People with moderate-to-severe depression may be more willing to engage with health systems through an online portal than by attending clinic visits, according to a study published in the Journal of General Internal Medicine. The authors studied data for 1,037 adults due for depression screening at an urban internal medicine clinic to determine whether a portal-based, population health approach could increase depression screening rates compared to the usual care. They found that the screening rate for patients invited to access an online portal was higher than for patients receiving the usual care. Access the study here.

The Health Resources and Services Administration (HRSA) National Center for Health Workforce Analysis (NCHWA) has released its updated Workforce Projections Dashboard. This interactive dashboard shows projections of the supply and demand for the health workforce across the United States. You can use this tool to view projections of the supply and demand for healthcare workers at the state and national level; analyze supply and demand trends by discipline, and analyze projected ‘What if?’ scenarios in the event of changes in the healthcare landscape. The projections are based on the Health Workforce Simulation Model that estimates the current and future supply and demand for healthcare workers by occupation, geographic area, and year. If you have any questions, send them to NCHWAinquiries@hrsa.gov.

On Nov. 30, the Biden Administration released proposed changes to the Alternative Dispute Resolution (ADR) rule. The ADR process is the way for manufacturers and covered entities to resolve disputes related to duplicate discounts, diversions, or overcharges within the 340B drug discount program. The new rule differs from the current ADR Process in several key ways: 1) Removal of the requirements to follow the Federal Rules of Evidence and Rules of Civil Procedure; 2) Limiting the ADR Panel members to 340B subject matter experts from the Office of Pharmacy Affairs; 3) Requiring all parties engage in good-faith dispute resolution efforts before initiating the ADR process; 4) Limiting claims to disputes involving overcharges, duplicate discounts, and diversion; 5) Establishing a reconsideration process for ADR Panel decisions; and 6) The 340B ADR Panel may suspend review of a claim if the specific issue that would be brought forth in a claim is the same as or similar to an issue that is pending in Federal court. NACHC will review and provide a comment letter template; comments are due Jan. 30, 2022.

There is good news regarding the requirements for CHCs to provide Good Faith Estimates (GFEs) to uninsured and self-pay patients. From a practical perspective, the requirement that CHCs include costs for services provided by non-CHC providers in the GFEs they give to uninsured and self-pay patients is on hold indefinitely per an FAQ released by CMS on Dec. 2. The FAQ acknowledges that providers will need adequate time for implementation for new regulatory requirements. CMS stated that it would delay enforcing the Phase Two requirements until it finalizes a regulation implementing those requirements. Providers are still waiting for a new regulation or FAQ for CHCs and other providers that use sliding fee scales. To indicate how long they would delay enforcing the legal deadlines, CMS broke the GFE rules into three phases.

•  Phase One: GFEs must be provided: Only to uninsured and “self-pay” patients, and only include costs for services/items that are provided and billed directly by the CHC.
•  Phase Two: GFEs for uninsured and self-pay patients must also include costs for services/ items that the patient receives from outside (non-CHC) providers during an “episode of care” that is coordinated by the CHC.
• Phase Three: GFEs must be provided to patients who plan to bill their insurance.

As of October 2022, the Pennsylvania Department of Human Services (DHS) reports that Medicaid Enrollment has soared to 3,603,622 eligible recipients with 2,165,516 adults and 1,438,106 children for an average of 0.4% increase over September 2022. Temporary Assistance for Needy Families — a program dedicated to helping low-income families and providing money to help pregnant women, dependent children, and other relatives who live with and care for them – has increased to 83,157. The Supplemental Nutritional Assistance Program (SNAP), which assists Pennsylvanians with buying goods, has increased enrollment to 1,911,684 individuals. Due to the Public Health Emergency, DHS was approved for a SNAP Waiver from the Food and Nutrition Service to issue one-time issuances to all households that were receiving benefits in the months of March 2020 through December 2022 to bring individuals’ SNAP benefit amounts to the maximum available for their household size.

Visitors to SSA.gov will find a new homepage with more user-friendly links to access documents, replace cards, and update information. Whether providing service in person or online, our goal is to help people understand what they may qualify for and seamlessly transition them to an application process. “Improved self-service capability allows people to skip calling or visiting an office, which helps Social Security staff focus on those visitors who need in-person assistance”, according to Acting SSA Commissioner Kilolo Kijakazi. With more than 180 million people visiting the site annually, this upgrade presents an opportunity for visitors to access needed information more efficiently. Learn more about the eligibility for the Affordable Connectivity Program and updates on COVID-19 vaccines for Medicare beneficiaries. Visit https://www.ssa.gov/

TiPS is a real-time, provider-to-provider behavioral health consultative service for children up to age 21 covered by Medicaid or CHIP (Children’s Health Insurance Program). The goal of TiPS is to improve treatment and access by providing psychiatric consultation to providers. There are no “wrong calls” to TiPS but common examples include patient-specific consults or general questions related to child psychiatry, behavioral health, medication, or accessing community resources. TiPS Teams are staffed by child psychiatrists, licensed therapists, and care coordinators. Call the TiPS Team in your region during business hours Monday through Friday to receive assistance within 30 minutes.

The new Rural Emergency Hospital designation is putting providers between a rock and a hard place, offering an infusion of cash from the federal government that is available only if they eliminate inpatient care, The New York Times reported December 9.

CMS released the final rule for the new designation in November. The rule aims to curb rural hospital closures by offering them a chance to shutter infrequently used inpatient beds and focus on providing outpatient and emergency department services. The new designation is set to go into effect in January.

Hospitals that convert will receive monthly payments of $272,866, with annual increases based on inflation, according to the report. They will also receive higher Medicare reimbursements than larger hospitals.

Some rural healthcare providers and health policy analysts said officials behind the rule are “out of touch with the difficulties of transferring rural patients,” according to the Times. Bigger hospitals are dealing with their own set of challenges and are increasingly unwilling to accept transferred patients, especially from small field hospitals that are unaffiliated with their systems.

Katy Kozhimannil, PhD, director of the University of Minnesota Rural Health Research Center, told the Times she is concerned that gambling with transfers could mean “some of the most extremely remote and marginalized communities could end up with no care at all — and that’s what we were trying to avoid in the first place.”

Some hospitals, such as Sturgis (Mich.) Hospital, have said they are planning to convert to a rural emergency hospital. The hospital was on the verge of closing when the Michigan Hospital Association suggested it convert to a rural emergency facility. Sturgis Hospital CFO Bobby Morin said 80 percent of the facility’s revenue comes from outpatient services, and a sizable portion of its expenses comes from the inpatient side.

Others, such as Bucktail Medical Center in Renovo, Pa., have ruled out the conversion because there would be nowhere to transfer patients in the case of another pandemic surge, according to the report. Bucktail’s financial margin for patient services was minus-43 percent in 2021.

“Am I going to lose some revenue? Possibly,” CEO Time Reeves told the Times. “But is it more important to provide the services needed? That’s the position we’re taking.”