Pennsylvania Gov. Josh Shapiro Proclaims November 13-17, 2023 Rural Health Week in Pennsylvania

Posted on by lad3

In an effort to draw attention to the wide range of issues that impact rural health, Gov. Josh Shapiro has declared November 13-17, 2023, as Rural Health in Pennsylvania week at the request of the Pennsylvania Rural Health Association (PRHA).

Gov. Shapiro made the proclamation to promote awareness of the full range of issues that impact rural health care throughout the Commonwealth and the health status of rural Pennsylvanians. Nationally, Pennsylvania ranks as one of the states with the highest number of rural residents, with 26 percent of Pennsylvanians residing in rural areas. In recognition of Pennsylvania’s diverse rural needs, the Commonwealth has supported the development of the Center for Rural Pennsylvania, the Pennsylvania Office of Rural Health, and other agencies and initiatives to address the needs of rural Pennsylvanians.

The week encompasses November 16, which is National Rural Health Day, established in 2011 by the National Organization of State Offices of Rural Health (NOSORH) to showcase rural America; increase awareness of rural health issues; and promote the efforts of NOSORH, State Offices of Rural Health (SORHs) and others in addressing those issues.

“Nearly 59.5 million Americans, including 3.4 million Pennsylvanians, live in rural communities,” said Lisa Davis, PORH director and outreach associate professor of health policy and administration at Penn State. “These small towns and communities continue to be fueled by the creative energy of citizens who step forward to provide a wealth of products, resources, and services.

Rural communities also face unique health care concerns: a lack of providers; accessibility issues, particularly in terms of transportation and technology; and affordability issues as the result of larger percentages of uninsured and underinsured citizens and greater out-of-pocket health costs. Rural hospitals and health care providers, which frequently are the economic backbone of the communities they serve, deserve special consideration so that they can continue to provide high-quality services and meet the needs of rural residents.”

To celebrate the work being done to achieve health care access and equity in Pennsylvania, the Pennsylvania Office of Rural Health will present Pennsylvania Rural Health Awards during virtual ceremonies across rural Pennsylvania.

PRHA is dedicated to enhancing the health and well-being of Pennsylvania’s rural citizens and communities. Through the combined efforts of individuals, organizations, professionals, and community leaders, the Association is a collective voice for rural health issues and a conduit for information and resources. More information can be found at paruralhealth.org.

Editors:  For additional information, please contact Lisa Davis, Director, Pennsylvania Office of Rural Health, at 814-863-8214 or lad30@psu.edu.

New Report Released on Equity of Hospital-based Emergency Care

Posted on by lad3

Researchers at Penn State have published a new report, A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks.

Emergency care includes two key components: initial stabilization and transfer to a higher level of care. Significant work has focused on ensuring that local facilities can stabilize patients. However, less is understood about transfers for definitive care. To better understand how transfer network structure impacts population health and equity in emergency care, we propose a conceptual framework, the hospital transfer network equity-quality model (NET-EQUITY). NET-EQUITY can help optimize population outcomes, decrease disparities, and enhance planning by supporting a framework for understanding emergency department transfers.

The central thesis of our framework is that the structure of hospital transfer networks influences patient outcomes, as defined by the Institute of Medicine, which includes equity. The structure of hospital transfer networks is shaped by internal and external factors. The four main external factors are the regulatory, economic environment, provider, and sociocultural and physical/built environment. These environments all implicate issues of equity that are important to understand to foster an equitable population-based system of emergency care. The framework highlights external and internal factors that determine the structure of hospital transfer networks, including structural racism and inequity. We also describe ways that NET-EQUITY can be applied to generate research questions and how policymakers can respond should research find inequity.

Authors:  Charleen Hsuan, PhD; Brandan Carr, PhD; David Vanness, PhD; Yinan Wang, PhD; Douglas Leslie, PhD; Eleanor Dunham, PhD; and Jeannette Rogowski, PhD

Read the full article here.

 

Can Rural Voters Be Swayed at the Ballot Box?

Posted on by lad3

While partisanship remains strong among rural voters, certain messages resonated with voters across the political spectrum. They included battling inflation, bringing good-paying jobs to local communities, and battling corporate greed.

Could Democratic candidates, whose support among rural voters has waned considerably over the past two decades, regain some support utilizing these messages?

Big Takeaways

  • The survey suggests as many as 37% of rural voters are swing blue-collar voters who could be swayed by the certain policy proposals and messaging.
  • While partisanship remains strong among the rural electorate, voters were aligned on many of their chief concerns: affordable housing, the high cost of food, and corporate greed.
  • Three messaging points — lowering prices; bringing good-paying jobs to local communities; and a populist message focused on corporate greed — received such broad support that they rivaled voters’ agreement on core values like family and freedom.
  • President Joe Biden is viewed 18 points more unfavorably than Donald Trump, suggesting the Democratic Party has a lot of work ahead if they plan to move rural swing voters.

The Numbers

  • 51 percent of Democrats thought the economy was working well for them, compared to 17 percent of Republicans.
  • Respondents were asked to pick two issues from a list of 14 that were the most important for themselves and their families. The respondents could also choose “other,” “none,” or “not sure.
    • 54% chose the rising cost of living as one of their most important issues, followed by retirement and Social Security (25 percent), health care (19 percent), dysfunction in government (15 percent), and jobs and the economy (15 percent).
  • Respondents were asked to pick two concerns from a list of 11 that were the most important for themselves and their families. The respondents could also choose “other,” “none,” or “not sure.
    • 43% chose the rising cost of food as one of their most important issues, followed by rising gas prices (24 percent), rising energy costs (21 percent), rising housing costs (19 percent), and a lack of good-paying jobs (18 percent).

