Last week, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Outpatient Hospital Prospective Payment System (OPPS) Final Rule for Calendar Year 2025.  In addition to annual updates in outpatient hospital Medicare payment rates, this rule finalizes new standards for hospitals and Critical Access Hospitals (CAHs) with obstetric (OB) units regarding maternal quality assessment and performance improvement, the organization, staffing, and delivery of OB care, and staff training on evidence-based maternal health practices.  For hospitals and CAHs with emergency services, it adds standards on facility readiness in caring for emergency services’ patients, including pregnant, birthing, and postpartum women. The rule also finalizes new transfer policies for hospitals that mirror the current CAH and Rural Emergency Hospital standards. These Conditions of Participation (CoPs) will be phased in over two years.

Effective January 1, 2025.  On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which updates the Medicare payment policies and rates for home health agencies (HHAs). CMS projects an increase in aggregate payments by 0.5 percent, and also finalizes a permanent prospective adjustment of -1.975% to the CY 2025 home health payment rate. CMS finalized a new standard for acceptance to service policy in the Home Health Conditions of Participation (HH CoPs) and their proposal with modification to require ongoing respiratory illness reporting for Long-Term Care (LTC) facilities. The rule is effective January 1, 2025.

Among key findings from the University of Minnesota Rural Health Research Center:

• Rural counties have a higher proportion of people with medical debt in collections than urban counties, and this difference is associated with lower average household incomes.
• The county-level median amount of medical debt in collections held by rural residents is higher compared to their urban counterparts, even after accounting for income differences.
• The proportion of people with and amount of medical debt in collections are both higher in rural and urban communities of color than in rural and urban communities overall.

A new report evaluates programs at the U.S. Department of Health & Human Services (HHS) and finds that uninsured rates among adults under age 65 in rural areas have fallen substantially since the passage of the Affordable Care Act (ACA), from 23.8 percent in 2010 to 12.6 percent in 2023.  Uninsured rates among rural residents are much higher in states that have not yet expanded Medicaid, and analysts acknowledge ongoing disparities in health outcomes between rural and urban areas.  Research has shown, for instance, disparities in maternal outcomes, behavioral and mental health outcomes, risk factors for chronic disease such as obesity, hypertension, and cardiovascular disease as well as in potentially harmful health behaviors such as smoking and physical inactivity, to name a few.

The Department of Health and Human Services (HHS) released new data showing that nearly 1.5 million people with Medicare Part D saved nearly $1 billion in out-of-pocket prescription drugs costs in the first half of 2024 because of the Biden-Harris Administration’s Inflation Reduction Act. Thanks to the Inflation Reduction Act, some people with high drug costs have their out-of-pocket drug costs capped at around $3,500 in 2024. Next year that cap lowers to $2,000 for everyone with Medicare Part D. The report shows that if the $2,000 cap had been in effect this year, 4.6 million enrollees would have hit the cap by June 30 and would not have to pay any more out-of-pocket costs for the rest of the year. Learn more here.

The president-elect campaigned on promises to shake up public health institutions, reshape federal health programs, and slash high costs across the system. Trump has said he’s ready for campaign lieutenants like Robert F. Kennedy Jr. to “go wild” on health, medicine, and food policy. Read more.

The CDC Advisory Committee on Immunization Practices issued a recommendation for people 65 years and older and those who are moderately or severely immunocompromised to receive a second dose of 2024-2025 COVID-19 vaccine six months after their first dose. See the announcement on CDC’s Newsroom website. CDC’s upcoming Clinician Outreach and Communication Activity call also relates to respiratory virus. The upcoming call, 2024-2025 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Providers, is Thursday, Nov. 14 from 2:00-3:00 pm. Join the day of the session. **CE credits available** Visit the call webpage for call-in info and more details.

In January 2024, the commonwealth launched PA Navigate, a new website that connects residents to community organizations, government agencies and health care providers for access to resources for basic needs, such as food, housing, and childcare. Read more In efforts to educate the community, a PA Navigate flyer was developed if you’d like to share within your community.

Pennsylvania has joined several interstate licensing compacts and is poised to join numerous others. Interstate compacts provide flexibility for trained professionals to practice where they want and where they are needed. However, the regulatory process in Pennsylvania to enact these licenses is long and arduous. Pennsylvania Governor Josh Shapiro signed Act 119, to give licensing boards the agility they need to get compacts up and running in a timely manner. The Act grants boards that are subject to an interstate licensure compact the power to promulgate temporary rules for compact implementation. Licensing boards would still be required to use the full regulatory process to establish permanent guidelines. Temporary regulations promulgated under this legislation would expire after three years.

ARC is seeking proposals from organizations, including non-profits, institutions of higher education, and other stakeholders to work in partnership with the ARC Academies & Institutes team to execute the Appalachian Leadership Institute (ALI), a leadership development program for people who live and/or work in Appalachian and are passionate about helping their communities thrive.

Launched in 2019, the Appalachian Leadership Institute is a leadership training opportunity that equips Appalachian community leaders to use economic development as a tool to drive positive change. Since its launch, ALI has trained approximately 200 Appalachian leaders.

ALI is a collaborative effort between the Appalachian Regional Commission and the Organization that serves as our curriculum partner. The selected organization will provide expertise on content and curriculum planning under the leadership and approval of ARC. More information on the breakdown of roles and responsibilities can be found in the RFP.

Proposals must describe the strategy for promoting and implementing action-oriented leadership in the Appalachian Region, to include, but not be limited to, the following major components under the ALI umbrella:

• A program aimed at 40 leaders from Appalachia’s public, private, and non-profit sectors.
• Curriculum and sessions focused on ARC’s five investment areas.
• Case study work that reflects both the opportunities and challenges in the region.
• Proposed areas of training in leadership skills development.
• Alumni Network Programming
  • Curriculum and sessions that build upon the core curriculum of the program
  • Proposed strategy for network building and continued growth

Key dates are outlined below. If you have any questions, please reach out to Academies & Institutes Program Manager Jessica Mosley at leadershipRFP@arc.gov.

RFP open date: November 7, 2024
Questions due: December 13, 2024
Answers posted on arc.gov: December 19, 2024
Proposal due date: January 10, 2025
Interviews: February 24-28, 2025
Selection date: March 10, 2025
Contract period: August 1, 2025 – July 31, 2026