This final rule requires—for the first time—that states, the District of Columbia (DC), and certain territories mandatorily report measures on the quality of health care provided to Medicaid and CHIP beneficiaries.  Prior to this rule, states voluntarily reported quality measures from the Medicaid Child Core Set and the Adult Core Set.  This rule implements mandatory annual reporting of the Child Core Set and the behavioral health measures on the Adult Core Set using a standardized format.  It also establishes reporting requirements of measures in the Health Home Core Set for states that elect to implement one or both of the optional Medicaid health home benefits.  Medicaid is an important source of health insurance covering over one in five rural residents under the age of 65.

The Pennsylvania Department of Human Services (DHS) has published three reports required by the Centers for Medicare and Medicaid Services on Pennsylvania’s Medicaid unwinding. The first report is a point-in-time baseline report with pending data. The second report is a monthly snapshot of data. Both reports are for the entire Medicaid population. A third document called the Continuous Eligibility Unwinding Plan explains how DHS will process all Medicaid and CHIP renewals. The July 2023 monthly report shows 273,057 total beneficiaries for whom a renewal was initiated during the reporting period with 247,827 due for renewal. Of those renewed and retained, 11,842 were renewed on an ex parte basis, 83,667 were renewed using a pre-populated form, 26,627 were transferred to Pennie, 20,606 individuals were terminated for procedural reasons and 105,085 renewals were not completed. The ex parte automated process has experienced system glitches, and some applications are being processed manually. To view these reports, visit the PA DHS Federal Unwinding Reports webpage.

A new report offers practical, rural-relevant strategies that critical access hospital (CAH) leaders and staff can adopt to more fully incorporate quality improvement efforts into their organization’s culture and develop a shared sense of responsibility for quality patient care.  Based on discussions among rural health quality leaders from across the country who attended the Critical Access Hospital Infrastructure Summit earlier this year, the report is the work of the National Rural Health Resource Center, in partnership with the Flex Monitoring Team and Stratis Health.

  Among the key findings in this study from the Rural and Minority Health Research Center: existing data is insufficient to determine national estimates of water quality or to compare water quality in rural versus urban areas; the lack of standardized data makes it challenging to protect the public from unsafe waters in a variety of settings.

Two briefs from the Rural and Minority Health Research Center document disparities in geographic access to health services for areas containing a high proportion of minoritized racial/ethnic group residents. The term “minoritized” refers to groups that have been historically marginalized by society and government institutions.

Researchers from the University of California released a paper this month examining the disparate impacts of the COVID-19 pandemic on school students. The pandemic exacerbated longstanding educational inequities in student academic performance and mental health outcomes based on race, ethnicity, and socioeconomic status.

Data from students across the United States during the 2020-21 school year shows:

• Pre-existing achievement gaps in reading and math widened notability for students of color and those from high-poverty school districts.
• Absenteeism and grade retention increased at higher rates for Black and Hispanic students, who were more likely to attend schools negatively impacted by the transition to remote learning.
• School closures were more typical in underserved communities, and low-income families had limited access to traditional in-person instruction and high-quality remote learning experiences.
• The pandemic led to widespread increases in fear, anxiety, depression, loneliness, and behavioral issues for students of all ages, regardless of race, ethnicity, or socioeconomic status.
• School engagement rates were highest among students from households with higher incomes and parental education levels.

Black and Hispanic students were more likely than White students to feel very or extremely worried about the pandemic. They reported disproportionately high rates of COVID-related stress despite their caregivers being less likely than white caregivers to report concerns about their children’s mental health in the wake of school closures.

Maternal health ensures mothers and birthing parents are healthy and their children have the best start possible. Research shows healthy mothers are more likely to raise healthy babies. Unfortunately, the U.S. has the highest maternal mortality rate among developed countries, and racial disparities plague the health care system for Black and Brown women.

Our first-ever maternal health county fact sheets show each county’s overall perinatal vulnerability index (PVI). The PVI uses data across five domains: behavioral health, environmental context, health care availability, pregnancy and birth outcomes, and social stratification. The fact sheets also highlight data about prenatal care and the percentage of low birth weight births.

In 2020, there were over 130,000 total births across Pennsylvania. Yet, only 13 counties had moderate access to care, and six counties were considered maternity care deserts, based on the March of Dimes Maternity Care Deserts Report (2022).

Research shows low birth weight is a strong indicator of maternal health, and the rate increased nationally by 4% since 2014. When children are born with low birth weight, there is an increase in the risk for future health and developmental issues.

Racial disparities limit access to maternal health care and can impact the health of both mother and child:

• The rate of non-Hispanic Black women giving birth to children with low birth weight is 14.5% compared to 6.8% of White women and almost double the state rate of 8.3% across all races.
• When comparing counties, the rate of low birth weight among Black women ranged from 22.9% in Lebanon County to 7.5% in Bucks County.

Thriving PA aims for women and birth parents to have access to the health resources needed for a healthy pregnancy and delivery. Maternal health is necessary for raising healthy children, and more attention is needed to make maternal health care more accessible, especially for Black and Brown women who have a higher risk of poor birth outcomes and maternal mortality and morbidity.

  The Kaiser Family Foundation examines newly released provisional data from the Centers for Disease Control and Prevention showing a record high of 49,369 suicide deaths in 2022.  Rates were highest among American Indian and Alaska Native people, males, and people who live in rural areas.  Suicide by firearm is identified as the primary driver of the increase – up by 8 percent from 2020 and another 3 percent in 2022, while deaths from other suicide methods remained more stable.

  The Office for Evaluation at the U.S. Department of Health & Human Services analyzed data from the Centers for Medicare & Medicaid Services.  The report covers all U.S. hospitals enrolled in Medicare with data on hospital type, rural/urban location, organizational structure, and types of ownership – organizational and hospital chains, and individual owners.

2023 Metropolitan Statistical Areas (MSAs)

The Office of Management and Budget (OMB) released the Revised Delineations of Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Combined Statistical Areas, and Guidance on Uses of the Delineations of These Areas.  Click here to view the bulletin.

The OMB Bulletin uses OMB’s 2020 Standards for Delineating Core Based Statistical Areas.  It is also the first delineation to use the 2020 Decennial Census, American Community Survey, and Census Population Estimates Program data.

2030 Census

Planning for the 2030 Census – the 25th in U.S. history – is underway. To develop the operational design, the U.S. Census Bureau will factor in past census experiences, your feedback, and new research. They will also consider evolving technologies and the changing world around us. The Census Bureau also released an updated timeline showing the lead-up to the 2030 Census. Click here to learn more.

New Report on Aging Veterans

A new report released by the U.S. Census Bureau shows U.S. veterans 65 years or older were less likely to be at risk of experiencing social isolation than other older adults. The report, Aging Veterans: America’s Veteran Population in Later Life, examines characteristics of the nation’s 8.1 million veterans ages 65 or older in 2021.