News & Research Reports

Rural Health Information Hub Latest News

New Data from the CDC Released on Preventable Premature Death

New Data from the CDC on Preventable Premature Death. The new study from the Centers for Disease Control and Prevention (CDC) is an extension of an earlier CDC study, which showed a higher percentage of early death from the five leading causes in rural counties compared with urban counties during 2010-2017.  More recent data show that the rural-urban gap in all-cause mortality continues to widen.  In 1999, the death rate in rural areas was 7 percent higher than in urban areas; by 2019, it was 20 percent higher.  View CDC’s rural health website and  Rural Public Health At-a-Glance to find out what CDC is doing to improve the health and well-being of rural communities.

Volunteer Opportunities Open for 2024 Pop-Up Dental Clinics in Pennsylvania

Looking to volunteer at a dental event in 2024? The PA Coalition for Oral Health compiled a list of pop-up clinics happening across the state. Click on the locations/dates for more information on each clinic. Looking to make a difference year-round? Free clinics rely on volunteers to provide quality, accessible healthcare in their communities. The Free Clinic Association of Pennsylvania can connect you with clinics in your region.

Click here for more info on volunteering with free clinics that see patients year-round.

Remote Area Medical (RAM) Clinics
Sharon, PA – June 8 & 9
Scranton, PA – August 3 & 4
Philadelphia, PA – August 24 & 25
Erie, PA – September 7 & 8
Allentown, PA – October 19 & 20

MOM-n-PA
Reading, PA – June 21 & 22

Mission of Mercy Pittsburgh
Pittsburgh, PA – November 1 & 2

PA’s Insurance Marketplace Issues RFP for Enrollment Assister Contract

Pennie, Pennsylvania’s official health insurance marketplace, has issued a Request for Proposal for Assister Services.  The awardee will collaboratively drive statewide activities to increase awareness of the financial help and health coverage available through Pennie, and work directly with community organizations to provide local, in-person enrollment assistance.  

The primary goals of this project are to:  

  • Increase awareness of affordable and high-quality coverage available through Pennie  
  • Expand the availability of direct, in-person enrollment assistance across Pennsylvania  
  • Diversify Pennie’s local partners across the Commonwealth so that assister services can be provided in a way that meets unique, local needs  
  • Increase outreach to historically marginalized communities who are disproportionately uninsured or underinsured.  

“Pennie hears every day from people looking for more support to find health coverage that works for their medical needs and their household budget.  This new contract will provide enrollment assistance and education through local and trusted partners in communities across the Commonwealth,” noted Pennie’s Executive Director Devon Trolley. “Knowing that ‘word of mouth’ is consistently how most Pennsylvanians learn of Pennie, we are excited to be expanding our network and partnerships to ensure Pennie is woven into the community fabric, and that free expert help is never too far from home.” 

Contract Details

The initial term of this contract is four years, including two optional two-year renewals. The Lead Contractor on the project will coordinate and subcontract with five to eight regional organizations across the Commonwealth. These regional offices will be responsible with the bulk of the day-to-day outreach, education, and enrollment assistance while consistently broadening their network of community-based organizations.  

Submission and Deadline 

Organizations interested in becoming the Lead Contractor can visit, https://www.emarketplace.state.pa.us/Solicitations.aspx?SID=PHIEA%2023-21. All proposals must be submitted by 1 pm on June 27 

For inquiries concerning the RFP specifically, please contact Gwen Zeh, Issuing Officer, at RA-PWPENNIEProcuremt@pa.gov. 

Other Opportunities

The new assister services approach will rely on partnering with established regional organizations across Pennsylvania. Pennie is actively seeking information about community partners looking to support enrollment assistance and outreach efforts. For organizations that are interested in supporting Pennie’s efforts but are not interested in becoming the Lead Contractor, visit this link to provide Pennie with your information and level of interest: https://pennie.com/partnerships/.

About Pennie

Pennie® is the official health insurance marketplace for the Commonwealth of Pennsylvania, and the only source of financial help to lower the cost of high-quality private health insurance plans. Pennsylvanians without access to other health coverage can find affordable health plans through Pennie that meet different needs and budgets. Eligibility for financial help is based on income, family size, and other factors. Pennie is operated by the Pennsylvania Health Insurance Exchange Authority, established under state law. For more information, visit pennie.com or follow us on social at fb.com/PenniePA and Twitter.com/PennieOfficial.

