New Report Highlights AI’s Uneven Effect on Regional Jobs

Posted on by lad3

Generative AI is already reshaping the U.S. economy, but new research shows its impact on workers may not be evenly spread. Using a new AI jobs transition framework to identify who is most exposed to AI’s risks and benefits, researchers found:

  • Jobs with lower education requirements (high school or some college) are most at risk. Lower- to middle-wage roles requiring less education, such as customer service representatives and administrative assistants, face a higher risk of automation. Jobs expected to grow with AI are mostly higher-wage and typically require a bachelor’s degree.
  • Women, Black, and Hispanic workers are less likely to benefit from AI-driven growth. Women are more than twice as likely as men to hold jobs at higher risk of automation.

In our region, the share of at-risk jobs is similar to the nation’s, but remote and smaller metros tend to have fewer jobs projected to grow with AI.

Read more.

New Report Details Infant Toddler Early Intervention System in Pennsylvania

Posted on by lad3

Pennsylvania Partnerships for Children (PPC), in partnership with the Thriving PA campaign, released a new data brief, Pennsylvania’s Infant Toddler Early Intervention System: Data, Gaps, and Policy Opportunities, that highlights the current landscape of Infant Toddler EI statewide. The report examines several data points, including expenditures; demographics of children served by the program; referrals and eligibility; service timelines; and workforce information from FY 2021-22 through FY 2024-25 at both the state and county/joinder level. Partnering with OCDEL to collect the data provides a foundation for understanding how the Infant Toddler EI system operates in Pennsylvania and helps us identify service gaps, barriers to access, and opportunities for improvement to better serve the needs of children and families.

As we enter the FY 2027-28 budget cycle, the Early Intervention workgroup of Thriving PA is seeking to offset the $5.2 million reduction included in this year’s final state budget. As part of our advocacy, we are underscoring the need for Infant Toddler EI to provide adequate rates for providers as well as funding to support outreach, referral, and early identification efforts to connect children and families with the program. Continued investments in the Infant Toddler EI system are essential to stabilize the workforce and allow more children to be identified and served through the program. Providing EI services early on allows children the best opportunity to thrive and need less costly interventions as they progress through school.

PPC plans to to obtain and analyze Infant Toddler EI data. We plan to release a data dashboard with both statewide and county-level data, as well as a more comprehensive system report in 2027.

How Aging Baby Boomers are Reshaping Pennsylvania’s Population

Posted on by lad3

From The Keystone and

The number of Pennsylvanians in advanced years is projected to jump by 43% in the next decade, a period when the commonwealth’s population overall is expected to contract, according to a new report by state analysts.

These anticipated changes to state demographics reflect declining birth rates and the fact Baby Boomers are starting to enter their 80s, said analysts with the Independent Fiscal Office, a nonpartisan agency that provides guidance to lawmakers.

The report published in October notes that, by 2035, the population of working-age adults is expected to shrink, while the number of older residents who rely on care and support will expand. Policymakers have predicted this shift could strain the state services and stretch healthcare systems that are already suffering from workforce shortages.

What’s the big picture for Pennsylvania’s population?

Overall, the analysts are predicting the Keystone State’s population will hold relatively flat in the next several years, contracting by just 0.1% to about 13 million residents by 2030. They’re expecting it to drop to about 12.9 million in the subsequent five years.

The commonwealth’s population of children and teenagers will fall by nearly 8% in the coming decade, and the number of adults aged 20 to 64 will contract by about 2%, the analysts predict.

Retirees aged 65 to 79 are expected to increase in number over the next five years, but their population will fall by 2035 as the Baby Boomer cohort transitions into their 80s, according to these estimates.

The population of advanced age adults will see the biggest growth in the next decade, increasing by more than 42% from about 668,000 to 953,000, the report predicts.

How are demographic changes different across Pennsylvania?

From 2020 to 2025, the analysts reported, population decreases were most dramatic in parts of rural Pennsylvania. Fayette and Cambria counties lost 4.3% and 3.2% of their populations respectively in that period.

Philadelphia and Allegheny counties have also been losing residents, albeit at slower rates, according to the report.

But some parts of the state have been experiencing growth, particularly suburban communities in eastern Pennsylvania. Pike, Cumberland and Chester counties all saw their populations climb by more than 4% in the past five years, the analysts noted.

