Pennsylvania expressly values older adults and individuals with disabilities and is committed to building and maintaining an age- and disability-friendly commonwealth so that all Pennsylvanians may live with dignity and independence. To accomplish that goal, Pennsylvania is putting together a 10-year Master Plan designed to help transform the infrastructure and coordination of services for Pennsylvania’s older adults. You are invited to contribute what you think should be the plan’s priority goals, objectives, and initiatives to support the highest quality of life for older adults. As part of that plan, the Pennsylvania Department of Aging (DOA) conducts a stakeholder engagement process, which is arbitrated by the Long-Term Care Council and the Governor. The process will involve outreach and requests for input from anyone or any group with an interest or with some interaction toward aging- and disability-related services, programs, and infrastructure. The state will be holding in-person and virtual stakeholder meetings across the state, with a minimum of an in-person meeting in each county over the next six months. People are also invited to submit comments directly through the website or can email DOA at AgingPlan@pa.gov. FQHCs were very involved in the development of a similar plan in California and DOA is hoping that Pennsylvania’s FQHCs will be as well. More information on the master plan can be found at https://www.aging.pa.gov/publications/MasterPlan/Pages/default.aspx.
The National Community Health Worker Awareness Week Has Been Announced
The National Association of Community Health Workers (NACHW) launched a campaign to increase awareness of the Community Health Worker’s identity, their role, impact on underserved and vulnerable communities, and leadership. NACHW will mark National CHW Awareness Week Aug 28 – Sept 1, 2023. The campaign was developed to highlight and promote policies that respect, protect, and authentically partner with the CHW profession. The Awareness Toolkit has templates that include a road map to guide participants through the process, implement strategies to help celebrate this national event, and customizable key talking points, as well as a checklist to aid meaningful conversation about CHW work and sustainability. Sign up for the CHW Awareness Week Mailing List.
Still Protecting Patients through the No Surprises Act
Beginning Jan 1, 2022, the No Surprises Act began protecting consumers from unexpected out-of-network medical bills from emergency room visits, non-emergencies related to a visit to an in-network hospital and air ambulance services. If consumers don’t have health insurance, usually providers must give a good faith estimate of how much health care would cost. To help patients, encourage them to check their medical bills for errors, read explanations of benefits, apply for any medical bill financial assistance, and be sure to contact individual health plans and providers for appeals.
Pittsburgh’s Duquesne Medical School Receives Pre-Accreditation
Moving toward its fall 2024 launch, Duquesne University’s College of Osteopathic Medicine (COM) has received “pre-accreditation status” from the Commission on Osteopathic College Accreditation (COCA). Because of this status, the university has begun recruiting students to the medical college and has received over 1,000 applications. (Those applications are not available to be downloaded until July.) Duquesne’s COM is committed to educating physicians with an emphasis on primary care and serving the underserved. The move to pre-accreditation status marks an important step, as it demonstrates the college has made significant progress toward its goals, having first earned candidate status in January 2022. Construction of the COM building is now well underway, senior leadership is in place, and the college’s curriculum has met COCA guidelines. Read more.
HHS Announces New Flexibilities to Slow Medicaid Disenrollments
The U.S. Department of Health and Human Services (HHS) announced on June 12, 2023, new flexibilities to minimize the number of Medicaid and Children’s Health Insurance Program beneficiaries disenrolled during eligibility redeterminations. New flexibilities include allowing health plans to help Medicaid members complete renewal forms, allowing states to delay procedural terminations for one month to allow additional outreach, and allowing pharmacies and community-based organizations to facilitate reinstatement of coverage based on presumptive eligibility criteria. The flexibilities are noted in an HHS announcement and in a letter to state governors. Read more.
Pennie ED Discusses Medicaid Unwinding Numbers During Spring Policy Forum
Devon Trolley, Pennie’s new executive director, presented enrollment numbers, 2024 key priorities and initiatives moving forward through the Medicaid unwinding process, and the coming 2024 open enrollment period during PACHC’s Spring Advocacy Forum this week. As of May 30, more than 33,000 applications for coverage have been transferred to Pennie from Medicaid. “Unwind” customers are those that have used the “Loss of Medical Assistance (MA)” special enrollment period qualifying life event. To streamline the customer experience and enrollment process, a customer could automatically have their eligibility assessed based on their MA information. The conversion rate of those moving from Medicaid and enrolling in Pennie over the past three months is 10%. These numbers will fluctuate over time due to customers’ ability to access retro enrollment through Medicaid and a Pennie 120-day Special Enrollment Period.
Pennsylvania State House Panel Approves Minimum Wage Hike Bill
The Pennsylvania House Labor and Industry Committee voted 12-9 along party lines to approve legislation that would increase the Commonwealth’s minimum wage incrementally through 2026. the House and Senate bills would raise the current minimum wage of $7.25 to $11 per hour beginning on Jan. 1, 2024 and to $13 per hour on Jan. 1, 2025. The following year (Jan. 1, 2026), the wage would rise again to $15 and increase by an annual cost-of-living adjustment using the percentage change in the Consumer Price Index (CPI). Click here to learn more.
