The National Maternal and Child Oral Health Resource Center recently shared a new resource, “Snapshot of the U.S. Jurisdictions’ Activities Addressing Title V National Performance Measure 13 (Oral Health) During Fiscal Year 2022.” The report presents a snapshot of jurisdictions’ experiences with implementing strategies to promote preventive dental visit for pregnant women, children, and adolescents. Challenges, accomplishments, and technical assistance needs related to each jurisdiction are discussed.
Coverage for Half a Million Children and Families Will Be Reinstated
CMS Requires States to Pause Disenrollments and Reinstate Coverage for Impacted Individuals
The U.S. Department of Health and Human Services (HHS) announced that it has helped half a million children and families regain their Medicaid and Children’s Health Insurance (CHIP) coverage. On August 30, the Centers for Medicare & Medicaid Services (CMS) issued a call to action to states about a potential state systems issue where systems were inappropriately disenrolling children and other enrollees, even when the state had information indicating the person remained eligible. Thanks to CMS’ swift action, nearly 500,000 children and other individuals who were improperly disenrolled from Medicaid or CHIP will regain their coverage, and many more are expected to be protected from improper disenrollments going forward.
CMS sent a letter on August 30 to all states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands requiring them to determine and report whether they have a systems issue that inappropriately disenrolls children and families, even when the state had information indicating that they remained eligible for Medicaid and CHIP coverage. Today’s summary indicates that to-date 30 states report having this systems issue. As a result, to avoid CMS taking further action, all 30 states were required to pause procedural disenrollments for impacted people unless they could ensure all eligible people are not improperly disenrolled due to this issue.
“Thanks to swift action by HHS, nearly half a million individuals, including children, will have their coverage reinstated, and many more will be protected going forward. HHS is committed to making sure people have access to affordable, quality health insurance – whether that’s through Medicare, Medicaid, the Marketplace, or their employer,” said HHS Secretary Xavier Becerra. “We will continue to work with states for as long as needed to help prevent anyone eligible for Medicaid or CHIP coverage from being disenrolled.”
“Medicaid and CHIP are essential for millions of people and families across the country,” said CMS Administrator Chiquita Brooks-LaSure. “Addressing this issue with auto-renewals is a critical step to help eligible people keep their Medicaid and CHIP coverage during the renewals process, especially children. CMS will keep doing everything in our power to help people have the health coverage they need and deserve.”
CMS’ letter on August 30 alerted states to a potential eligibility systems issue related to automatic renewals for Medicaid and CHIP coverage. Auto-renewals (also known as “ex parte” renewals) are one of the strongest tools that states have to keep eligible people enrolled in Medicaid or CHIP coverage during the renewals process. Federal rules require states to use information already available to them through existing reliable data sources (e.g., state wage data) to determine whether people are still eligible for Medicaid or CHIP. Auto-renewals make it easier for people to renew their Medicaid and CHIP coverage, helping to make sure eligible individuals are not disenrolled due to red tape. CMS continues to provide technical assistance to states as they address these system issues.
Throughout the renewals process, CMS has offered states many strategies to assist them in making it easier for people to renew their coverage. Nearly all states have adopted at least some of these strategies, and CMS continues to urge states to adopt these strategies. Additionally, to help make transitions from Medicaid to other health coverage options more accessible in every state, CMS has launched national marketing campaigns and made available Special Enrollment Periods through HealthCare.gov, State-based Marketplaces, and Medicare. CMS’ top priority remains making sure everyone has access to affordable, quality health coverage.
For a preliminary overview of state assessments regarding compliance with Medicaid and CHIP automatic renewal requirements at the individual level (as of September 21, 2023), visit: https://www.medicaid.gov/resources-for-states/downloads/state-asesment-compliance-auto-ren-req.pdf.
Expanding Jail-Based Mental Health Services in Rural Counties
A feature article in The Rural Monitor examines the challenges of providing access to mental health services in rural jails. Features a telehealth counseling program in rural Texas and an Ohio program offering case management and mental health services to people in the county jail.
Join Us for PTAC Public Meeting on Rural Participation in Alternative Payment Models
The next quarterly public Physician-Focused Payment Model Technical Advisory Committee (PTAC) meeting will focus on encouraging rural participation in population-based total cost of care models. PTAC was authorized under the Medicare Access and CHIP Reauthorization Act of 2015 to make recommendations on population-based total cost of care model proposals. Selected topics to be discussed in the two-day September PTAC meeting include challenges facing rural providers and patients and approaches for involving rural providers in such alternative payment models. For further information on the hybrid (in-person and livestream) meeting, please see the agenda, panelist bios, and registration form. The meeting will be held September 18-19.
Report: Rural-Urban Differences in the Availability of Hospital-Based Cardiac Services Between 2010-2020
Among the findings from the Rural and Minority Health Research Center: From 2010 to 2020, the proportions of metropolitan and micropolitan hospitals offering specialized cardiac care substantially increased, but there was no significant change among hospitals in rural noncore counties.
