- Colorectal Cancer Is Rising among Younger Adults. Some States Want to Boost Awareness.
- 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
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Rural RPM Program Is a Lifeline for Pregnant Women
- 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
Stimulus Bill Will Make Health Insurance More Affordable for Millions
The $1.9 trillion COVID-19 stimulus package passed by Congress includes several provisions that aim to make health care more affordable for households. They include increasing premium subsidies through the federal marketplace and state exchanges for 2021 and 2022, expanding who qualifies for them, and forgiving amounts due by taxpayers who received too much in subsidies in 2020. The Congressional Budget Office report estimates that the expanded eligibility would result in 1.7 million more people getting insurance through the marketplace, with 40 percent of them being individuals who are currently ineligible for premium tax credits because their income is above the 400 percent cap. Read more.
CDC Announces $2.25 Billion to Address COVID-19 Health Disparities in Communities at High-Risk and Underserved
The Centers for Disease Control and Prevention (CDC) announced a plan to invest $2.25 billion over two years to address Coronavirus Disease 2019 (COVID-19)-related health disparities and advance health equity among populations that are at high-risk and underserved, including racial and ethnic minority groups and people living in rural areas. This funding represents CDC’s largest investment to date to support communities affected by COVID-19-related health disparities.
CDC’s new National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved Communities, Including Racial and Ethnic Minority Populations and Rural Communities, will offer grants to public health departments to improve testing and contact tracing capabilities; develop innovative mitigation and prevention resources and services; improve data collection and reporting; build, leverage, and expand infrastructure support; and mobilize partners and collaborators to advance health equity and address social determinants of health as they relate to COVID-19.
“Everyone in America should have equal opportunity to be as healthy as possible,” said CDC Director Rochelle P. Walensky, MD, MPH. “This investment will be monumental in anchoring equity at the center of our nation’s COVID-19 response—and is a key step forward in bringing resources and focus to health inequities that have for far too long persisted in our country.”
Data show that COVID-19 has disproportionately affected some populations and placed them at higher risk, including those who are medically underserved, racial and ethnic minority groups, and people living in rural communities. These groups may experience higher risk of exposure, infection, hospitalization, and mortality. In addition, evidence shows that racial and ethnic minority groups and people living in rural communities have disproportionate rates of chronic diseases that can increase the risk of becoming severely ill from COVID-19 and may also encounter barriers to testing, treatment, or vaccination.
To stop the spread of the COVID-19 virus and move toward greater health equity, CDC continues to work with populations at higher risk, underserved, and disproportionately affected to ensure resources are available to maintain and manage physical and mental health, including easy access to information, affordable testing, and medical and mental health care. For more information and community resources visit: https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/index.html
This initiative is funded through the Coronavirus Response and Relief Supplemental Appropriations Act, 2021, (P.L. 116-260) and is expected to award funding to up to 108 state, local, territorial, and freely associated state health departments, or their bona fide agents. CDC will be accepting applications for this initiative through April 30, 2021.
Pennsylvanians are Experiencing Hunger at Highest Levels Since Onset of Pandemic
At the end of 2020, more than 12% of Pennsylvania households were experiencing hunger — the highest rate since the onset of the COVID-19 pandemic, according to researchers in Penn State’s College of Agricultural Sciences. Their report confirms anecdotal and media reports and highlights the role that community resources, such as food pantries and free school lunches, are playing in the state.
“We’ve seen the media accounts of exceptionally long lines at food banks and wanted to get a better understanding of the magnitude of the problem,” said Stephan Goetz, professor of agricultural and regional economics and director of the Northeast Regional Center for Rural Development (NERCRD).
“Our synthesis suggests that while the state’s rate of food insufficiency tends to be lower than the nation’s as a whole, it is still a significant and growing problem,” he said. “More than one in 10 households in Pennsylvania sometimes or often didn’t have enough food to eat last year, and food insufficiency status has grown worse for all but the wealthiest Pennsylvanians since the beginning of the pandemic.”
Goetz and his colleagues examined data from the U.S. Census Household Pulse Survey, a survey administered in three phases beginning in 2020 to a randomly selected representative sample of U.S. households. The goal of the survey is to better understand the social and economic effects that the coronavirus pandemic has had on households across the country.
Survey respondents answer questions about their employment status, food and housing security, education disruptions, and physical and mental well-being. When responding to questions about food sufficiency and availability, they base their answers on the previous seven days.
