The Rural Health Telehealth Resource Center has published a new brief.

Economic analysis of health care utilization is a pressing priority. However, procuring economic data presents many challenges. One approach is to obtain charge and reimbursement data within a single health care organization, but this approach lacks external validity. Another approach is to obtain charge and reimbursement data across health care organizations by analyzing claims databases (e.g., Medicare, Medicaid claims). But this approach restricts the sample to covered beneficiaries (e.g., older, disabled), which restricts generalizability. We aimed to obtain economic data on emergency department (ED) visits from a number of unrelated rural hospitals and sought an approach for doing so. It appeared feasible to have rural hospitals report the Current Procedural Terminology (CPT) code (AMA, 2021) and associated charge for a sample of ED visits, since CPT codes would be generated for billing and insurance claims submission. The specific aim of this analysis is to explore the characteristics of the resulting dataset in terms of distribution and association with related variables.

Please click here to read the brief.

The Pennsylvania Department of Health, Public Health Management Corporation, the Healthy Pennsylvania Partnership, and Bloom Planning have released the 2020 Pennsylvania State Health Assessment: The State of Our Health: A Statewide Health Assessment of Pennsylvania.

The state health assessment was completed between January and December 2020 and focuses on eight priority areas. The report explores the many ways Pennsylvanians have been impacted by social determinants of health and health inequities, as well as by COVID-19. The report highlights assets that can be utilized to improve health and identifies cross-cutting needs, like addressing access, prevention, and racism. This work aims to educate and mobilize communities to develop priorities, leverage resources, and plan actions to improve population health.

The Pennsylvania Partnerships for Children released Career and Technical Education is Essential for our Economy Post-COVID-19, a fact sheet produced with PA Schools Work coalition partner the Pennsylvania Association of Career & Technical Administrators (PACTA), outlining the impacts of the pandemic on CTE programs, which are essential for our state’s workforce and economy. The fact sheet includes the results of a survey conducted earlier this year by PPC on PACTA members to understand better the challenges they face in delivering education during the public health crisis.

While federal stimulus funds received from Washington over the past year have helped address one-time costs – including additional expenses associated with equipment in delivering CTE – state investments over the past two years have stalled. We highlight how access to these programs has not improved and the timing because CTE is a pipeline for many industries that supply the frontline workforce. To ensure that all interested students have an opportunity to access career and technical education, we call on Governor Wolf and policymakers to make a $25 million investment in CTE in the upcoming 2022-23 state budget.

The Community Preventive Services Task Force (CPSTF) has released its 2020 Annual Report to Congress.

The report summarizes the CPSTF’s work from fiscal year 2020 and includes recommendations for intervention approaches that address health equity, HIV prevention or tobacco and economic reviews of previously recommended interventions that address cardiovascular disease or cancer screening. The report also lists critical evidence gaps identified by the systematic reviews and highlights the priority topics CPSTF selected to guide future reviews from 2020 to 2025.

The U.S. Preventive Services Task Force (USPSTF) has published an article titled, “Actions to Transform U.S. Preventive Services Task Force Methods to Mitigate Systemic Racism in Clinical Preventive Services,” in the Journal of the American Medical Association (JAMA). The article details action the Task Force is taking to promote antiracism and health equity in preventive care by confronting these issues throughout its recommendation development process. These efforts are aimed at reducing the effects of social injustices in health care and, ultimately, helping better equip clinicians with the evidence-based guidance they need to prevent disease and keep everyone as healthy as possible.

The United States had the second-steepest decline in life expectancy among high-income countries in 2020, according to research published last week. U.S. men saw life expectancy fall by 2.3 years, from about 76.7 to 74.4. Women lost more than 1.6 years, falling from about 81.8 to 80.2. Researchers compared observed life expectancy in 2020 with what would have been expected for the year based on historical trends from 2005-2019. Life expectancy dropped in 31 of the 37 countries studied. Only Russia had a steeper decline than the U.S.

