- 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
CDC: How to Select, Wear, and Clean Your Mask
The Centers for Disease Control and Prevention (CDC) added this easy-to-understand guide to their COVID-19 resources. According to National Institutes of Health Director Dr. Francis Collins, face coverings could save 130,000 American lives by March.
Comments Requested: CMS Proposed Rule on Durable Medical Equipment – January 4
The Centers for Medicare & Medicaid Services (CMS) proposed policy changes for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule effective April 1, 2021, or the date immediately following the duration of the COVID-19 public health emergency. Under the rule, CMS is proposing continuation of higher payment rates for items and services furnished in rural and non-contiguous areas, classifying all continuous glucose monitors as DME, and revisions to the application process for common procedure codes.
CMS Finalizes CY2021 End-Stage Renal Disease (ESRD) Rule
The Centers for Medicare & Medicaid Services (CMS) finalized Medicare payment policy updates for renal dialysis services provided to Medicare beneficiaries beginning January 1, 2021. The final rule includes an overall payment increase of 2.0 percent or $250 million for all ESRD facilities, while rural ESRD facilities are estimated to experience a 1.0 percent increase as a result of the proposed changes. Other policy changes include adoption of the 2018 OMB delineations, expansion of the list of new equipment and supplies, TPNIES, to include home dialysis machines, and updates to the low-volume payment adjustment due to the COVID-19 public health emergency.
Medicare Advanced Payment Model (APM) Changes for 2021
Under the Medicare Quality Payment Program (QPP), clinicians can participate in two tracks for payment purposes based on their practice size, specialty, location, or patient population: the Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). The criteria for clinicians to qualify as a participant in an APM are changing as of January 1, 2021, so the Centers for Medicare & Medicaid Services (CMS) developed a Quick Start Guide and an Eligibility Decision Tree to help clinicians determine if they qualify for an APM or if they will need to participate in MIPS in 2021. Find more information here.
Final Medicaid and CHIP Managed Care Rule
The Centers for Medicare & Medicaid Services (CMS) finalized revisions to the Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations that were proposed in 2018. The 2018 proposed rule and this final rule modifies several provisions from the 2016 managed care rule based on stakeholder feedback, including pass-through payments, network adequacy standards, and the Quality Rating System. It also adds a provision allowing states to determine the most appropriate method to coordinate Medicare and Medicaid benefits for those that qualify for both.
Making it Work: Models of Success in Rural Maternity Care
Researchers at the University of Minnesota Rural Health Research Center identify common factors and best practices for rural-based obstetrics with a look at what leaders have done at the community level in Wisconsin, Kansas, and Arkansas. Read more here.
HHS Launches KidneyX COVID-19 Kidney Care Challenge
The U.S. Department of Health & Human Services announced a new project to address the higher risk of severe illness from COVID-19 for people with kidney disease. With encouragement to communities that face health disparities, the Challenge invites new solutions from entities or individuals that can reduce the impact of pandemic without requiring significant time, expertise, money, or other resources from the patient.
CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment
Coverage Available at No Cost to Beneficiaries Across Variety of Settings in Health Care System
CMS announced that starting November 10, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat COVID-19 with no cost-sharing during the Public Health Emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an Emergency Use Authorization (EUA) from the FDA on November 9.
“Today, CMS is announcing a historic, first-of-its kind policy that drastically expands access to COVID-19 monoclonal antibodies to beneficiaries without cost sharing,” said CMS Administrator Seema Verma. “Our timely approach means beneficiaries can receive these potentially life-saving therapies in a range of settings – such as in a doctor’s office, nursing home, infusion centers, as long as safety precautions can be met. This aggressive action and innovative approach will undoubtedly save lives.”
CMS anticipates that this monoclonal antibody product will initially be given to health care providers at no charge. Medicare will not pay for the monoclonal antibody products that providers receive for free but this action provides for reimbursement for the infusion of the product. When health care providers begin to purchase monoclonal antibody products, Medicare anticipates setting the payment rate in the same way it set the payment rates for COVID-19 vaccines, such as based on 95% of the average wholesale price for COVID-19 vaccines in many provider settings. CMS will issue billing and coding instructions for health care providers in the coming days.
CMS anticipates the announcement will allow for a broad range of providers and suppliers, including freestanding and hospital-based infusion centers, home health agencies, nursing homes, and entities with whom nursing homes contract, to administer this treatment in accordance with the EUA, and bill Medicare to administer these infusions.