CMS Updates CAH Rural and Distance Eligibility Review Guidance

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The Centers for Medicare and Medicaid Services (CMS) issued updated guidance for evaluating whether Critical Access Hospitals (CAHs) continue to meet Medicare rural status and distance requirements, including clarification of the circumstances that trigger an eligibility review. Effective September 20, 2026, CMS will conduct reviews when a new acute care hospital is seeking Medicare certification near an existing CAH, when CMS identifies a nearby acute care hospital not considered during a prior review, or when a hospital seeks new CAH certification or conversion.

Beginning in 2033, CMS will also review all existing CAHs for compliance with rural status and distance requirements on a 10-year cycle although CMS may conduct a review of rural and distance eligibility at any time. CAHs found no longer eligible will generally have a set period of time to reclassify as rural, convert to an acute care hospital or Rural Emergency Hospital if eligible, or face termination of Medicare participation.

The guidance also recommends that CAHs seek an advance CMS determination before adding a provider-based location to ensure the location will not affect CAH eligibility and clarifies that routine recertification surveys may proceed without CMS first confirming rural and distance eligibility.

“State Survey Agency and CMS-Approved Accrediting Organization recertification surveys may be performed based on the CAH’s existing recertification schedule and no longer require confirmation from CMS of rural and distance eligibility to proceed.”

For additional information, click here or contact CAHReviewTeam@cms.hhs.gov

Pennsylvania Cost Containment Council Welcomes Experts to Technical Advisory Group

Posted on by lad3

The Pennsylvania Health Care Cost Containment Council (PHC4) is pleased to announce the appointment of two new members to its Technical Advisory Group (TAG): Scott W. Cowan, MD, FACS, healthcare executive and thoracic surgeon who serves as Chief Medical Officer (CMO) and Chief Quality Officer (CQO) at Thomas Jefferson University Hospitals, Inc.; and Nancy A. Garrett, Ph.D., Vice President of Provider and Market Analytics at Highmark Health. Their appointments were formally approved by the Council on Sept. 3, 2026.

TAG plays a vital role in addressing complex analytical and methodological issues that arise from PHC4’s work. In this capacity, Cowan and Garrett will join a respected panel of physicians, researchers, biostatisticians and healthcare organization representatives committed to strengthening healthcare transparency for Pennsylvanians. The group reviews critical healthcare measurement strategies and provides guidance on research design, statistical analysis and risk‑adjustment methodology, offering rigorous recommendations to ensure the integrity of PHC4’s data and reports.

Cowan and Garrett bring deep expertise that will enhance TAG’s impact and oversight. Garrett shared that she looks forward to advancing PHC4’s mission, noting, “This is more important than ever now, and we have a huge opportunity to leverage this collaborative to make a difference.” Cowan echoed her sentiments and expressed enthusiasm about contributing his clinical and quality-improvement expertise to the group.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered. For more information, visit phc4.org or review PHC4 Council, Committees, and Groups here.

Pennsylvania Data Center Provides New Census, Other Data

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Research Brief Highlights New ACS 1-Year Estimates

The U.S. Census Bureau released a new set of estimates from the American Community Survey (ACS) for the year 2025, providing new data for a variety of demographic and economic topics for the nation, states, and other areas with populations of 65,000 or more.

New 2025 ACS data for Pennsylvania show statistically significant increases in the 65+ and Hispanic or Latino populations, bachelor’s degrees, household income, cost of rent, owner costs, home values, and broadband access, plus a decline in labor force participation.

Read the full 1-Year Estimates release brief.

Note: This release was delayed from its typical September release timeframe due to a new Department of Commerce departmental administrative order (DAO) on disclosure avoidance for statistical products. Other ACS release dates for 2025 have yet to be announced.

Nonemployer Statistics (NES) is an annual data product that provides subnational economic data for U.S. businesses with no paid employees by industry. This series includes the number of establishments and total receipts.

States Race to Get the Word Out About New Medicaid Work Requirements

Posted on by lad3

We’re entering a moment where missing a few pieces of mail could mean losing your Medicaid.

In 2027, roughly 20 million people will begin to face more eligibility checks, and need to prove they’re working, volunteering, going to school or exempt from new requirements pushed through by Republicans as part of President Trump’s Big Beautiful Bill.

