Medicare Open Enrollment is approaching, October 15.  In preparation, materials are being released to be shared with consumers, colleagues and others who may assist Medicare consumers.

• The attached Press Releases announce the Medicare Advantage landscape.
• The Medicare Health & Drug Plan Finder  will be updated with the 2023 Medicare health and prescription drug plan information on October 1, 2022. 1-800-MEDICARE is also available 24 hours a day, seven days a week to provide help in English and Spanish as well as language support in over 200 languages. People who want to keep their current Medicare coverage do not need to re-enroll.
• To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance and copayments if people meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other necessities like food, housing or transportation. Individuals interested in learning more can visit here. 
• To view the premiums and costs of 2023 Medicare Advantage and Part D plans, please visit: https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovgenin

Select the various 2023 landscape source files in the downloads section of the webpage.

• For state-by-state information, important dates and enrollment resources for Medicare Advantage and Part D in 2023, please visit: https://www.cms.gov/files/document/2023-medicare-advantage-and-part-d-state-state-fact-sheets.pdf
• For more information on the Medicare Advantage Value-Based Insurance Design Model, including plan participation, please visit: https://innovation.cms.gov/innovation-models/vbid.
• During Open Enrollment, people with Medicare who take insulin are encouraged to call 1-800-MEDICARE or contact their State Health Insurance Assistance Programs (https://www.shiphelp.org/) for help comparing plans and costs this year.

Shareable Social Media, Videos, TV & Radio Ads will be placed in the CMS Medicare Open Enrollment website located  HERE. 

Naloxone, originally approved by the FDA under the brand name Narcan, is an anti-overdose, therapeutic medication

Pennsylvania has one of the highest rates of opioid overdose in the nation, and, according to Penn State researchers, one’s chances of surviving that overdose can depend on where the person lives.

Using data from the Pennsylvania Overdose Information Network from the years 2018-20 and American Community Survey data from 2015-19, Penn State geography researchers looked at the prevalence of overdoses in the state and found the availability of the anti-overdose therapeutic Naloxone to be a key factor in overdose survival. The findings were reported in the Journal of Drug and Alcohol Dependence.

Data showed individuals who received at least one dose of Naloxone were nine times as likely to survive an overdose. Naloxone was administered in about 75% of the survival cases and just 29% of fatal overdose cases.

Yet, the availability of the drug at the time of overdose ranged between 41%-47% in the lowest counties such as nearby Clinton and Huntingdon Counties to 92% in Philadelphia County, the highest. In broad strokes, lesser populated counties had less access to the life-saving treatment, with exceptions for Centre and Mercer Counties, which fared better than similarly populated counties.

“One of the main goals of this research is to inform public health practitioners and policymakers who have the capacity to do something about the distribution of Naloxone, which is clearly effective,” said Louisa Holmes, assistant professor of geography at Penn State, member of Penn State Social Science Research Institute’s Consortium on Substance Use and Addiction (CSUA) and lead author of the study. “It gives leaders a target for combating the opioid epidemic by saving lives.”

Data showed 82% of Pennsylvania adults survived opioid overdoses. In 2020, there were 4,314 opioid related deaths in the state, a 16% increase over 2019, according to the Pennsylvania Department of Health.

According to the Centers for Disease Control and Prevention, opioid overdose deaths have increased steadily from 1999 to 2018, before ballooning in 2020 after a dip in 2019, resulting in the first multi-year decrease in life expectancy in more than 50 years.

The increase in overdose deaths coupled with the effectiveness of Naloxone prompted the Office of the Surgeon General in 2018 to call for its increased distribution. Similarly, Pennsylvania issued standing orders in 2015 and updated in 2022 authorizing anyone to obtain Naloxone, although it leaves decisions to stock the drug up to pharmacists. A recent survey of Pennsylvania pharmacies found 55% did not stock Naloxone, and the majority of pharmacists were unclear on policies related to the standing order. The survey also found out-of-pocket Naloxone prices in 2017 to range from $50 to $400.

