- 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
Critical Access Hospitals’ Initial Response to COVID-19
The Flex Monitoring Team (FMT) has released a new data report, Critical Access Hospitals’ Initial Response to COVID-19 by System Affiliation. This report presents data on the initial response to COVID-19 in system-affiliated and independent Critical Access Hospitals (CAHs). The data come from a survey of CAH CEOs in eight states about their response to COVID-19 from February to August 2020, and findings include information on COVID-19 case volume, personal protective equipment (PPE) supply, and the perceived impact of being a system-affiliated or independent CAH on their overall response to COVID-19.
Study Finds Lack of High School Education Predicts Hesitancy
A lack of a high school education was the most important predictor of COVID-19 vaccine hesitancy in 3,142 U.S. counties, finds a study yesterday in the American Journal of Infection Control. Of all reasons cited for COVID-19 vaccine hesitancy, a lack of trust in the vaccines (55%) was the most common, followed by worries about side effects (48%) and low trust in the government (46%). Five of the 10 most common reasons given for vaccine hesitancy were related to a lack of knowledge about potential side effects, benefits, effectiveness and risks of being unvaccinated.
COVID-19 Claims Reimbursement for Uninsured Patients
Health Resources and Services Administration is accepting requests for claims reimbursement to healthcare providers, generally at Medicare rates, for testing uninsured individuals for COVID-19, for treating uninsured individuals with a COVID-19 primary diagnosis and for COVID-19 vaccine administration to the uninsured. Applications are accepted on an ongoing basis. A separate program, the HRSA COVID-19 Coverage Assistance Fund, is available to reimburse providers for COVID-19 vaccine administration to underinsured individuals whose health plan either does not include COVID-19 vaccination as a covered benefit or covers COVID-19 vaccine administration but with cost-sharing.
Pennsylvania Health Department Issues Update Guidance on COVID-19 Protocols
The Pennsylvania Department of Health (DOH) issued several Health Alert Updates to reflect the most recent guidance related to COVID-19, including updates for the general population and return to work guidance for healthcare personnel.
- 616 – UPDATE: Work Restriction Issued
- 615 – 12/30/2021 – UPD – UPDATE: Isolation and Quarantine Periods for COVID-19 for the General Population
- 614 – 12/28/21 – UPD – UPDATE: Return to Work Healthcare Personnel with Confirmed or Suspected COVID-19
- 613 – 12/23/21 – UPD – UPDATE: COVID-19 Treatment Options
Click here for the latest DOH Health Alerts, Advisories and Updates.
COVID-19: New HCPCS Code for Remdesivir Antiviral Medication
Following the recent statement from the National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel regarding therapies for the COVID-19 Omicron variant, CMS created HCPCS code J0248 for VEKLURY™ (remdesivir) antiviral medication when administered in an outpatient setting. This code is available for use by all payers and is effective for dates of service on or after December 23, 2021:
- Long descriptor: Injection, remdesivir, 1 mg
- Short descriptor: Inj, remdesivir, 1 mg
Medicare Administrative Contractors (MACs) determine Medicare coverage when there is no national coverage determination, including in cases when providers use FDA-approved drugs for indications other than what is on the approved label. The MACs consider the major drug compendia, authoritative medical literature and accepted standards of medical practice to determine medical necessity when considering coverage. Therefore, the MACs will determine Medicare coverage for HCPCS code J0248 for VEKLURY™ (remdesivir) administered in an outpatient setting.
Your MAC will share coverage and claims processing information for J0248. Contact your MAC if you have questions about coverage.
CDC Releases “Rural Considerations for Vaccine Confidence and Uptake Strategies”
The Centers for Disease Control and Prevention (CDC) has released another COVID-related rural resource that may be of interest. A “Rural Considerations” addendum was recently added to its field guide for conducting a Rapid Community Assessment (RCA).
An RCA is a process for quickly collecting community insights about a public health issue in order to inform program design. The assessment involves reviewing existing data and conducting community-based interviews, listening sessions, observations, social listening, and surveys. In addition to the rural considerations addendum, the CDC RCA webpage provides an assessment guide and tools for those who wish to better understand their community’s needs regarding COVID-19 vaccine acceptance and uptake among adults, adolescents, and children. Addendums for conducting RCAs in tribal communities and among adolescent populations were also recently posted to the webpage.
The original COVID-19 Vaccination Field Guide: 12 Strategies for Your Community presents evidence-based strategies being applied in communities across the country to increase COVID-19 vaccine confidence and uptake. To help rural communities apply these strategies, the addendum includes rural considerations and examples for the 12 strategies based on successes in the field and input from health departments and rural health organizations.
State and local health departments, community- and faith-based organizations, and local nonprofits are encouraged to try a combination of these strategies to increase vaccination rates. Please share widely! Questions may be directed to ruralhealth@cdc.gov.