Through a flurry of webinars, text messages and trainings, hundreds of health care groups are hustling to let people know what’s ahead. But they have a long way to go.

“If I spoke to 10 people about the changes, maybe one person might know that it’s coming,” said Toya Walker, an outreach worker pounding the pavement in Camden, New Jersey, a small city across the Delaware River from Philadelphia.

For this week’s story, we traveled to Camden to see those outreach efforts in action. We also spoke with more than a dozen experts — including health insurers, state Medicaid officials and researchers — about how this communications blitz is unfolding across the country.

Here are some key takeaways:

  • States know what they need to do to reach people — but actually doing it is a lot tougher. Experts generally agree that training trusted messengers and getting clear information to people most affected by these policies are among the best communication strategies. But with time and money tight, states are struggling to execute. “I don’t want to say communications is a luxury item,” said Manatt consultant Kinda Serafi, “but it does feel like it’s not always at the top of the list.
  • State Medicaid programs are leaning heavily on partners to get the word out. Those partners include hospitals, community clinics, advocacy groups and the insurance companies that manage many people’s Medicaid. “The state has turned to us to get to all of those groups that are in between the cracks,” said Kathleen Noonan, CEO of the Camden Coalition, a New Jersey-based nonprofit that’s worked with people who have complex medical and social needs for nearly 25 years.
  • Complicated and evolving rules about who the new requirements apply to make clear communication particularly tricky. One state’s fact sheet, for example, lists 16 different exempt groups. Nearly a dozen states are offering self-screening tools to help consumers figure out for themselves whether these new rules apply to them. Federal officials have also been slow to clarify some details, like who qualifies for a medical exemption, which has left outreach workers like Toya Walker feeling frustrated. “I need clarity, and I need clarity now,” she said.
  • Technology has a big role to play in minimizing coverage losses, but its adoption has been uneven. States have the power to use existing data sources, such as income and tax filings, to automatically verify many people’s Medicaid eligibility. “The best way to keep people covered is to ask as little of the enrollee as possible,” said Harvard researcher Adrianna McIntyre. While more than a dozen states now automate most of their renewals, many others are far less tech savvy. To make automation easier, some states are asking people to share more data about their income — a request that’s met significant resistance.

Despite all of these efforts, experts still expect millions of people to lose their insurance. Harvard’s McIntyre points to Arkansas’ experience with a similar work requirement in 2018 as a cautionary tale.

Many people ended up automatically excused, but the rest needed to confirm they were working or had a valid exemption. The state sent 900,000 letters and emails to let people know what they needed to do to keep their Medicaid.

“You didn’t have to prove it. You just had to check a box,” McIntyre said. “And we still lost something like 80% of enrollment.” That’s why experts like McIntyre said in addition to trying to communicate the coming changes, states also need to prepare to catch people who will, inevitably, fall through the cracks.

To learn more about how states are trying to beat those long odds with a combination of new-school technology and old-school boots on the ground, listen to the full story or read the transcript.

DOL Finalizes Pharmacy Benefit Manager Fee Disclosure Rule

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The U.S. Department of Labor’s employee benefits arm unveiled a final rule on October 28, 2026 that requires pharmacy benefit managers – which act as intermediaries between drugmakers, pharmacies and insurers – to make new disclosures on their fees and compensation to employer-sponsored group health plans.

Penn State Health Policy Researchers Publish Papers on Consolidation in U.S. Healthcare

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Adding to the national conversation on consolidation in U.S. healthcare, Penn State researchers contributed to an upcoming special issue of Medical Care Research and Review (guest edited by Dennis Scanlon). Their research was also discussed at a recent meeting in Washington, D.C. involving stakeholders from federal and state government, the healthcare industry, labor unions, and academia.

Recent Evidence on Consolidation in U.S. Healthcare: Integration Pathways, Impacts, and Implications for Policy, Regulation, and Research

Authors: Dennis Scanlon, Nima Khodokarami, and Yunfeng Shi

This article synthesizes findings from studies included in a special issue of Medical Care Research and Review (MCRR) about consolidation in U.S. health care. Articles are grouped thematically, with findings discussed relative to the existing literature on the impact of consolidation on outcomes such as price, expenditures, access, and quality of care delivered. The article highlights key limitations and offers the following suggestions to better inform public policy, regulation, and new payment models: (a) traditional market definitions should be reconsidered given the evolution of consolidation and its impact on the contestability of markets; (b) fair and efficient pricing requires knowledge of production costs, which is currently limited; (c) payment, policy, and regulatory options should better account for the unique challenges in rural markets; (d) state policy change, including examination of existing provider licensing laws, could yield market improvements; and (e) continued investments in data infrastructure are needed to mitigate the potential negative effects of consolidation.

