The Agency for Healthcare Research and Quality (AHRQ) is among federal partners and stakeholders that have joined a new initiative to strengthen primary health care nationwide. The effort, launched by the HHS Office of the Assistant Secretary for Health (OASH), follows a National Academies of Sciences, Engineering, and Medicine report that documented the weakening of primary care and called upon the Department of Health and Human Services (HHS) to take a leadership role in ensuring high-quality primary care for all. Judith Steinberg, MD, MPH, a leader in primary healthcare transformation and former chief medical officer at HRSA Bureau of Primary Health Care (BPHC), will lead development of an HHS plan to strengthen primary healthcare with the aim of improving health outcomes and advancing health equity.

The plan, which will be presented to HHS Secretary Xavier Becerra for his review, will include the role of HHS in leading this effort and specific actions to be taken across HHS.

The Centers for Medicare & Medicaid Services (CMS) published two reports on rural health care, including the annual report on rural health accomplishments: Improving Health in Rural Communities: FY 2021 Year in Review as well as CMS recognizes the more than 57 million Americans who live in rural areas and face several unique challenges that can differ dramatically among the different kinds of rural areas across the country. These reports will assist in identifying and addressing some of these challenges.

Improving Health in Rural Communities: FY 2021 Year in Review

In its annual report, CMS demonstrates its commitment to improving the health and wellbeing of individuals living and working in rural areas. Rural, frontier, tribal, and island communities face structural barriers to achieving equitable health outcomes, including practitioner shortages, hospital closures, and long travel distances to access care. CMS is committed to working with rural communities to address these barriers and build on existing advancements to achieve optimal outcomes for all rural Americans.

Through its Rural Health Strategy, CMS is working with federal partners, community organizations, and Tribes to achieve equity in access to care, quality of care, and health outcomes for rural individuals.

The activities and accomplishments outlined represent CMS’s commitment to designing programs and policies that affect rural, frontier, and tribal communities in fiscal year (FY) 2021. They are presented across 10 focus areas: the coronavirus disease 2019 (COVID-19); the Federally Facilitated and State Marketplaces; Medicare Payment and Policy; Practitioner Workforce; Medicaid and Children’s Health Insurance Program Enrollment, Payment, and Policy; Long-Term Services and Supports; Maternal Health; Mental Health and Substance Use Disorders; Models and Demonstrations; and Quality and Equity.

Examining Rural Hospital Bypass for Outpatient Services

CMS has also recently published a report on rural hospital bypass. This report provides an overview of a study, which sought to explore the drivers of rural hospital bypass for outpatient services. This national mixed methods study explores the relationship between hospital outpatient services and inpatient utilization to address the extent of rural hospital bypass, patient characteristics, and utilization of outpatient services.

For more information, visit https://go.cms.gov/ruralhealth or contact RuralHealth@cms.hhs.gov.

Paid for by the US Department of Health and Human Services.

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.