New Rules Will Help Adults and Children Enroll — and Stay Enrolled in — Medicaid and CHIP

On April 2, the Centers for Medicare and Medicaid Services (CMS) published the most significant set of eligibility regulations since the initial rule implementing the Affordable Care Act (ACA). The new rule will help eligible individuals enroll in Medicaid and Children’s Health Insurance Program (CHIP) coverage and stay enrolled as long as they remain eligible. Many of the provisions address issues that contributed to coverage losses during the unwinding of the continuous enrollment provision that has resulted in at least 13.7 million people losing Medicaid coverage, mostly for procedural reasons.

The new rule is effective 60 days after publication, but because most of the new regulatory requirements will necessitate significant policy, operational, and system changes, CMS has set a three-year pathway for states to come into compliance. This approach attempts to balance the competing needs of making the streamlined processes available as soon as possible and responding to states’ capacity issues.

Key changes that address Medicaid unwinding specifically include:

  • Updating address information. States took different steps during the unwinding process to update addresses and respond to returned mail. Certain actions, like relying on updated address information from managed care plans and the United States Postal Service (USPS), were permitted only under temporary authority. The final rule codifies many of these best practices and outlines actions states must take to respond to returned mail and use address information from reliable data sources, such as the USPS. States must come into compliance by December 2025.
  • Timelines for responding to requests for information. During the unwinding period, some beneficiaries lost their coverage because they did not respond to requests for information in a timely manner. The final rule allows more time for beneficiaries to respond to such requests. For example, individuals will have at least 15 days to respond to requests at the time of application and 30 days to respond to requests when they report a change in circumstances. A 30-day minimum period already exists at renewal. States must come into compliance with these changes by June 2027.
  • Transitions between Medicaid and CHIP. Children can lose coverage or have gaps in coverage when transitioning between Medicaid and CHIP programs. For example, if a child is enrolled in Medicaid and family income increases, he or she may be no longer eligible for Medicaid but eligible for CHIP. In this case, the child would still need to go through a CHIP eligibility determination. The new rule requires each agency to accept determinations of eligibility made by the other agency at both application and renewals, ensuring that children no longer “bounce” between state-run programs. States must come into compliance with these changes by June 2024.

Other key changes in the new regulations include:

  • Aligning eligibility and enrollment processes across Medicaid eligibility groups. The final rule extends streamlined, modernized processes that are already required for children, pregnant people, parents, and adults eligible under the ACA Medicaid expansion to people who are older and disabled. For example, under the new rules, individuals who seek coverage based on disability status or age (i.e., 65 or older) must be able to submit applications in person, online, by telephone, or by mail and have their eligibility determined without an in-person interview. Renewals cannot be more frequent than every 12 months, states must first attempt to renew coverage by reviewing data sources rather than requesting documentation, and individuals must have a minimum time period to respond to renewal forms. These changes will significantly ease the administrative burden on individuals who are older or disabled. These populations are more likely to live on fixed incomes and be financially eligible for coverage but disproportionately challenged with meeting enrollment and renewal requirements. States must implement these changes by June 2027.
  • Removing CHIP coverage barriers. The final rule eliminates the ability of states to lock out children who are behind in premiums for a set time period (e.g., 30 or 60 days). It also eliminates waiting periods before children can enroll and annual and lifetime benefit limits for CHIP-enrolled children. States are also no longer permitted to require payment of past-due premiums as a condition of reenrollment. Fourteen states currently lock CHIP-enrolled children out of coverage for a period for failure to pay premiums. Nine states have waiting periods, a practice dating back to the early days of CHIP to address concerns that CHIP might “crowd out” or “substitute” coverage under group health plans. Thirteen states currently impose annual or lifetime limits on CHIP benefits, most applied to dental and orthodontia services. States must implement these changes to CHIP by June 2025.