Using data for 16,673 unique overdose incidents occurring in Pennsylvania, researchers found 13,724 people survived, while 2,949 did not. About 70% of the deaths were male, 53.5% were ages 25-39 and 90% were white. About 33% of the victims lived in the most rural portions of the state, versus 28% who lived in the most populated areas.

Researchers say the data point to a need for more comprehensive and consistent access to Naloxone for emergency responders, agencies, opioid use disorder patients and their families, citing the effectiveness of programs such as community distribution of Naloxone kits, which cut overdose deaths by 42%. Measures such as expanding take-home Naloxone programs, overdose response training and pharmacist education could also save lives, researchers said.

Although Pennsylvania law allows first responders such as EMTs and police officers to administer Naloxone, researchers said such training is scarcer in rural areas.

This research is related to more broad efforts by the CSUA, which is a large collective of substance-based addiction researchers, practitioners and educators across all of Penn State’s campuses that work on everything from opioids to e-cigarettes to alcohol. Holmes was hired in 2019 among a team of researchers tasked with addressing addiction research.

“The expanding research being done by the CSUA on these topics further positions Penn State as a leader both regionally and nationally,” said Brian King, head of the Department of Geography and co-author of the research. “It is a testament to how research at this institution directly impacts residents in the Commonwealth of Pennsylvania.”

 Initiatives will ensure children in Oregon have continuous Medicaid coverage until the age of six, and expand access to coverage and address nutrition and housing needs in Massachusetts and Oregon

 Approvals of the initiatives come during the White House Conference on Hunger, Nutrition, and Health, taking direct action on the Biden-Harris Administration’s National Strategy to end hunger, reduce diet-related diseases, and eliminate health inequities

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved groundbreaking Medicaid section 1115 demonstration initiatives in Massachusetts and Oregon. Both demonstrations aim to test improvements in coverage, access, and quality with innovative approaches to ensure more eligible people retain their Medicaid coverage, including by approving Oregon’s demonstration to keep children enrolled in Medicaid up to age six — preventing gaps in coverage that can cause children to lose access to needed care in their formative early years.

The initiatives also take steps to address unmet health-related social needs, such as by giving Massachusetts and Oregon new authority to test coverage for evidenced-based nutritional assistance and medically tailored meals, clinically-tailored housing supports, and other interventions for certain beneficiaries where there is a clinical need. These efforts coincide with the White House Conference on Hunger, Nutrition, and Health, where the Biden-Harris Administration released its national strategy to end hunger, improve nutrition and physical activity, and reduce diet-related diseases and disparities – all goals supported by the initiatives approved today.

“This is an historic moment in our nation’s fight to end hunger and improve health equity, particularly in states like Oregon and Massachusetts,” said HHS Secretary Xavier Becerra. “Groundbreaking action in each state will ensure children and youth remain connected to health care, and that we double down on tackling social needs impacting health, such as nutrition. Everyone should get the access to care they need to live safe and healthy lives.”

“I’m proud to partner with Oregon and Massachusetts to improve quality and access, reduce health disparities, and improve health equity, for those who need it most. For the first time ever, children with Medicaid coverage in Oregon will be able to keep their coverage until the age of 6 — ensuring they can get the care they need during their formative years. This is just one aspect of the groundbreaking demonstration initiatives that I’m approving today,” said CMS Administrator Chiquita Brooks-LaSure. “These states are also partnering with community-based providers to address the root social causes of health concerns, like lack of access to nutritious food and housing insecurity. We applaud Massachusetts and Oregon for helping us use every tool available to protect and expand access to high-quality, comprehensive, affordable health care coverage.”

