A recent report by the anti-poverty group Oxfam America ranked all 50 states based on a variety of metrics, from whether workers can earn a livable wage, its friendliness to organized labor, and the support services it offers to workers. Based on those metrics, Pennsylvania finished 24th in the nation, finishing behind five of the Keystone State’s six neighbors.

“While the U.S. economy is thriving for some, it is leaving millions of working families behind. As the federal government has refused to advance labor laws that would help, most states have stepped up to make vital improvements in wages and conditions,” the study’s authors wrote.

Here’s how Pennsylvania’s neighboring states finished overall: Delaware (16), Maryland (13), New Jersey (12); New York (13), Ohio (20) and West Virginia (25).  The full report can be accessed here. 

The Patient-Centered Primary Care Collaborative (PCPCC) 2019 Executive Report provides quantitative data and analysis of primary care spend at the state and payer levels, as well as a window into the association between primary care spend and key patient outcomes. The report shows:

• Primary care investment as a percentage of total health care expenditures was low between 2011 and 2016, and it varied considerably across states and across payers
• An association between more primary care investment and better patient outcomes
• A description of legislative/regulatory efforts in 10 states to measure and report on primary care spend and to shift more resources into primary care

Read more.

The Centers for Disease Control and Prevention (CDC) released new data this week that finds that one in seven individuals with diabetes did not take their medication as prescribed because of the cost. The survey found that 13.2% of diabetics either skipped a dose, took less medicine or delayed filling a prescription because of cost. The high cost of insulin has been at the epicenter of discussions on how to make prescription drugs more affordable in the U.S.

The National Alliance to End Homelessness has released a new report, Understanding Encampments of People Experiencing Homelessness and Community Responses:  Emerging Evidence as of Late 2018, to discuss  different models to assist people living in encampments by removing barriers to accessing services and housing through the use of navigation centers, such as those used in San Francisco.  Evidence shows that clearing out encampments without follow-up support services does nothing to solve the actual problem but instead creates unnecessary trauma for inhabitants. More research on the demographic characteristics of people living in encampments would better inform policy and program initiatives.

The Pennsylvania Data Advisory Committee (DAC) is pleased to announce the availability of the 2019  Burden of Cancer in Pennsylvania Report. This report provides a comprehensive analysis of the burden of cancer in Pennsylvania and lists disparities and the harms of cancer for policy makers, program administrators, business and industry leaders, and the citizens of the commonwealth.

Eight cancers were selected for study: cervix uteri, colon and rectum, female breast, leukemia, lung and bronchus, melanoma of the skin, ovary, and prostate.  These selections were based on a survey from cancer control partners in Pennsylvania, each cancer’s impact on the overall burden of cancer, and the fact that screenings and preventive measures exist for most of them.  This report shows different aspects each cancer including incidence, mortality, comparison by sex, race and ethnicity, US and PA trends, age of diagnosis, stage and 5-year net survival.

The DAC is a committee of the Pennsylvania Cancer Control, Prevention and Research Advisory Board with members representing the Pennsylvania Cancer Registry, the Bureau of Epidemiology, Bureau of Health Statistics and Research and the Division of Cancer Prevention and Control within the Department of Health and selected external organizations.

The report can be accessed on the Pennsylvania Department  of Health website at https://www.health.pa.gov/topics/disease/Cancer/Pages/Cancer.aspx

A new report from the Rural and Minority Health Research Center provides the results of a web-based survey disseminated to a geographically diverse sample of nurses throughout the U.S. to assess perceived barriers and facilitators to nursing practice; job satisfaction; and self-identified challenges in nursing work environments and patient care. Of particular interest were nurses in ambulatory care practices.  The full report can be accessed here.

The Rural & Minority Health Research Center (RMHRC) is one of ten HRSA/FORHP-supported centers for research and policy analysis.  In this series of policy briefs, the RMHRC provides data on social determinants of health (SDOH) for four minority groups living in rural areas: African American, Hispanic, American Indian/Alaska Native, and Asian and Pacific Islander.  For each of these groups, researchers used several national data resources such as the U.S. Census to determine rates for educational attainment, poverty status, disability, veteran status, nativity, access to computers and broadband, and access to health care.

The reports can be accessed here.

As part of the transition to value-based care, Medicare Shared Savings Program Accountable Care Organizations (ACOs) have developed a number of strategies to reduce Medicare spending and improve quality of care. This report describes the strategies that selected ACOs have found successful in reducing spending and improving quality of care. These strategies involve working to increase cost awareness in ACO physicians, engaging beneficiaries to improve their own health, and managing beneficiaries with costly or complex care needs to improve their health outcomes. Other strategies that ACOs found successful involve reducing avoidable hospitalizations, controlling costs and improving quality in skilled nursing and home healthcare, addressing behavioral health needs and social determinants of health, and using technology to increase information sharing among providers. ACOs also report challenges in each of these areas and describe the ways they overcame them.

The Centers for Medicare & Medicaid Services (CMS) recently made changes to the Shared Savings Program. As CMS carries out this and other ACO programs and develops new alternative payment models, it should support the use of these strategies and other successful strategies that emerge. These strategies can apply not only to ACOs but also to other providers committed to transforming the healthcare system toward value.

The OIG recommend that CMS take the following actions to support efforts to reduce unnecessary spending and improve quality of care for patients: (1) review the impact of programmatic changes on ACOs’ ability to promote value-based care; (2) expand efforts to share information about strategies that reduce spending and improve quality among ACOs and more widely with the public; (3) adopt outcome-based measures and better align measures across programs; (4) assess and share information about ACOs’ use of the skilled nursing facility (SNF) 3-day rule waiver and apply these results when making changes to the Shared Savings Program or other programs; (5) identify and share information about strategies that integrate physical and behavioral health services and address social determinants of health; (6) identify and share information about strategies that encourage patients to share behavioral health data; and (7) prioritize ACO referrals of potential fraud, waste, and abuse. CMS concurred with all of our recommendations.

The full report can be found at oig.hhs.gov/oei/reports/oei-02-15-00451.asp.

July 2019
OEI-02-15-00451
U.S. Department of Health and Human Services
Office of Inspector General

New Data on HIV Diagnoses; Disproportionate in Rural Areas. The Centers for Disease Control and Prevention (CDC) recently released a new Morbidity and Mortality Weekly Report (MMWR) on HIV testing.  The CDC data show that less than 40% of people in the U.S. have ever been tested for HIV; in the seven states with rural areas that are particularly affected by HIV, just 26% of people recommended for annual HIV testing were tested in the past year.  The proposed HHS-wide initiative, “Ending the HIV Epidemic – A Plan for America,” is  multiyear initiative designed to end the HIV epidemic over 10 years by significantly increasing public health resources, technology, and expertise on the ground in the hardest-impacted areas. The plan, if funded, will focus first on the geographic areas with the greatest HIV burden, including the 50 local jurisdictions and seven states highlighted in the MMWR report, before expanding to reach all areas of the nation affected by HIV.