While some states have already implemented many of these policies under temporary authority granted by CMS during the unwinding period, all states will need to evaluate the policy, operational, and systems changes needed to comply with the new rule. Given the issues arising during the unwinding period, states will be developing corrective action plans following the unwinding period. The phased timing of the provisions in the new rule will allow states to combine these efforts, bringing their systems into compliance with both the new and the preexisting rules. Notably, the implementation of many of these changes will qualify for enhanced federal administrative matching funds, helping defray the cost of implementation for states. Once implemented, the changes should result in a more streamlined, efficient, and customer-focused process to determine eligibility, enroll, and renew Medicaid and CHIP coverage.

2024 NHSC New Site Application Opens Soon

Do you know that becoming a National Health Service Corps (NHSC) approved site can help your recruitment and retention goals?  You can:

  • Inform clinicians of your NHSC-approved status, so they can apply for one of the NHSC Loan Repayment Programs.
  • Post a position on the Health Workforce Connector and search job seeker profiles.
  • Participate in Virtual Job Fairs, online job fairs that connect you with job-seeking primary care trainees and practicing clinicians.
  • Hire an NHSC scholar or an NHSC Students to Service participant.

Eligible healthcare facilities provide outpatient, primary health care services to people in Health Professional Shortage Areas. Sites must contact their State Primary Care Office when applying for or inquiring about a HPSA designation.

Interested in learning more?  Click here to check eligibility!

Young Adults and Former Foster Care Children Need Your Help Obtaining Coverage

Every year, around 20,000 young people transition out of foster care. The primary source of health coverage for this population is Medicaid, and since continuity of health coverage is crucial, continue reading for helpful information you can use when working with Former Foster Care Children (FFCC).

Changes to the Former Foster Care Children Medicaid Policy

Under federal law, Medicaid provides coverage for qualifying youth who age out of foster care until they reach age 26, under the mandatory FFCC eligibility group.

Until recently, to be considered eligible for the FFCC eligibility category, individuals had to meet all of the following criteria:

  • Are under age 26;
  • Are not eligible for or enrolled in another mandatory eligibility group;
  • Were in foster care in the state in which the individual is seeking Medicaid eligibility upon attaining age 18 (or higher as the state has elected in its title IV-E plan); and
  • Were enrolled in Medicaid in such state while in foster care.

However, updates to these criteria, effective January 2, 2023, expand the ability for FFCC to obtain Medicaid coverage. Individuals now must have been in foster care in any state upon attaining age 18 (or higher as the state has elected in its title IV-E plan) as well as have been enrolled in Medicaid in any state while in such foster care.

View a CMS resource with more information about these updates here.

University of Pittsburgh Seeks Clinical Training Sites for Dental Assistant Trainees

The University of Pittsburgh School of Dental Medicine is seeking additional training sites for the Dental Assistant Training Program. The training program consists of three months of online training followed by the three weeks of clinical training at the site as an internship. Following the internship, trainees are expected to give a one-year commitment of full-time employment and sites can choose to require an employment contract. Additional sites are needed for the next cohort of trainees starting July 8, 2024.

Click here for more information.
Click here to sign up as a training site.

CMS Updates Mental Health and Substance Use Disorders (SUD) Medicare.gov Content

The Centers for Medicare & Medicaid Services (CMS) has updated its Mental Health and Substance Use Disorders (SUD) content on www.medicare.gov. The content updates are part of the CMS broader Behavior Health Strategy and will make it easier for users to access mental health and substance use disorder information.  Visit https://www.medicare.gov/coverage/mental-health-substance-use-disorder to see the new updates.

The CMS Behavioral Health Strategy translates our goals into a framework focused on outcomes and focuses on three key areas:

  • Substance Use Disorders Prevention, Treatment, and Recovery Services,
  • Ensuring Effective Pain Treatment and Management, and
  • Improving Mental Health Care and Services.

You can find more information on CMS’ Behavioral Health Strategy and our mission to ensure that high-quality behavioral health services and supports are accessible to the people we serve, by visiting https://www.cms.gov/cms-behavioral-health-strategy.

If you or someone you know is in crisis, call, text 988 or chat 988lifeline.org, 24 hours a day, 7 days a week. Call 911 if you’re in an immediate crisis.

Federal Administration Acts to Improve Access to Kidney Transplants

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced the Increasing Organ Transplant Access (IOTA) Model. The proposed model, which would be implemented by the CMS Innovation Center, aims to increase access to kidney transplants for all people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process to receive a kidney transplant, and increase the efficiency and capability of transplant hospitals selected to participate. This proposed model would improve the kidney transplant system and the collaborative efforts between CMS and the Health Resources and Services Administration (HRSA) to increase organ donation and improve clinical outcomes, system improvement, quality measurement, transparency, and regulatory oversight.