Focusing on Pennsylvania, the researchers analyzed the survey data to assess the most recent levels of household food security, how food security has changed over the course of the pandemic, and how households in different income brackets have experienced the crisis. They also assessed how families have adapted to food insufficiency by accessing free food. They released their findings this week in a new report titled “Pennsylvania Food Insufficiency Reached New High at the End of 2020.”
The report shows that food insufficiency in Pennsylvania is closely linked to the state’s unemployment rate. During weeks when unemployment claims are at their highest in the state, reports of food insufficiency also are relatively high, or rising. For policymakers, this underscores the close connection between income from working and food security of individuals. Community safety nets, such as free school lunches and food pantries, play a significant role in meeting household food needs.
“Our synthesis shows an increasingly dire food insecurity situation for many households in Pennsylvania and beyond,” Goetz said. “As the pandemic drags on, it is likely to become an even more serious problem as families deplete their savings and are forced to choose between paying for food or paying for other necessities.”
The report is part of an ongoing series of briefs and reports authored by NERCRD researchers, focusing on the coronavirus pandemic in the context of direct farm sales, the fruit and vegetable industry, consumer spending and sourcing, network science, and regional science.
The center also has available the data included in the report for other states in the northeastern U.S.
Other members of the research team who contributed to the report described here include Zheng Tian, research associate; Claudia Schmidt, assistant professor of marketing and local/regional food systems; and Yuxuan Pan, graduate research assistant.
Visiting Loved Ones in a Nursing Home – UPDATED Graphic Available (English and Spanish)
On March 10, 2021, the Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). Today, CMS is releasing a graphic to further explain the expanded visitation options.
According to the updated guidance, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation. Read the full press release and review the graphic in English and Spanish.
Pennsylvania Governor and COVID-19 Vaccine Task Force Announce Targeted Vaccination Strategies, Including for Food Processing & Farmworkers
Agriculture is essential. While so many people saw their world turn upside down last March, not much changed for this industry. People need to eat, so we continued farming, planting, growing; caring for livestock; processing and packing; and putting food on the shelves.
Governor Tom Wolf and the Legislative Vaccine Taskforce recognize agriculture’s invaluable service. On March 12, 2021, they announced that farm workers, food manufacturing employees, and grocery workers are the next targeted groups to receive the FDA approved Johnson & Johnson COVID-19 vaccine which has been approved by the FDA for targeted administration.
This effort is separate from Phase 1B, where agriculture falls in the commonwealth’s vaccine rollout plan. It’s recognition that these groups have had no choice but to continue working to keep Pennsylvania and the world fed through a pandemic.
Strengthening the resiliency of agriculture requires acknowledging the transformative power of science and research. And that’s what we have in the COVID-19 vaccine.
Read the Governor’s announcement here. Check out the FAQs here.
Effective April 4, More Options in Pennsylvania for Restaurants and Other Businesses, Mass Gathering Maximums Increase
As COVID-19 cases have declined and vaccination rates are climbing, Pennsylvania Governor Tom Wolf today announced the lifting of some targeted restrictions on restaurants and other businesses, as well as increased gathering limits.
Effective April 4, restaurants may resume bar service; alcohol service will be allowed without the purchase of food; the curfew for removing alcoholic drinks from tables will be lifted; and indoor dining capacity will be raised to 75 percent for those restaurants that are currently self-certified and those that undergo the self-certification process, which involves agreeing to strictly comply to all public health safety guidelines and orders, including the cleaning and mitigation protocols and other operational requirements contained in the Governor and Secretary of Health’s mitigation and enforcement orders issued on November 23, 2020, as amended. Those restaurants that do not self-certify may raise capacity to 50 percent. Outdoor dining, curbside pick-up and takeout are still encouraged.
Requirements such as mask-wearing, and social distancing, including 6 feet between diners, also still apply.
Capacity for other businesses also will be increased effective April 4, including moving personal services facilities, gyms and entertainment facilities (casinos, theatres, malls) to 75 percent occupancy.
The governor also announced revised maximum occupancy limits for indoor events to allow for 25% of maximum occupancy, regardless of venue size, and maximum occupancy limits for outdoor events to allow for 50% of maximum occupancy, regardless of venue size. Maximum occupancy is permitted only if attendees and workers are able to comply with the 6-foot physical distancing requirement.