The Flex Monitoring Team (FMT) has released a new policy brief: Critical Access Hospitals’ Initial Response to the COVID-19 Pandemic: Use of Federal Funding and Regulatory Flexibilities. This brief uses survey data collected by the FMT about Critical Access Hospitals’ response during the first seven months of the COVID-19 pandemic and describes key findings from the survey including:

• How many participating CAHs received federal funding and from which sources
• Which regulatory waivers and flexibilities were most commonly used by participating CAHs

On our website, you can read more about other FMT work assessing the impact of the COVID-19 pandemic on Critical Access Hospitals.

Counties with greater primary care access, more robust public health and fewer social vulnerabilities had fewer COVID-19 infections and deaths, according to a report from the Primary Care Collaborative (PCC) and Robert Graham Center. “As we emerge from the current pandemic and re-imagine and rebuild primary care, we also need to look at other factors, such as investment in public health and community-based services,” PCC President and CEO Ann Greiner said in a statement. “It is beyond time for us all to reach beyond our silos and join forces to address the widening health inequities that the pandemic laid bare.”

More than 2 in 5 children in PA now rely on publicly funded or supported health insurance

Pennsylvania Partnerships for Children (PPC), the only statewide advocacy organization with a public policy agenda that spans a child’s life prenatally through adulthood, released its 2021 State of Children’s Health Care in Pennsylvania: Health Insurance During the COVID-19 Pandemic. Due to the unique circumstances of the COVID-19 pandemic and the limited data available as a result, this year’s report takes a different approach by using alternate data sources.

The report highlights steps to connect Pennsylvania children to health insurance better and reduce known racial disparities that will continue to deepen if not directly addressed.

“We found that families have weathered the pandemic storm under the umbrella of public health coverage because enrollment increased in the last year,” said Kari King, President and CEO of Pennsylvania Partnerships for Children.

Together, Medicaid, the Children’s Health Insurance Program, and Pennie™, the state-based marketplace, account for 45.9% of children covered in Pennsylvania. Statewide, Medicaid and CHIP have enrolled 10% more children since the beginning of the pandemic, and every county has seen an increase.

King said a key factor affecting the increase is the disenrollment freeze implemented in the Families First Coronavirus Response Act in March of 2020, which will be in place for as long as the federal public health emergency (PHE) is in effect.

However, an estimated 500,000 individuals stand to lose coverage once the PHE expires and routine Medicaid operations resume if Pennsylvania does not carefully plan.

“Threats to safety net programs existed before the pandemic,” said King. “We cannot understate the importance of ensuring that every eligible child and pregnant or postpartum individual does not unnecessarily lose coverage.

“Keeping eligible people connected to Medicaid once the public health emergency ends is avoidable,” she continued. “In partnership with other Pennsylvania health advocates, we offer best practices to assist DHS, the state’s Medicaid agency, in its planning efforts for the enormous task ahead, some of which can start now, before the PHE ends.”

Those recommendations include ensuring those with existing coverage stay connected without unnecessary gaps in coverage through auto-renewal strategies, updating current mailing addresses and more extended time frames for continuous coverage.

In addition, data shows disproportional impacts of the pandemic by race and ethnicity on Pennsylvania households with children, causing economic hardship, food insufficiency and delayed medical care. Larger percentages of children of color enrolled in Medicaid during the pandemic than their White counterparts, which would appear consistent with existing health disparities that have become exacerbated over the past nearly two years.

“We acknowledge that we do not have all of the pieces of the puzzle. What we do know is that these disparities will continue to deepen if not directly addressed. Using data disaggregated by race and ethnicity coupled with feedback from impacted communities can help achieve equitable outcomes,” said King.

The report also covers the impact of the pandemic on routine immunizations that protect from 17 childhood diseases. Overall, Pennsylvania had a 5% decline in vaccination coverage. The early part of 2021 shows vaccination gaps continued among children, particularly preschool and young school-age children ages 4-10. Ensuring kids are up to date on routine immunizations is necessary for community health and helps keep them healthy enough to stay in school.