Citation: Scanlon DP, Khodakarami N, Shi Y. Recent Evidence on Consolidation in U.S. Health Care: Integration Pathways, Impacts, and Implications for Policy, Regulation, and Research. Medical Care Research and Review. 2026;0(0). doi:10.1177/10775587261499650

Community Characteristics Associated with Health System Penetration

Authors: Haoyu Bi, Mark Ramos, Jeannette Rogowski, and Charleen Hsuan

Health systems have become a dominant form of health care organization in the United States, yet little is known about how their presence varies across communities. This study examined the association between the community-level characteristics and health system penetration, defined as the percentage of general acute care hospital beds affiliated with a health system in a geographic market. We found that communities with higher health system penetration tended to have lower levels of competition. In rural areas, greater insurance coverage was associated with greater penetration. In urban areas, communities without health system presence were more likely to have larger Black populations relative to White populations. However, among communities with some system presence, those with larger Black populations tended to have higher levels of penetration. Policymakers should adopt context-specific policies that encourage investment in underserved communities, promote equitable access to high-quality care, and guard against the potential adverse effects of consolidation.

Citation: Bi H, Ramos ML, Rogowski JA, Hsuan C. Community Characteristics Associated With Health System Penetration. Medical Care Research and Review. 2026;0(0). doi:10.1177/10775587261469029

698 Rural Hospitals at Risk of Closing, By State

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From Becker’s Hospital Review

Nearly 700 rural hospitals across the country, about one-third of all rural facilities in the U.S., are at risk of closing due to severe financial problems, according to an Oct. 28 Center for Healthcare Quality and Payment Reform analysis.

Of the 698 hospitals at risk, 260 face immediate risk of closure. Rural hospitals are at risk of closing in almost every state, except four: Utah, Delaware, Maryland and New Jersey. More than 25% of rural hospitals are at risk of closure in the majority of states and 50% or more are at risk in 11 states.

The numbers are slightly lower than the July CHQPR analysis, which found 700 hospitals at risk of closure and 264 at risk of immediate closure. They are also down from the think tank’s May report, in which 720 hospitals were at risk of closure with 294 at immediate risk.

Becker’s has reported on just six planned hospital and emergency department closures so far in 2026. At this point in 2025, Becker’s had already reported on 22.

Since 2015, 110 hospitals have closed, the report found. Since 2023, 56 hospitals have ended inpatient services to qualify for grants that are available only to rural emergency hospitals. That number was 53 in July 2026.

More than 40% of rural hospitals are still losing money on delivering patient services, and more than a quarter of rural hospitals lost money overall in 2025. In July, the analysis reported nearly one-third of rural hospitals had lost money in 2024 and 2025.

The center’s report said private insurers are the primary reason rural hospitals are at risk of losing money. About half of the services at an average rural hospital go to patients with private insurance, including employer-sponsored plans and Medicare Advantage. Losses on these patients, not Medicare or Medicaid payments, determines in many cases whether a rural hospital loses money.

Increased payments enough to prevent closures of at-risk hospitals would cost about $4 billion per year, the analysis said. The July report estimated $5 billion.

“Rural hospitals should not be forced to eliminate inpatient care in order to receive higher payments for other services, as is required under the federal ‘Rural Emergency Hospital’ program,” the analysis said. “Federal programs should preserve and expand rural healthcare services, not reduce them.”