“Pennsylvanians have stepped up and done their part of help curb the spread of COVID-19,” Gov. Wolf said. “Our case counts continue to go down, hospitalizations are declining, and the percent positivity rate gets lower every week – all very positive signs. The number of people getting vaccinated increases daily and we are seeing light at the end of the tunnel. It’s time to allow our restaurants, bars and other service businesses to get back to more normal operations.”
While the lifting of these restrictions is good news, Gov. Wolf cautioned that mask-wearing, social distancing and business adherence to all safety orders are still imperative.
“We’ve come so far and now is not the time to stop the safety measures we have in place to protect ourselves, our families and our communities,” Gov. Wolf said. “Keep wearing a mask, social distancing, and, please, get vaccinated when it’s your turn.”
Find more on the restaurant self-certification process here.
Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine
On March 15, CMS increased the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. At a time when vaccine supply is growing, CMS is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible.
Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.
These updates to the Medicare payment rate for COVID-19 vaccine administration reflect new information about the costs involved in administering the vaccine for different types of providers and suppliers, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.
CMS is updating the set of toolkits for providers, states, and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare, or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine.
Coverage of COVID-19 Vaccines:
As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers are prohibited from charging patients any amount for administration of the vaccine. To ensure broad and consistent coverage across programs and payers, the toolkits have specific information for several programs, including:
Medicare: Beneficiaries with Medicare pay nothing for COVID-19 vaccines and there is no applicable copayment, coinsurance, or deductible.
Medicare Advantage (MA): For calendar years 2020 and 2021, Medicare will pay providers directly for the COVID-19 vaccine (if they do not receive it for free) and its administration for beneficiaries enrolled in MA plans. MA plans are not responsible for paying providers to administer the vaccine to MA enrollees during this time. Like beneficiaries in Original Medicare, Medicare Advantage enrollees also pay no cost-sharing for COVID-19 vaccines.
Medicaid: State Medicaid and Children’s Health Insurance Program agencies must provide vaccine administration with no cost sharing for nearly all beneficiaries during the Public Health Emergency (PHE) and at least one year after it ends. Through the American Rescue Plan Act signed by President Biden on March 11, 2021, the COVID vaccine administration will be fully federally funded. The law also provides an expansion of individuals eligible for vaccine administration coverage. There will be more information provided in upcoming updates to the Medicaid toolkit.
Private Plans: CMS, along with the Departments of Labor and Treasury, is requiring that most private health plans and issuers cover the COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost sharing during the PHE. Current regulations provide that out-of-network rates must be reasonable, as compared to prevailing market rates, and reference the Medicare reimbursement rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect commercial carriers to continue to ensure that their rates are reasonable in comparison to prevailing market rates.
Uninsured: For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA).
More Information:
- Medicare COVID-19 Vaccine Shot Payment webpage: Payment for COVID-19 vaccine administration, including a list of billing codes, payment allowances, and effective dates
- CDC COVID-19 Vaccination Program Provider Requirements and Support webpage: How the COVID-19 vaccine is provided at 100% no cost to recipients
- HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured webpage
Biden Administration to Expand COVID-19 Vaccine Program to 950 Community Health Centers
The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC), announced that an additional 700 HRSA-supported health centers will be invited to join the Health Center COVID-19 Vaccine Program. These health centers will have the opportunity to join the program over the next six weeks, increasing the total number of invited health center participants to 950. Find the full HHS press release here and a list of the health centers participating in or invited to join the program here.
President Biden Signs the American Rescue Plan into Law
Yesterday, President Biden signed into law a $1.9 trillion COVID-19 relief package. Thanks to the advocacy of NRHA and its members, the package includes a number of provisions to protect and promote rural health. Most notably, NRHA has secured the infusion of $8.5 billion for rural providers, a key provision which NRHA worked closely with Senator Manchin’s office to develop. The $8.5 billion for rural providers will be provided through a fund called the Health Care Heroes Sustainability Fund (HCHSF), which will be similar to the Provider Relief Fund (PRF) but specific to rural providers. Find details on the additional rural health provisions included in the relief package in the National Rural Health Association’s latest Rural Health Voices blog.
Dollar General’s Reach Could Give It a Rural Advantage in Vaccine Distribution
By Liz Carey
The retailer is in talks with the CDC about delivering Covid-19 vaccines to underserved areas. Three-quarters of Americans live within five miles of one of its 17,000 stores, the company says.
Read more