health systems were selected to serve six regions across Pennsylvania. Southcentral Pennsylvania’s RRHC is Penn State Health.
Each RRHC is required to make a minimum of two on-site visits to each facility in their region, including an initial on-site assessment that will help the RRHC evaluate a facility’s COVID-19 prevention and mitigation strategies and their preparedness to respond to an outbreak if that were to occur. Based on this assessment, the RRHCs will help those facilities implement best practices in infection control, implement contact tracing programs in facilities, support clinical care through on-site and telemedicine services, and provide remote monitoring and consultation with physicians. RRHCs are in regular communication with DHS, the Department of Health (DOH), and the Pennsylvania Emergency Management Agency (PEMA)to report on experiences interacting with facilities, trends experienced by facilities, and potential challenges.
When a RRHC engages with a facility or is called in to help with a concern identified from collaboration between DHS, DOH and PEMA daily calls, these efforts are classified as missions. A mission could be anything from assistance with testing, assessing a facility’s preparedness, staffing support, rapid response deployment to facilities, PPE support, testing to ensure PPE is properly fitted, and questions or concerns requiring consultation. Since launching, the RRHCs have been assigned more than 6,200 missions, primarily covering testing, consultations, facility assessments, and support with PPE. The RRHCs are also working with the Jewish Healthcare Foundation to operate a statewide learning network available to all long-term care facilities. This network holds regular webinars on topics related to infection control and the latest guidance for responding to and mitigating spread of COVID-19. These webinars have reached more than 1,800 participants since the start of the RRHC program.
The administration can also deploy rapid response teams staffed by the RRHCs when an outbreak is suspected or confirmed at a long-term care facility. These rapid response teams consist of clinical and infection control professionals from the RRHCs to evaluate the situation, ensure proper cohorting of patients based off COVID status, facilitate resident transfers and additional staffing if necessary, and coordinate safe continued care for residents who are not COVID-positive. The rapid response teams can also provide emotional support to both residents or staff to help with the stress and fear associated with an outbreak. Rapid response teams are designed to stabilize potential or confirmed outbreaks, and assistance from RRHCs is not withdrawn until the situation is stabilized and there is no immediate risk to staff and residents.
The RRHC is funded through Pennsylvania’s Coronavirus Aid, Relief, and Economic Security (CARES) Act award, the program is currently scheduled to end on December 1. The Wolf administration recently sent a letter to President Trump requesting funding to extend the program so it may continue to be a resource throughout the winter. Governor Wolf urged President Trump to work with Congress on a new stimulus package that would support the RRHC program and other resources crucial to protecting the lives, health and safety of Pennsylvanians.
“The last eight months have been a period of great learning. We’re now at a point where we have a system that is working and helping to stabilize and prevent outbreaks. As the country works to get a vaccine that is effective in market and available, we need to do all we can to protect people who are most vulnerable to this virus,” said Secretary Miller. “The RRHC program cannot stop COVID altogether, but it is undoubtedly making us better at fighting it. We cannot lose this resource.”