The state-by-state breakdown below shows rural hospitals at risk of closing and those at immediate risk, with the percentage of rural hospitals that number represents:

Alabama
 24 hospitals at risk of closing (52%)
17 at immediate risk of closing (37%)

Alaska
 2 hospitals at risk of closing (12%)
1 at immediate risk of closing (6%)

Arizona
 4 hospitals at risk of closing (15%)
0 at immediate risk of closing (0%)

Arkansas
 32 hospitals at risk of closing (70%)
8 at immediate risk of closing (17%)

California
 16 hospitals at risk of closing (27%)
4 at immediate risk of closing (7%)

Colorado
 11 hospitals at risk of closing (26%)
3 at immediate risk of closing (7%)

Connecticut
 3 hospitals at risk of closing (75%)
2 at immediate risk of closing (50%)

Delaware
 0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)

Florida
 9 hospitals at risk of closing (41%)
3 at immediate risk of closing (14%)

Georgia
 22 hospitals at risk of closing (30%)
9 at immediate risk of closing (12%)

Hawaii
 8 hospitals at risk of closing (62%)
0 at immediate risk of closing (0%)

Idaho
 8 hospitals at risk of closing (30%)
2 at immediate risk of closing (7%)

Illinois
 15 hospitals at risk of closing (19%)
8 at immediate risk of closing (10%)

Indiana
 10 hospitals at risk of closing (18%)
5 at immediate risk of closing (9%)

Iowa
 8 hospitals at risk of closing (9%)
2 at immediate risk of closing (2%)

Kansas
 58 hospitals at risk of closing (58%)
21 at immediate risk of closing (21%)

Kentucky
 13 hospitals at risk of closing (19%)
2 at immediate risk of closing (3%)

Louisiana
 24 hospitals at risk of closing (43%)
10 at immediate risk of closing (18%)

Maine
 10 hospitals at risk of closing (42%)
2 at immediate risk of closing (8%)

Maryland
 0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)

Massachusetts
 1 hospital at risk of closing (14%)
0 at immediate risk of closing (0%)

Michigan
 10 hospitals at risk of closing (15%)
3 at immediate risk of closing (5%)

Minnesota
 15 hospitals at risk of closing (15%)
3 at immediate risk of closing (3%)

Mississippi
 35 hospitals at risk of closing (52%)
24 at immediate risk of closing (36%)

Missouri
 29 hospitals at risk of closing (51%)
10 at immediate risk of closing (18%)

Montana
 15 hospitals at risk of closing (29%)
3 at immediate risk of closing (6%)

Nebraska
 5 hospitals at risk of closing (7%)
0 at immediate risk of closing (0%)

Nevada
 4 hospitals at risk of closing (31%)
1 at immediate risk of closing (8%)

New Hampshire
 5 hospitals at risk of closing (28%)
1 at immediate risk of closing (6%)

New Jersey
 0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)

New Mexico
 7 hospitals at risk of closing (26%)
1 at immediate risk of closing (4%)

New York
 22 hospitals at risk of closing (43%)
10 at immediate risk of closing (20%)

North Carolina
 9 hospitals at risk of closing (16%)
5 at immediate risk of closing (9%)

North Dakota
 13 hospitals at risk of closing (35%)
3 at immediate risk of closing (8%)

Ohio
 6 hospitals at risk of closing (8%)
3 at immediate risk of closing (4%)

Oklahoma
 44 hospitals at risk of closing (61%)
17 at immediate risk of closing (24%)

Oregon
 7 hospitals at risk of closing (21%)
3 at immediate risk of closing (9%)

Pennsylvania
 18 hospitals at risk of closing (35%)
9 at immediate risk of closing (17%)

Rhode Island
 1 hospital at risk of closing (100%)
0 at immediate risk of closing (0%)

South Carolina
 7 hospitals at risk of closing (32%)
2 at immediate risk of closing (9%)

South Dakota
 5 hospitals at risk of closing (10%)
3 at immediate risk of closing (6%)

Tennessee
 19 hospitals at risk of closing (36%)
12 at immediate risk of closing (23%)

Texas
 84 hospitals at risk of closing (55%)
26 at immediate risk of closing (17%)

Utah
 0 hospitals at risk of closing (0%)
0 at immediate risk of closing (0%)

Vermont
 8 hospitals at risk of closing (62%)
0 at immediate risk of closing (0%)

Virginia
 6 hospitals at risk of closing (18%)
3 at immediate risk of closing (9%)

Washington
 19 hospitals at risk of closing (43%)
6 at immediate risk of closing (14%)

West Virginia
 8 hospitals at risk of closing (24%)
4 at immediate risk of closing (12%)

Wisconsin
 13 hospitals at risk of closing (16%)
6 at immediate risk of closing (7%)

Wyoming
 6 hospitals at risk of closing (22%)
3 at immediate risk of closing (11%)