Pennsylvania House of Representatives Approves Bill Establishing COVID-19 At-Home Testing Distribution Program
The Pennsylvania House of Representatives unanimously approved a legislative amendment that would create a $10 million program to assist counties that want to distribute at-home COVID-19 tests. The amendment was added to HB 2033, that extends reporting requirements for state labs that conduct COVID-19 tests. The amended bill still must make its way through the Senate before it can reach the desk of Gov. Tom Wolf. According to the amendment, the Pennsylvania Department of Health would buy the test kits. Counties would then have 30 days to apply by stating how many tests they need and detailing how they plan to distribute them.
KFF COVID-19 Vaccine Monitor: Differences in Vaccine Attitudes Between Rural, Suburban, and Urban Areas
Throughout the past year, the Kaiser Family Foundation (KFF) COVID-19 Vaccine Monitor has provided a look into how the coronavirus pandemic has impacted people living in different areas of the U.S., including analyses of the vaccine intentions of rural residents. This latest report draws on two surveys conducted in November (before news of the omicron variant) – one of adults and one of parents – and shows that those living in different types of communities hold very different views of COVID-19 vaccines, particularly when it comes to children. In addition, parents living in different community types report getting different levels of information regarding COVID-19 vaccines from their children’s schools and pediatricians.
- Rural and suburban adults continue to lag somewhat behind those living in urban areas in terms of vaccine uptake. As of November, eight in ten urban residents (79%) say they have gotten at least one dose of a COVID-19 vaccine compared to seven in ten suburban adults and 67% of rural adults. One in five (21%) of those living in rural areas and one in six (16%) of those living in suburban areas say they will “definitely not” get a COVID-19 vaccine, at least twice the share of urban residents who say the same (8%).
- The rural-urban gap in vaccination intention is even larger when it comes to children. About half of rural parents say they will definitely not get their 12-17 year-old children or their 5-11 year-old children vaccinated for COVID-19. A quarter of rural parents (26%) say they have vaccinated their 12-17 year-old, compared to nearly two-thirds of parents in urban areas (64%) and about half of those living in suburban areas (47%) areas. One in ten rural parents and a similar share of suburban parents (14%) report that their 5-11 year-old child is vaccinated, compared to about a quarter (23%) of urban parents who say the same.
- Four in ten parents overall say they have spoken to their child’s pediatrician about the COVID-19 vaccine. Yet, those living in rural areas are more likely than those living in suburban or urban areas to report their child’s pediatrician did not recommend the vaccine for their child. More than one-third of rural parents say they had a conversation with their child’s health care provider and the provider did not recommended they get their child vaccinated (compared to around one in ten urban and one in seven suburban parents).
- Around half of all parents say their child’s school has provided them with information on how to get a COVID-19 vaccine for their child, but smaller shares of rural than urban parents say their child’s school has encouraged parents to get their child vaccinated (36%) compared to parents in suburban (44%) and urban (50%) areas.
- Views on COVID-19 vaccine mandates also differ across communities. A majority of urban residents support the federal government requiring large employers to either have their employees be vaccinated or get tested weekly, while rural and suburban residents are more divided on this Biden administration guideline. In addition, most workers living in urban areas say their employer already requires employees to be vaccinated for COVID-19 or that they support such a requirement, while six in ten rural workers and half of suburban workers do not want their employer to issue a vaccine mandate. Opposition to schools requiring eligible students to be vaccinated for COVID-19 is also higher among rural and suburban parents compared to urban parents.
- While differing partisanship and demographics may contribute to differences in vaccine attitudes between people living in urban, suburban, and rural communities, multivariate analysis suggests that there is a relationship between community type and COVID-19 vaccine uptake that exists even when controlling for party identification and demographics. Using a statistical technique called logistic regression, we find that rural and suburban adults are less likely than urban adults to report being vaccinated for COVID-19, even after controlling for age, race, ethnicity, education, income, party identification, and ideology.
To access the full set of findings and methodology, click here.
COVID-19 Vaccine Access in Long-term Care Settings
The federal government is committed to ensuring that residents and staff in long-term care settings, such as nursing homes, assisted living, residential care communities, group homes and senior housing, have access to COVID-19 vaccines to receive primary series and booster shots.
Long-term care providers are encouraged to consider the option that works best for their residents and staff when coordinating access to COVID-19 vaccines, either in the local community or on-site. The CDC has additional details on these options. Find Medicare billing and payment information.
As a reminder, through enforcement discretion, CMS will allow Medicare-enrolled immunizers, including but not limited to pharmacies working with the United States, to bill directly and receive direct reimbursement from the Medicare program for vaccinating Medicare skilled nursing facility residents.
The Impact of Pandemics on Oral Health
An article in the latest issue of the Journal of the American Dental Association (JADA) explores the role of pandemics on societal behavior and their impact on oral health care. The analysis explores the past, present, and future of pandemic and what measures the dental community should adopt moving forward. The latest issue also features articles about ultrasonic scaler aerosol and spatter mitigation, the use of teledentistry with older patients, and the promotion of community water fluoridation.