The Government Accountability Office (GAO) released a study on the impact rural hospital closures have on their community. The study, which was conducted from January 2013 through February 2020, examined the effects of the 101 rural hospitals that closed during that time. Among other findings, the GAO discovered that over this time period, disparities in these rural communities were further exacerbated and the availability of physicians for patients declined significantly. Read the full study here.
President Biden Signs Executive Orders on Health Care
On January 28, 2021, President Biden signed two executive orders related to health care. The White House stated that these new executive orders, “Will re-open enrollment to the Health Insurance Marketplace, take additional steps to strengthen Medicaid and the Affordable Care Act, and protect women’s health.” Subsequently, the U.S. Department of Health and Human Services (HHS) announced a Special Enrollment Period (SEP) for individuals and families for Marketplace coverage in response to the COVID-19 Public Health Emergency. In a recent alert about the SEP, the Centers for Medicare and Medicaid Services (CMS) relayed that the Marketplaces would be open from February 15, 2021 through May 15, 2021. President Biden’s executive order to protect women’s health included a Presidential Memorandum to protect and expand access to comprehensive reproductive health care, among other, more controversial policies.
CMS Updates SUD Data Book
On Jan. 19, the Centers for Medicare and Medicaid Services published an update to its Substance Use Disorder (SUD) Data Book for Congress. The data book uses 2018 Transformed Medicaid Statistical Information System (T-MSIS) data. Notable findings include:
- Of the 55.9 million Medicaid beneficiaries with full or comprehensive benefits ages 12 and older, 4.6 million (8 percent) were treated for a SUD in 2018.
- 57 percent of beneficiaries treated for a SUD were diagnosed with tobacco use disorder and 30 percent had an opioid use disorder.
- Nearly half of beneficiaries (46 percent) treated for a SUD received emergency services (the most common SUD treatment service).
- 26 percent received at least one service in an outpatient or home- or community-based setting within 30 days of discharge.
Vaccines National Strategic Plan
On Jan. 19, the U.S. Department of Human Health Services (HHS) released its Vaccines National Strategic Plan: 2021–2025 that is focused on protection across the lifespan. View the plan here.
USPSTF Statement on Systemic Racism in Preventive Care
The U.S. Preventive Services Task Force (USPSTF) has published an editorial, “The USPSTF Values Statement and Actions to Address Systemic Racism Through Clinical Preventive Services,” in the Journal of the American Medical Association (JAMA). Authored by members of the Task Force, this editorial affirms that, while clinical preventive services improve health and well-being, systemic racism in the healthcare system prevents many Black, Indigenous, and Hispanic/Latino people from fully benefitting from these services. The editorial also advances a roadmap designed to address systemic racism and help eliminate health inequities.
The FQHC Story on Oral Health Value-Based Care
With Federally Qualified Health Centers (FQHCs) serving as a point of care for more than 28 million patients, many of whom are uninsured, living in poverty and located in rural areas, these social determinants of health create chronic conditions, including a disproportionate burden of oral disease. FQHCs have been at the forefront of providing comprehensive, person-centered health care that has been facilitated by better access to technology infrastructure and coordinated primary care delivery. As such, a series of analyses were performed by the DentaQuest Partnership using three data sources to explore health outcomes and service provision in an FQHC population compared to non-FQHC populations. Click here to read more.
Medicaid Expansion Saved Hospitals an Average of $6.4 Million
Hospitals in Medicaid expansion states saved an average of $6.4 million on uncompensated care, according to a study published in Health Affairs. Uncompensated care made up six percent of total expenses for hospitals in non-expansion states in 2017, double the amount for those located in states that had expanded the program. “As COVID-19 has brought hospitals to a time of great need, findings from this study provide important information on what hospitals in states that have yet to expand Medicaid could gain through expansion and what is at risk should any reversal of Medicaid expansions occur”. Read more.
Vaccine Shortage Won’t Last Forever
Pfizer and Moderna currently have the market on COVID-19 vaccination, but if all goes well, that won’t be true much longer. COVID-19 has existed for barely more than a year, but 64 vaccines are in clinical development and another 173 in preclinical development worldwide, according to the World Health Organization. Dozens of hopefuls are in clinical trials in the U.S. The two inching closest to the finish line here—by Oxford-AstraZeneca and Johnson & Johnson—although behind original schedules, could win emergency use authorization from the U.S. Food and Drug Administration as soon as this spring. Unfortunately, this week Merck announced it has halted development of two potential vaccines for the coronavirus, citing data that showed a lack of immune response.
CDC Changes COVID-19 Vaccine Guidance to Okay Mixing Pfizer and Moderna Shots
The Centers for Disease Control and Prevention (CDC) quietly changed its guidance on COVID-19 vaccinations, saying it is okay to mix use of Pfizer’s and Moderna vaccine for first and second doses in “exceptional situations” and that it’s also fine to wait up to six weeks to get the second shot of either company’s two-dose immunization. While Pfizer’s and Moderna’s vaccines, which both use messenger RNA technology, were authorized to be given 21 and 28 days apart, respectively, the CDC now says you can receive either shot so long as they are given at least 28 days apart, according to new guidance posted Thursday on its website. Read more.
New MA Bulletin Updates Vaccine Administration Fees
The Pennsylvania Department of Human Services (DHS), Office of Medical Assistance Programs has issued a new bulletin. The purpose of this bulletin is to inform Medical Assistance (MA) providers about updates related to billing and payment for the administration of the novel coronavirus (SARSCoV-2) vaccines, effective Dec. 1, 2020. MAB 01-20-59 advised providers that the administration fee for first and second doses was $10.00. The new administration fee, going back to Dec. 1, 2020, is now $16.94 for the first dose and $28.39 for the second dose. The new fees are based on what Medicare is paying for first and second dose administration and publication of the bulletin indicates DHS received approval from the Centers for Medicare and Medicaid Services (CMS) to pay at Medicare rates. DHS will also pay FQHCs/RHCs for COVID-19 vaccination not affiliated with an FQHC/RHC encounter at Medicare rates, but has not yet published the MA Bulletin affirming this.