New Brief Addresses Metro-Non-metro Clinician Performance with MIPS
Differences in the Merit-based Incentive Payment System (MIPS) Performance of Clinicians in Metropolitan and Nonmetropolitan Counties in 2018
Mina Shrestha, PhD; Lili Xu, MS; Hari Sharma, PhD; Fred Ullrich, BA; A. Clinton MacKinney, MD; Keith Mueller, PhD
The Merit-based Incentive Payment System (MIPS) is a pay-for-performance system for clinicians under the Medicare Quality Payment Program designed to reward clinicians providing higher quality of care and lower costs. This study compared clinicians’ MIPS performance in 2018 based on their practice location, size, and minority population proportion.
Key Findings:
- The overall performance in the MIPS program was comparable for metropolitan and nonmetropolitan clinicians. However, a smaller proportion of nonmetropolitan clinicians were likely to receive exceptional performance payments.
- Most of the clinicians receiving reduced payments were in solo practice in both metropolitan and nonmetropolitan areas.
- Clinicians serving a high proportion of minorities were less likely to get exceptional performance payments but were also less likely to have their payments reduced under MIPS.
Nonmetropolitan clinicians had a lower total risk-adjusted Medicare Spending Per Beneficiary than metropolitan clinicians indicating that nonmetropolitan clinicians have lower Medicare spending for similar beneficiaries.
Pennsylvania Rural Health Advocate Receives Doctoral Program Scholarship
Lannette Fetzer, quality improvement coordinator and certified AgriSafe Nurse Scholar in the Pennsylvania Office of Rural Health (PORH), is the recipient of the 2023 Preventive Measures Legacy Scholarship Award from the Preventive Measures Foundation.
PORH is administratively located in the Department of Health Policy and Administration in Penn State’s College of Health and Human Development on the University Park campus.
The scholarship recognizes Fetzer’s academic aptitude exhibited in the essay titled “Impact on Humanity,” which she submitted with her application. Fetzer reflected on her experience growing up in a large family and the intergenerational connectedness she experienced, which led her to pursue a nursing career. Fetzer integrates perseverance, dedication and empathy in her professional and personal interactions to “give back and pay forward” the gifts she was given by her family.
A lifelong learner, the scholarship will support Fetzer’s doctorate of nurse practice degree at Frontier Nursing University, where she will focus on quality improvement theories, processes and programs. Her doctorate of nurse practice project will address quality improvement following the “Model for Improvement” from the Institute for Healthcare Improvement. Fetzer will apply the knowledge and skills gained in her graduate studies to improve patient care and enhance current health care policies.
“I am very humbled and appreciative to receive this scholarship from Preventive Measures, which believes health care is a basic human right and every patient deserves access to the best care,” Fetzer said. “Their goals align with what I believe. I am fortunate to work with a talented team at the Pennsylvania Office of Rural Health, who empower me every day to make quality improvement goals a reality in health care.”
In her position with PORH, Fetzer serves as the quality improvement coordinator overseeing health care quality improvement data collection, benchmarking, assessment and strategies for Pennsylvania’s 16 critical access hospitals and other small rural hospitals in the state.
Located in Allentown, the Preventive Measures Foundation seeks to improve the mental health of individuals so they can live life to their full potential. The foundation looks to meet those needs at an individual, community and global level.
PORH was formed in 1991 as a joint partnership between the federal government, the commonwealth of Pennsylvania, and Penn State. The office is one of 50 state offices of rural health in the nation and is charged with being a source of coordination, technical assistance, networking and partnership development.
PORH provides expertise in the areas of rural health, population health, quality improvement, oral health, and agricultural health and safety.
KFF Health News: Find Out How Much Opioid Settlement Cash Your Locality Received
Companies that made, sold, or distributed opioid painkillers are paying out more than $50 billion in settlements over nearly two decades. So far, more than $3 billion has landed in state, county, and city coffers. KFF Health News obtained documents from BrownGreer, a court-appointed firm administering the settlements, which show exact dollar amounts — down to the cent — that local governments have been allocated so far. Curious to see how much your locality has received? Click here for thee details.
“Distributors” refers to the pharmaceutical distributors AmerisourceBergen, Cardinal Health, and McKesson, which settled jointly with states. Distributors made their first payment in 2021. It was held in escrow and delivered to states in 2022. The distributors’ second payment was made in 2022 as well. The distributors’ third payment was made in 2023.
Janssen is the pharmaceutical subsidiary of Johnson & Johnson. Janssen made its first payment in 2022. Some states chose to accelerate their payouts and received a larger amount that first year, taken out of their allotments for future years. Janssen made its second payment in 2023.
Documents for some states are not available because those states were not part of national settlement agreements, had unique settlement terms, or opted not to have their payments distributed via BrownGreer. In some cases, BrownGreer combined the payments for multiple years into one document.