- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
- Rural RPM Program Is a Lifeline for Pregnant Women
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
- AJPH Call for Papers Special Section on Intersections of Public Health And Primary Care
- NIH HEAL Initiative Turns Attention to Pragmatic Trials in Rural Communities
- Limited Continuing-Care Options in Rural Virginia Create Challenges for an Aging Population
New Toolkit for Long-term Services and Supports
The Centers for Medicare & Medicaid Services (CMS) developed this toolkit to support states’ efforts to rebalance long-term services and supports (LTSS), so there is an equitable balance between services and supports delivered in-home and community-based settings relative to institutional care. The kit includes strategies to increase the share of LTSS provided in community-based settings; tools to assist with policy and programmatic changes; case studies of innovative programs; and links to relevant resources.
Comments Requested: Medicare Advantage Advance Notice Part II – November 30
Last week, the Centers for Medicare & Medicaid Services (CMS) released Part II of the Calendar Year 2022 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies for public comment. It includes estimates of changes in payments to MA plans and requests input on future quality measures and concepts for the MA and Prescription Drug plan Star Ratings system, which helps beneficiaries to compare plans. Find more information here.
ONC Interim Final Rule on Pandemic-Related Health IT
The Office of the National Coordinator for Health Information Technology (ONC) is accepting comments on an Interim Final Rule, effective on December 4, pertaining to Information Blocking and the ONC Health IT Certification Program that were outlined in the ONC Cures Act Final Rule released in March 2020. Find more information here.
States Turn to Telehealth During the Pandemic
With funding support from the Health Resources and Services Administration, the National Conference of State Legislatures provides details of more than 79 bills changing telehealth policies in 36 states, the District of Columbia and Puerto Rico.
USDA: The Meatpacking Industry During COVID-19
The Economic Research Service at the U.S. Department of Agriculture (USDA) provides data on rural counties where meatpacking is the primary employer, and where confirmed cases are higher than in other rural areas.
HRSA Celebrates National Rural Health Day
The Health Resources and Services Administration (HRSA) will recognize the annual event with online activities on Thursday, November 19. HRSA Administrator Tom Engels will kick off the day, along with a welcome from Jeff Colyer, Chair of the National Advisory Committee on Rural Health and Human Services. HRSA will host a variety of events throughout the week which are open to the public, including a virtual rural job fair and webinars focused on the rural response to COVID-19, social determinants of health, and telehealth.
Rural Infections Surge Past 110,000 for the Week, Breaking Another Record
By Tim Murphy and Tim Marema
Rural counties had record-breaking numbers of new infections, for the sixth consecutive week.
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Jobs Report, September 2019-2020: Most Rural Counties Lose Jobs but Do Better than Metro
By Bill Bishop
September’s employment numbers show the pandemic is hurting rural areas less than metropolitan ones.
Read more
New Simulation Finds Max Cost for Cost-effective Health Treatments
As health care costs balloon in the U.S., experts say it may be important to analyze whether those costs translate into better population health. A new study led by a Penn State researcher analyzed existing data to find a dividing line — or “threshold — for what makes a treatment cost-effective or not.
David Vanness, professor of health policy and administration, led a team of researchers that created a simulation to consider health care treatment costs, insurance premiums, quality of life, and life expectancy to explore whether a treatment delivers enough value for its costs to be considered beneficial for population health.
According to Vanness, the term “treatment cost” in this research incorporates all the costs and savings related to a treatment. For example, the cost of a treatment to lower blood cholesterol would include how much it costs but also take into account potential savings for preventing a heart attack and its subsequent treatment.
“We know that we are spending more and more on health care in the U.S. and that we’re getting less and less for it,” Vanness said. “We do a good job of developing new treatments in this country, but we don’t do a good job of covering everybody or making sure that people have access to basic health care. We’re spending a lot on our medical treatments, but many of those treatments just don’t have a lot of value.”
Vanness added that in order to improve a population’s health without spending too much, it’s important to be able to tell whether the prices drug and device manufacturers are charging are justified by what they deliver in health improvements.
The researchers found that in their simulation, for every $10 million increase in health care expenditures, 1860 people became uninsured. This led to five deaths, 81 quality-adjusted life-years lost due to death, and 15 quality-adjusted life-years lost due to illness. In health care economics, one quality-adjusted life-year (QALY) is equal to one year of perfect health.
Vanness said these results — recently published in the Annals of Internal Medicine — suggests a cost effectiveness threshold of $104,000 per QALY.
“If a treatment is beneficial but it costs more than about $100,000 to gain one quality-adjusted life-year using that treatment, then it may not be a good deal,” Vanness said. “Because our simulation was using data estimates, we wanted to come up with a range of plausible values. So anything over a range of $100,000 to $150,000 per QALY gained is likely to actually make our population’s health fall.”
To create the simulation, Vanness said he and the other researchers used a variety of data, starting with estimates about how likely people are to drop their insurance when their premiums go up.
“We also used evidence from the public health literature on what happens to people’s health and mortality when they gain or lose health insurance,” Vanness said.
The simulation then compiled that data and estimated how much the health of a population goes down when costs increase. According to Vanness, that relationship determines the cost-effectiveness threshold — how much a treatment can cost relative to the health benefits it gives before it causes more harm than good.
The researchers said the findings could be especially important to organizations like the Institute for Clinical and Economic Review, which provides analysis to several private and public insurers to help negotiate prices with manufacturers. These organizations could use the findings as empirical evidence for what makes a treatment a good value in the United States.
“Moving forward, I think some changes could be made to national policy to make cost effectiveness analysis more commonly used,” Vanness said. “Our goal is to get that information out there with the hope that somebody is going to use it to help guide coverage or maybe get manufacturers to reduce their prices on some of these drugs.”
James Lomas at the University of York, and Hannah Ahn, a Penn State graduate student, also participated in this work.
Detailed Population Estimates Dashboard Released
The Pennsylvania State Data Center has released their Detailed Population Estimates Dashboard. Now with the latest estimates for 2019, users can access state and county level data on the total population, the change in population since 2010, and detailed characteristics like sex, age, race, and Hispanic origin.
Click here to visit the dashboard.