There were a record number of primary care positions offered in the 2024 Match, with a 92.9% fill rate for the specialties this year, according to the National Resident Matching Program (NRMP).This month’s Match figures showed 4,595 medical students and graduates matching into family medicine residency programs; there were 5,231 slots this year, or 124 more than in 2023. There was a total of 19,423 primary care positions, or 46.8% of all positions offered in the Match, comprising family medicine, internal medicine, internal medicine-pediatrics, and pediatrics, according to NRMP.

AstraZeneca this week became the second company in recent weeks to announce it will cap the out-of-pocket costs that patients pay for its inhalers at $35. The cap is effective June 1 and will apply to the company’s entire range of inhaler products used to treat asthma and chronic obstructive pulmonary disease, including inhalers Symbicort, Breztri Aerosphere, and Airsupra. The cap will be applicable for patients who are uninsured or underinsured.

A new HRSA-funded study shows that Community Health Centers with the highest use of patient support services (aka enabling services) such as transportation, score higher than other FQHCs on 90% of clinical quality process measures (e.g., cervical cancer screening, childhood immunization status). This suggests that health-related social services make a significant positive impact on clinical health outcomes. The article is the top one listed here.

The Department of Labor (DOL)’s Final Rule governing the standard for determining independent contractor status under the Fair Labor Standards Act (FLSA) became effective March 11, 2024. The Final Rule establishes a six-factor economic realities worker classification test and rescinds a narrower rule issued in 2021. The multifactor test uses a totality-of-the-circumstances analysis to determine whether a worker is an employee who is economically dependent on the employer for work or an independent contractor who is in business for themself. For more information, read this SEK article.

From 240 individual hospitals not that long ago, Pennsylvania is down to 19 independent hospitals not affiliated with a larger health system. Pennsylvania is not alone in this trend that has raised some alarm. Consequently, the Department of Justice, Department of Health and Human Services, and Federal Trade Commission seek public comment on the effects of private equity funds’ acquisition of health care providers, mergers involving providers and health systems, and private payers’ purchase of physician practices. There is concern about patients’ health, workers’ safety, quality of care, and the rising cost of health care for patients and taxpayers. The Departments are particularly interested in receiving input on the effects of consolidation on patients and healthcare providers, including any differences between rural and urban areas. This is your opportunity to weigh in on how mergers and acquisitions have impacted your patients, your health center and your communities. The deadline for comments is May 6, 2024. Find more information including the link to submit comments here.

The Medicare Advantage Open Enrollment period runs from Jan. 1 through March 31. During this period each year, consumers can switch from their Medicare Advantage Plan (excluding Medical Savings Accounts, cost plans, and PACE) to another Medicare Advantage Plan, or to Original Medicare with or without a Part D plan. They can only use this enrollment period if they have a Medicare Advantage Plan. If consumers signed up for Part A and/or Part B because of an exceptional situation, they’ll have two months to join a Medicare Advantage Plan (with or without drug coverage) or a Medicare drug plan (Part D). The coverage will start the first day of the month after the plan receives the request to join.

The Shapiro Administration recently added new tools to help health care providers and public safety professionals across the commonwealth battle the overdose and opioid crisis. The PA Department of Health launched new training opportunities to help prevent unintentional drug overdoses. These online courses are offered at no cost and include continuing education credits for healthcare providers that may also meet various licensing requirements. You can find these trainings, resources and more information on DOH’s website for healthcare providers and public safety professionals. Learn more.

The PA Department of Human Services will join select fellow Medicaid agencies from across the country seeking to address member health-related social needs in a new initiative. The Center for Health Care Strategies (CHCS) announced selection of nine states to join the Medicaid Health-Related Social Needs Implementation Learning Series. This peer learning series will assist the selected states — California, Massachusetts, Michigan, New York, North Carolina, Oregon, Pennsylvania, Washington, and Wisconsin — in developing, implementing, or refining health-related social need (HRSN) initiatives for Medicaid populations. The focus of the 12-month learning series will be on practical, on-the-ground implementation efforts that promote health equity and are informed by community member perspectives. Lessons learned will be shared broadly with stakeholders across the country.

Fifth Round Makes $700 Million Available to Bring Affordable High-Speed
Internet to Rural and Tribal Communities

The U.S. Department of Agriculture (USDA) Rural Development Under Secretary Dr. Basil Gooden announced USDA is accepting applications until May 21, 2024, for funding under the ReConnect Program.

This is the fifth round of funding under the program, which provides loans and grants to bring high-speed internet to the most remote and difficult-to-serve rural and Tribal communities in America.

A total of $700 million is available under four funding categories:

• Up to $200 million is available for loans.
• Up to $200 million is available for loan/grant combinations.
• Up to $150 million is available for grants.
• Up to $150 million is available for grants serving Alaska Native corporations, Tribal
  governments, colonias, persistent poverty areas and socially vulnerable communities.

Read full announcement.

From Becker’s Hospital CFO Report

Obstetrics and delivery services are one of the leading money losers of all hospital services, and a growing number of rural hospitals are closing obstetric departments to protect the financial viability of the overall enterprise, according to a recent analysis by Kaufman Hall.

About 40% of rural hospitals are losing money on obstetrics programs, according to a recent study conducted by the University of Minnesota Rural Health Research Center. Many obstetrics programs hemorrhage money, and they are generally among the first services that financially struggling or low-volume rural hospitals cut.

Several hospitals scaled back or eliminated labor and delivery services last year, and Becker’s has reported on 15 hospitals that have cut these services so far in 2024.

Ultimately, it’s a money problem. Rising costs and staffing shortages have hit rural hospitals particularly hard, but low Medicaid reimbursement is the biggest challenge for obstetrics departments.

“This is especially detrimental in rural areas where a higher number of births are covered by Medicaid,” Eric Fish, MD, president and CEO of Schneck Medical Center, in Seymour, Ind., told Becker’s. “In Indiana, over half of babies born on an annual basis are covered by Medicaid, which pays 57 cents on the dollar of the cost of providing care. This means hospitals, specifically in rural areas, are experiencing significant financial losses. Increasing Medicaid reimbursement is imperative to keep these services open and to preserve access in the future.”

Medicaid reimbursement rates set by states do not cover the full cost of providing obstetric services. This translates to financial losses for hospitals providing these services in rural areas, where a higher proportion of births are covered by Medicaid.

Given that Medicaid funds 50% of deliveries in rural areas, hospitals would receive significant financial respite from improved Medicaid reimbursement for these services.

“To help cover the losses associated with obstetrics, perhaps rural hospitals offering obstetrics could qualify for a special exception through Medicaid with an add-on payment program or an annual lump-sum payment, similar to [prospective payment system] hospitals that have received disproportionate numbers of low-income patients, based on the hospital’s disproportionate OB patient percentage,” Brett Altman, DPT, CEO of Atlantic, Iowa-based Cass Health, told Becker’s.

The other challenge, particularly in rural America, is the lack of staff and expertise when it comes to obstetrics nurses and physicians.

“We have spent upwards of $3 million annually for traveling obstetric nurses to keep our unit staffed 24/7/365, but it is the right thing to do for southwest Iowans in order to decrease the excessive mileage required to reach the nearest obstetrics unit,” Dr. Altman said. “Low volume obstetrics is not profitable and is one of the key drivers for why so many obstetric units have closed in rural areas as these hospitals hit financial headwinds in addition to concerns of competency.”