Among key findings in this brief from the North Carolina Rural Health Research and Policy Analysis Center:

• Various hospital types converted to REHs in 2023: seven were Sole Community Hospitals, six were Critical Access Hospitals, four were Prospective Payment System hospitals, and two were Medicare Dependent Hospitals.
• Counties with REH conversions were relatively challenged, showing highest median rates of poverty, uninsured individuals, and people in poor or fair health.
• Counties with a REH conversion also faced health care access challenges, with fewer primary care and mental health providers and higher emergency department visit rates among Medicare beneficiaries.

In response to a court order, the Centers for Medicare & Medicaid Services (CMS) has finalized appeals processes for certain Medicare beneficiaries who are initially admitted as hospital inpatients but are subsequently reclassified as outpatients receiving observation services during their hospital stay, along with other eligibility criteria.  This final rule establishes processes for standardized appeals, expedited appeals, and retrospective appeals for beneficiaries, and it extends the timeframe for providers to submit a claim following a favorable decision and to submit records as requested by a contractor. While CMS estimates a relatively low number of appeals that meet these criteria, they acknowledge that there will be administrative costs for hospitals to accommodate the new appeals process. This final rule is effective October 11, 2024.

– Respond by December 9. In response to an Executive Order to lower prescription drug costs, the Centers for Medicare & Medicaid Services (CMS) developed a model to test whether a simpler approach to offering low-cost, clinically important generic drugs can improve medication adherence, lead to better health outcomes, and improve satisfaction with the Part D prescription drug benefit for people with Medicare and for prescribers.  This RFI aims to obtain input from a broad range of interested parties to support continued development of the model.

A survey by Gallup and West Health showed that accessing health care may be easier for residents in some states due to low costs, high rates of health insurance coverage and an abundance of health care providers. The survey found that Pennsylvania has the sixth highest number of primary care physicians per 10,000 residents (19.78) and the sixth highest number of specialist physicians per 10,000 residents (22.01). Read more.

A new legislative study urges state officials in Pennsylvania to take a comprehensive look at the impact of housing on public health and the way that housing services under the Medical Assistance (MA) program address health care. The study by the Legislative Budget and Finance Committee (LBFC) is part of a growing emphasis on the issue of housing availability and affordability in Pennsylvania. Gov. Josh Shapiro issued an executive order last month directing the state Department of Community and Economic Development to work with groups to deliver a Housing Action Program within one year. Among the study’s recommendations are that the Governor’s Office and General Assembly convene a working group to address housing and health issues, including use of resources. It also recommended that the state Department of Human Services (DHS) develop more data on MA housing program health impacts and give counties more flexibility to increase the maximum fee allowed by law for affordable housing trust funds. Under a 1992 state law, counties have the option to raise revenue from recording fees on deeds and mortgages and establish trust funds for affordable housing.

In 2011, Tennessee-based company Community Health Systems operating locally as Commonwealth Health bought several local hospitals, including Tunkhannock’s Tyler Memorial. After 10 years of operation under Commonwealth Health, inpatient and surgical care ended in 2021, with emergency services coming to a halt in 2022. When the Tunkhannock hospital closed, community leaders stepped up to turn the closed hospital into a community health hub. A local family partnered with 18 organizations to offer residents accessible healthcare in the wake of the closure. The Wright Center is one of 18 partners operating within the new center. President and CEO Dr. Linda Thomas-Hemak saw the closure as part of an unfortunate trend of healthcare not centering around community needs. Click here to learn more.

The US Census Bureau has published the 2023 American Community Survey data on the uninsured in PA for 2022 and 2023 by county, population and percentage. PA did not see a significant change in the uninsured rate among non-elderly adults or public coverage rates among non-elderly adults from 2022 to 2023 based on the data. Non-elderly adults accessing private coverage saw a significant decrease. The same findings were true of children 0-18. Access more data here. 

The Pennsylvania Insurance Department announced the Affordable Care Act Health Insurance Rates offered on Pennie for 2025 for the individual and small group market. It is estimated that Pennsylvanians will save approximately $77.2 million in health insurance premiums. These rates reflect a statewide average increase of 6% for the individual market and a 7.6% increase for the small group market. While the majority of insurers will remain in the Pennie market, Cigna will exit for the 2025 enrollment period and UPMC will cease offering Pennie plans in Rating Area 6 consisting of Union, Snyder, Northumberland, Montour, Columbia, Centre, Mifflin, and Rating Area 7 which includes Adams, York, Lancaster, Berks, Lehigh, and Northampton. View the Rating Area Map.

In keeping with the Shapiro Administration’s commitment to eliminating barriers to licensure for qualified Pennsylvania workers and businesses, Secretary of the Commonwealth Al Schmidt today announced dramatic reductions in processing times for multiple professional and occupational licenses. The chart in the link below compares processing times from January 2023 and September 2024 for complete license applications for three categories of businesses and five professions. The three healthcare professions that were highlighted were: pharmacists, who saw their initial application by exam reduced from 26 days to 1 day; MD (U.S.-educated) were reduced from 43 days to 2 days; and physical therapists were reduced from 31 days to 2 days. Click here to learn more.