Maternal Mortality Crisis and Extension of Medicaid Postpartum Coverage
Examining the effect of extended postpartum coverage brought by the American Rescue Plan Act of 2021, policy experts present evidence that ensuring access to care for 12 months after giving birth is a key strategy to address the U.S. maternal mortality crisis. The authors note that Medicaid is used predominantly in rural areas and by individuals who are racial/ethnic minorities. The latest data from the Centers for Disease Control and Prevention (CDC) show significantly higher rates of maternal death in 2021. A separate report from the CDC, out last month, reveals 1 in 5 women reported mistreatment while receiving maternity care, with clear disparities by race/ethnicity and insurance types. The FORHP-funded Rural Health Research Centers have increased their work on this issue in the last three years, following an earlier determination that rates of maternal mortality have long been higher for rural residents.
Congress Has Increased Rural Physician Training – Is it Working?
Experts analyze Medicare-funded residency training two years after Congress created 1,000 new residency slots reserved specifically for rural and underserved areas. The data show a need to re-examine residency slot distribution methods, sustainable funding, and technical assistance supporting rural locations. FORHP began a separate effort a few years before with the Rural Residency Planning and Development Program (RRPD). Since 2019, RRPD has funded $54 million to 73 organizations across 36 states and six medical disciplines.
New! Highlights and Opportunities Identified from Rural Health Value Summit: Driving Value Through Community-Based Partnerships
The Rural Health Value team is pleased to release the following report that from a recent summit that explored driving value through community-based partnerships:
Rural Health Value Summit: Driving Value Through Community-Based Partnerships
Four rural communities (in AK, MI, OR, SC) shared experiences with health care and community-based partnerships that highlighted several opportunities for policymakers, payers, and health system leaders for building and supporting social needs infrastructure in rural communities in alignment with value-based care strategies. Possible next steps for cross-sector leaders to explore the opportunities further are offered.
Related resources on the Rural Health Value website:
- Profiles in Innovation. See links stories in rural health care delivery and finance that emerging across the nation. The profiles describe exciting, and potentially replicable, innovations in rural health care that show promise in improving health, improving care, and lowering costs. Many of the profiles include actions to address community health needs.
- Northern Michigan Community Health Innovation Region. This partnership of health and community providers across ten rural counties in Northern Michigan addresses social determinants of health through systems change and collaboration, including development of a Community Connections Hub Network, a clinical community linkages model that connects individuals and families to community resources.
Understanding and Addressing Social Determinants of Health: Opportunities to Improve Health Outcomes. A Guide for Rural Health Care Leaders. This guide provides rural health care leaders and teams with foundational knowledge, strategies, and resources to understand the impact of social determinants of health (SDOH) on patients and communities.
Contact information:
Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu
Pennsylvania Data Center News: ACS 1-Year Estimates Released
New 1-Year Estimates Data Released
The U.S. Census Bureau has released a new set of estimates from the American Community Survey (ACS) for the year 2022, providing new data for a variety of demographic and economic topics for the nation, states, and other areas with populations of 65,000 or more.
Significant statistical changes for the Commonwealth from 2021 to 2022 included a decline in median household income, an increase in the median value of owner-occupied housing units, and an increase in the share of householders who rented. For more information, or to access these estimates, please click here to read our full brief.
Upcoming Decennial Census Release
The U.S. Census Bureau plans to release its next decennial product one week from today (9/21), the 2020 Census Detailed Demographic and Housing Characteristics File A. The Detailed DHC-A provides population counts and sex-by-age statistics for approximately 1,500 detailed race and ethnic groups and detailed American Indian and Alaska Native (AIAN) tribes and villages. Stay tuned for more information as the data are released!
September 2023 Updates on HRSA’s OPTN Modernization Initiative
The Health Resources and Services Administration (HRSA) is pleased to share an update on our efforts related to the Organ Procurement and Transplantation Network (OPTN) Modernization Initiative.
HRSA is committed to continued dialogue with OPTN stakeholders to ensure that patient, family, and clinician voices are engaged in the OPTN modernization efforts. In June 2023, HRSA, through its engagement with a program management support contractor, kicked off stakeholder interviews to better understand the pain points and perspectives of individuals and organizations that directly interact with the OPTN. Stakeholder engagement with patients also began this month. In addition, a web-based contact form is now available on the OPTN Modernization website to provide another avenue to solicit feedback from patients, families, clinicians, and other interested parties.
HRSA is focused on fostering robust competition and innovation to procure best in class support for the OPTN through ongoing market research and industry engagement. To advance this, HRSA hosted an Industry Day for interested parties and vendors to solicit feedback on the Fall 2023 solicitation. Information shared during Industry Day is available on SAM.gov.
HRSA and the Centers for Medicare & Medicaid Services are engaged in a coordinated effort through the Organ Transplant Affinity Group’s (OTAG) newly released action plan to improve organ donation, procurement, and transplantation. Both agencies are committed to drive improvements in donations, clinical outcomes, system improvement, quality measurement and transparency, and regulatory oversight.
HRSA will continue to provide updates on our modernization efforts toward achieving enhanced accountability, equity, and performance in the organ transplantation system.
For more information and the latest OPTN Modernization updates, visit www.hrsa.gov/optn-modernization.