Under the Biden-Harris Administration, thanks to the American Rescue Plan and other Administration efforts, more Americans than ever before have health insurance coverage. Today’s approvals will build on these efforts and support President Biden’s executive orders in April 2022 and January 2021 directing federal agencies to take action to expand affordable, quality health coverage, including by strengthening Medicaid and the Affordable Care Act.

Both demonstrations approved today will work to improve enrollment and continuity of coverage. In Oregon, children determined eligible for Medicaid will be able to stay continuously enrolled until they turn six years old, without their families needing to renew their coverage. This will minimize red tape for both families and the state, and help to ensure access to care throughout this critical period of early childhood. Individuals older than six will be able to keep their coverage for up to two years, even if their household income fluctuates. Massachusetts will provide up to 12 months of continuous coverage for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries upon release from correctional settings and 24-months of continuous eligibility for beneficiaries with a confirmed status of chronic homelessness, eliminating gaps in coverage for these vulnerable populations.

Evidence indicates that health-related social needs, such as food insecurity and housing instability, are critical drivers of an individual’s health outcomes. With this demonstration, Massachusetts will receive expanded authority to provide certain time-limited housing supports, clinical nutrition education, and medically-tailored food assistance services when medically appropriate. These services will be available to a range of at-risk populations, including postpartum individuals for up to 12 months. Massachusetts will also provide additional meal support for certain households when an eligible beneficiary is a child or pregnant woman with special clinical needs. Oregon will expand health-related social needs coverage for certain food assistance, housing supports, and other interventions that are medically appropriate for individuals experiencing certain life transitions, including individuals who are homeless or at risk of homelessness. In both states, the time-limited housing and nutritional support services provided in the demonstration can be expected to stabilize the housing and nutritional circumstances of these Medicaid enrollees and thus ensure that they will keep receiving and benefiting from the Medicaid-covered services to which they are entitled.

Massachusetts will also be implementing an innovative Hospital Quality and Equity Initiative for private acute hospitals and the Commonwealth’s only non-state-owned public hospital, Cambridge Health Alliance. The initiative is expected to reduce health inequities by improving outcomes in populations that are likely to face barriers to quality health care. As such, the demonstration is likely to help improve the quality of care and is also likely to reduce health disparities through this value-based care approach.

CMS will require both states to systematically monitor the demonstrations and conduct rigorous independent evaluations to determine the outcomes and impacts.

For additional information about the Massachusetts’ MassHealth Section 1115 Demonstration, please visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82006.

The Centers for Medicare & Medicaid Services (CMS) released the 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2023 Medicare Part D income-related monthly adjustment amounts.

Please review the Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly.  For more information on the 2023 Medicare Parts A and B premiums and deductibles (CMS-8077-N, CMS-8078-N, CMS-8079-N), please visit https://www.federalregister.gov/public-inspection/current.

The Rural Health Information Hub collaborated with NORC Walsh Center for Rural Health Analysis to create resources for developing, implementing, evaluating, and sustaining rural health literacy programs.

The Federal Communications Commission provides easy-to-understand material – flyers, social media content, videos, audio PSAs – in English and Spanish to help consumers understand the federal program that helps households pay for internet service.

This report from the Center for Economic Analysis of Rural Health explores the relationship between health care and local economies, as well as the economic implications associated with COVID-19.

Last week, the U.S. Department of Health & Human Services (HHS) introduced the Roadmap for Behavioral Health Integration, to advance the White House Strategy to Address our National Mental Health Crisis announced earlier this year. The HHS paper explains policy and programs that will build three pillars of the national strategy: 1) Strengthen System Capacity by developing a diverse workforce; 2) Connect Americans to Care through health financing; and 3) Support Americans by Creating Healthy Environments with investments in behavioral health, upstream prevention, and recovery.  The Roadmap includes rural communities as part of its cross-cutting equity priority, but does not cover all of the behavioral health initiatives across the Department; important efforts already underway include the HHS Overdose Prevention Strategy and the new three-digit 988 Suicide and Crisis Lifeline.