Under section 6008 of the Families First Coronavirus Response Act (FFCRA), state and territorial Medicaid programs may receive a temporary 6.2 percentage point increase in the Federal Medical Assistance Percentage (FMAP), through the end of the quarter in which the COVID-19 PHE ends. A condition for receipt of this enhanced federal match is that a state or territory must cover COVID-19 testing services and treatments, including vaccines and their administration, specialized equipment, and therapies for Medicaid enrollees without cost sharing. This means that this monoclonal antibody infusion is expected to be covered when furnished to Medicaid beneficiaries, in accordance with the EUA, during this period, with limited exceptions.
View the Monoclonal Antibody COVID-19 Infusion Program Instruction.
New Cases Put 80% of Rural Counties in the Red Zone
The presidential election offers plenty of evidence that ignoring the coronavirus won’t make it go away.
Last week, while most of us focused on the race for the White House, the number of Covid-19 infections in rural counties grew by 30% and set a record for the number of new cases for the seventh consecutive week. There were 144,043 new infections in rural counties last week, up from about 110,000 the week before.
Also last week, another 97 rural counties were added to the red-zone list, bringing the total to 1,599, or four out of five of all nonmetropolitan counties. (This article using nonmetropolitan counties as synonymous with rural.)
Red-zone counties have a new infection rate of 100 or more cases in one week per 100,000 residents. The Trump administration’s White House Coronavirus Task Force says that red-zone counties need to enact tougher measures to control the virus.
The current surge originated in rural areas two months ago and more recently has spread into metropolitan counties. Previously, metropolitan counties had their worst new infection rates in July. But those counties surpassed those summer peaks for the past two weeks.
Here are other facts from last week’s analysis, which covers Sunday to Saturday, November 1 to 7.
- Rural counties had 1,873 Covid-19 related deaths last week, an increase of 20% from the previous week, and a new record. About 29% of new U.S. deaths occurred among rural residents, who constitute about 14% of the U.S. population.
- This fall’s surge has created a new class of rural hotspots. One quarter of rural counties (479) have one-week infection rates of at least 500 new cases per 100,000 residents — five times the red-zone infection level. Fourteen percent of metropolitan counties (141) meet that criterion. As the map below shows, these hotspot counties are primarily in the Upper Midwest, Great Plains, and the Intermountain region of that includes Montana, Wyoming, and Idaho.
COVID-19: Prevention Keeps Pennsylvania Healthy
As Pennsylvania continues to combat COVID-19 and we enter cold and flu season, the most important step in preventing sickness is following healthy habits. These best practices limit the spread of germs for yourself and others.
Download the COVID Alert PA App
The COVID Alert PA app notifies you if you have had a potential exposure to someone who has tested positive for COVID-19. The app works by using anonymous Bluetooth technology that identifies other devices with the app in your proximity. When an app user who was near you reports they have a positive COVID-19 diagnosis, you may receive an alert, depending on the date, how long you were exposed and how close you were to the other person. It does not track your location or store your personal information.
The app also includes an interactive COVID-19 symptom checker, updates on the latest public health data about COVID-19 in PA and advice for what to do if you have a potential exposure to COVID-19.
Learn more and download now. The more Pennsylvanians that download the app, the more successful we will be in stopping the spread of the virus.
Mask Up
In Pennsylvania, masks must be worn whenever anyone leaves home. Masks are mandatory in all public spaces. Members of the public should wear homemade cloth or fabric masks and save surgical masks and N95 respirators for health care workers and first responders.
Remember this saying: “My mask protects you, your mask protects me.”
Social Distance
It’s important to keep a safe space between yourself and other people who are not from your household. To practice social or physical distancing, stay at least 6 feet from other people who are not from your household in both indoor and outdoor spaces.
Washing your hands is one of the most important steps you can take in staying healthy. When you wash, make sure you:
- Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
- Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
- Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
- Rinse your hands well under clean, running water.
- Dry your hands using a clean towel or air dry them.
Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
Avoid Touching Your Face
Avoid touching your face with unwashed hands. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
Clean Surfaces
Clean and disinfect frequently touched surfaces at home, work, or school — especially when someone is ill.
Make sure your child’s school, child care program, or college routinely cleans frequently touched objects and surfaces, and that they have a good supply of tissues, soap, paper towels, alcohol-based hand rubs, and disposable wipes on-site.
At work, routinely clean frequently touched objects and surfaces including doorknobs, keyboards, and phones to help remove germs. Learn more about effective steps for cleaning from the CDC.
Stay Home When Sick
Stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others. It’s a good idea to build an at-home kit so you have all the items you need (food, medication, etc.) to stay inside and focus on feeling better.
Practice the healthy habits above and also do your best to get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
For the most up to date information on COVID-19 in Pennsylvania, visit the Pennsylvania Department of Health or PA Unites Against COVID and download the COVID Alert PA App.