Click here to read the full report.

Integrating Mental Health Care into Primary Care Doesn’t Add to Costs

Posted on by kow5101

Penn Medicine and Independence Blue Cross have been studying a new billing code created to help healthcare providers address mental health issues since 2018. Their work previously showed that linking primary care and mental health services increased the number of patients receiving needed behavioral health care and led to mental health improvements. Their new research shows it doesn’t add costs. Read more.

The Commercial Price for Paxlovid Will be 100 Times Production Cost

Posted on by kow5101

Last week, drug maker Pfizer released that the commercial list price for its COVID-19 treatment Paxlovid will be $1,390 per treatment course. For comparison, earlier this year experts at Harvard University calculated the cost of producing a five-day treatment course of Paxlovid tablets to be only $13.38. Public health advocates are urging the Biden administration to force Pfizer to lower the price, noting that the Department of Health and Human Services has the legal authority to do so because Paxlovid was developed in part with federal funds. To date, the federal government has never used this authority, even though it has existed in law for more than 40 years.

CMS Has Finalized its Remedy for 340B Payments, and Hospitals Are Not Happy

Posted on by lad3

From Fierce Healthcare

The Centers for Medicare & Medicaid Services (CMS) has dropped the final rule to remedy the invalidated 340B-acquired drug payment policy for calendar years 2018 to 2022.

Earlier in July, the federal government agreed to pay eligible hospitals in the 340B program $9 billion to offset payment cuts that the Supreme Court had previously ruled unlawful. The prescription drug payment cuts were made by the Department of Health and Human Services (HHS) in 2018 and subsequently opposed in the courts by the American Hospital Association (AHA) and other hospital groups.

In 2022, the Supreme Court rejected the massive payment cuts, ruling them to be unlawful because HHS did not follow the proper procedure.

As part of its final rule, CMS is maintaining budget neutrality. The agency estimates that hospitals were paid $7.8 billion more for non-drug items and services during that time period than they otherwise would have been without the 340B payment policy. To carry out the nearly $8 billion budget neutrality adjustment, CMS will reduce future non-drug item and service payments by adjusting the conversion factor for payments for outpatient services.

The offset was originally proposed for 2025 but faced industry pushback during the comment period. The adjustment will continue until the full $7.8 billion is offset, which CMS estimates will take 16 years.

In a statement, AHA president and CEO Rick Pollack commended the coming repayment to 340B hospitals but condemned HHS’ choice to cut Medicare rates. “HHS made a grievous mistake in choosing to claw back billions of dollars from America’s hospitals, especially those that serve rural, low-income, and other vulnerable communities. HHS decided to ignore hundreds of comments from hospitals and other providers explaining why this Medicare cut is both illegal and unwise,” he said.

Healthcare group purchasing organization Premier Inc. echoed Pollack’s disappointment. “Premier will continue to press CMS to hold hospitals harmless from policy deemed unlawful to preserve patient access to high-quality pharmaceuticals,” Soumi Saha, senior vice president of government affairs at Premier, said in a statement.

In a statement, Chip Kahn, president and CEO of the Federation of American Hospitals, condemned the rule, saying “CMS’s decision to brush aside the Medicare statute and recoup $7.8 billion from hospitals treating Medicare beneficiaries is extremely disappointing. This sets a dangerous precedent by breaking a promise to seniors and their providers that care will be covered.”

The annually determined payment rate is final, Kahn added, and hospitals rely on it to serve their populations. It does not allow Medicare to claw back funds. “This statutory predictability and stability of payment is mission critical to sustain patient access to care,” he said. The recoupment through outpatient rate cuts will also likely reduce Medicare Advantage plan payments to hospitals, per Kahn.

Health Insurance Premiums Jump

Posted on by kow5101

The average cost of workplace health insurance premiums for family coverage reached nearly $24,000 this year, jumping 7% from 2022, according to the latest annual Kaiser Family Foundation survey of employer-sponsored coverage. Workers on average contributed $6,575 toward the cost of family coverage — up about $500 from last year — while employers kicked in $17,393, according to the KFF survey of over 2,000 firms. “It’s just an incredible amount of money to spend on health insurance every year,” according to KFF health insurance expert Matthew Rae, a co-author of the report. Higher expenses for healthcare providers increase health costs for employers, which is leading to higher premiums. Average deductibles stayed largely the same in recent years, hovering around $1,735 and continuing five years of relatively flat deductible growth following years of steady hikes. Read more.

Harnessing the Power of Enabling Services to Address Services and Social Drivers of Health

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As a part of a collaborative project for the Bureau of Primary Health Care’s National Training and Technical Assistance Cooperative Agreement, the Association of Asian Pacific Community Health Organizations (AAPCHO), MHP Salud, the National Health Care for the Homeless Council (NHCHC), and Health Outreach Partners (HOP) will host a webinar on Health Center Enabling Services and Social Drivers of Health (SDOH), Nov. 8 at 3:00 pm. Learn about the role of enabling services staff, including Community Health Workers, in screening for and addressing SDOH and how data can be used for meaningful change. Speakers will discuss successes, challenges, best practices, and other helpful information. Register here.