New Report Offers State-Level Analysis of Primary Care Investment

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.

Rural Guide to Improving Chronic Obstructive Pulmonary Disease Care (COPD)

A policy brief issued last year by the University of Minnesota reported that while the COPD prevalence rate is higher for individuals living in rural areas,  Critical Access Hospitals are less likely to employ any respiratory therapists.  With support from HRSA’s Federal Office of Rural Health Policy, the National Rural Health Resource Center created this guide to help rural hospitals and clinics identify areas for improvement with diagnosis, treatment, and long-term care of COPD patients. The guide is developed as part of the COPD National Action Plan, with the goal of developing resources for improving the lives of patients living with COPD in rural communities.  Click here to access the full brief.

Comments Requested:  Proposed Changes to Confidentiality of Substance Use Disorder Patient Records

The Confidentiality of Substance Use Disorder Patient Records regulations (42 CFR Part 2), aka “Part 2,” protect patient privacy when receiving substance use disorder treatment.  The Substance Abuse and Mental Health Services Administration (SAMHSA) has proposed changes to these rules based on stakeholder feedback and to facilitate coordination of care.  The proposals include allowing non-opioid treatment program providers to become eligible to get information from prescription drug monitoring programs and changing the requirements for patient consent.   See this HHS Fact Sheet for a summary of the proposals and RHIhub for more information on substance use disorder treatment in rural areas.  Comments are due on October 25, 2019.

Improving the Reach and Quality of Cancer Care in Rural Populations

The National Cancer Institute (NCI) at the National Institutes of Health recently announced a new study aimed at improving the quality of cancer care in rural areas among low-income and underserved populations. The request for applications that will go out at the end of September encourages two areas of study: 1) observational research that includes pilot testing of interventions to understand and address predictors of cancer; and 2) intervention research to address known predictors. Specifically, the focus for observational studies (with pilot testing) is understanding and addressing the predictive and/or mediating role of social determinants of health, barriers to care, and treatment; and the focus for interventional research is on addressing quality of care related to cancer diagnosis, treatment and/or survivorship. Most existing cancer control interventions are not ready for direct implementation and dissemination in low-income rural areas, so proposals should seek to develop, adapt, and/or implement, and test interventions.  Earlier this year, NCI launched The Cancer Information Service, an online resource for answers to difficult questions, treatment center locations, and help finding clinical trials among other topics.   Click here for the full announcement.

Comments Requested: Bipartisan Policy Center Rural Health Task Force

The Bipartisan Policy Center (BPC) has launched a Rural Health Task Force of leaders to develop and promote a rural health agenda. The task force will develop policy recommendations to: 1. Shore up the current rural health care system, including transforming critical access hospitals, small rural clinics, and rural hospitals to meet community needs; 2. Address barriers and opportunities for rural participation in new delivery models; and 3. Build on successful rural workforce and graduate medical education proposals. The BPC is encouraging public comments for solutions in these three areas, as well as other ideas that support reforming America’s rural healthcare system. Commentators may email policy ideas to  Click here for more information.  Comments are due on September 7, 2019.

Comments Requested: Rural Access to Health Care Services

The Health Resources and Services Administration (HRSA) seeks information from the public about measuring access to health care in rural communities. This Request for Information (RFI) supports the ongoing work of the HHS Rural Health Task Force that is seeking to identify the needs of rural communities, how to meet those needs, and what HHS policy changes can address those needs. Questions for public comment specific to rural communities include: what are the core health care services needed, what types and numbers of health care professionals are needed, what factors are important to identify core health services, and how should access to health care services be measured. People in rural communities face a range of health disparities, including greater obesity and disease burden in children and adults, higher mortality rates, and shorter life expectancy. Rural areas also have fewer health professionals per person compared to urban areas.  Click here to access the RFI.  Comments are due on October 9, 2019.

ACA Has Reduced Racial Disparities in Health Care

The Affordable Care Act (ACA) has not only spurred a decline in uninsured rates across all U.S. racial and ethnic groups, it’s also reduced disparities in coverage, according to a new Commonwealth Fund analysis published this week. Researchers found that the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. The gap between Hispanics and whites, meanwhile, dropped from 25.4 points to 16.6 points. While disparities in coverage shrank both in states that expanded Medicaid and in those that did not, the reduction was greater in the expansion states, according to the study authors. Read more.

State Selects Vendor as State-Based Exchange Navigator

The Pennsylvania Insurance Department (PID) has selected the Pennsylvania Association for Community Health Centers (PACHC) as the Navigator for the state-based exchange (SBE) that the state is developing. The SBE will take the place of the commonwealth’s current reliance on the federal Marketplace for Affordable Care Act (ACA) coverage. Full transition to the SBE is targeted for January 2021. This selection and accompanying funding will allow PACHC to continue and build on the hub and spoke enrollment assistance model we developed for individuals interested in Marketplace coverage. This includes monthly health center-based enrollment assister peer network calls, a dedicated outreach and enrollment track at our Annual Conference, trend analysis, intervention and outreach.

Free Lyme Testing for Un- and Underinsured in Pennsylvania

The Pennsylvania Department of Health (DOH) has increased lab capacity for Lyme disease testing in the Bureau of Laboratories and is now offering this testing free of charge for persons who are uninsured or underinsured. DOH has issued Lyme Serology Test Specimen Collection and Submission Guidance outlining the collection and testing procedures. Test methods offered at the Bureau of Laboratories are:   1) EIA for qualitative detection of IgG and IgM class antibodies to VlsE1 and pepC10 antigens from Borrelia burgdorferi in human serum; and 2) Western Blot for the confirmation of IgG and IgM antibodies – positive ELISA will automatically reflex. See document for complete instructions.

2019 Effectuated Enrollment Snapshot

As of March 15, 2019, 10.6 million consumers in the nation had effectuated coverage through the health insurance exchanges for February 2019. This means consumers paid their first month’s premium. This number represents approximately 92% of consumers who made plan selections during the 2019 Open Enrollment Period (11.4 million). The average total monthly premium for enrollees nationwide in February 2019 was $594.17, a decrease of one percent from the February 2018 average premium of $597.20. Approximately 9.3 million, or 87% of Exchange enrollees in February 2019 received Advance Premium Tax Credits (APTC), consistent with the percentage of enrollees who received APTC in February 2018. The average monthly amount of APTC per enrollee receiving APTC fell by approximately 1% from February 2018, to $514.01. To view Pennsylvania specific data, click here.