“The organ transplant industry, like every other part of society, is not immune to racial inequities,” said HHS Secretary Xavier Becerra. “Black Americans disproportionately struggle with life-threatening kidney disease, yet they receive a smaller percentage of kidney transplants. The Biden-Harris Administration is taking concrete steps to remove racial bias when calculating wait times and rooting out profiteering and inequity in the transplant process.”

Kidney transplantation is the best treatment for most individuals with ESRD, a condition that occurs when the kidneys are no longer able to function properly. People with ESRD who receive transplants have better outcomes than people who receive dialysis, improvements in quality of life, and are freed from lengthy and burdensome dialysis treatments. However, the scarcity of organs, particularly for kidney transplants, leads to increased patient mortality and a significant gap between demand and supply. Despite this scarcity, approximately 30% of donor kidneys go unused annually, highlighting gaps in procurement, distribution, and utilization. Prolonged waiting times, averaging three to five years or more, intensify patient suffering. With just over 28,000 kidney transplants performed in 2023 and more than 90,000 people on a waitlist during that same time, urgent measures are needed to improve the efficacy and efficiency of the system.

“Modernizing the organ transplantation system is a top priority for the Biden-Harris Administration,” said CMS Administrator Chiquita Brooks-LaSure. “Kidney transplantation helps people live healthier and longer lives because they no longer have to undergo dialysis. The Increasing Organ Transplant Access Model would be an important step forward in improving the kidney transplant process for everyone on a waitlist and those who have received a transplant.”

In the proposed model, participating transplant hospitals would be measured by increases in the number of transplants, increased organ acceptance rates, and post-transplant outcomes. The Increasing Organ Transplant Access Model would hold kidney transplant hospitals accountable for the care they provide. Hospitals eligible to be selected for the proposed model are non-pediatric facilities that conduct a minimum of 11 transplants each during a three-year baseline period. Out of the 257 transplant hospitals in the country, an estimated 90 would be required to participate in the proposed six-year model beginning January 1, 2025.

To further improve equity and access, the model would offer additional performance incentives to participating transplant hospitals to improve equity in the transplant process. The proposed model would require participating transplant hospitals to establish health equity plans to identify gaps in access among populations in their communities and develop strategies to address these gaps. For example, participants could establish programs to educate and support potential living donors from underserved communities or to provide transportation assistance to patients on a waitlist. Participating transplant hospitals would also have the flexibility to address barriers related to social drivers of health, such as food insecurity and out-of-pocket prescription drug costs.

The proposed mandatory model would align with the HHS Organ Transplant Affinity Group’s strategy to coordinate a series of initiatives to increase transplantation access through payment, quality, and regulatory efforts. This model would be complementary to existing and future regulatory efforts for Organ Procurement Organizations, nephrologists, and dialysis facilities to improve the overall transplant system for people with ESRD. In March 2023, HRSA launched its OPTN Modernization Initiative to strengthen accountability and the performance of the nation’s organ transplant system by focusing on improving the OPTN’s governance, technology, and operations. Across the nearly 40-year history of the OPTN, all functions of the OPTN were managed by a single vendor rather than multiple contracts based on technical expertise in areas like IT or operations. HRSA is also taking transformational steps to modernize the critical organ matching technology while increasing transparency and accountability by issuing new data reporting requirements to better address pre-waitlist and organ procurement practices, which will help address inequities in the transplant waitlist process by reducing racial and ethnic variation both in patient referrals and in organ procurement.

The current kidney transplant process is complex and fragmented care and disparities contribute to the inequitable distribution of this life-saving treatment. Access to organ transplantation varies not only by geography but also by factors such as race, ethnicity, disability status, and socio-economic status. For example, according to the Scientific Registry of Transplant Recipients (SRTR) Annual Data Report, 32% of waitlisted individuals were African American in 2021, but only 13.5% of recipients of a transplant from a living donor were African American. White individuals made up 35.8% of the waitlist and 61.8% of transplant recipients from a living donor. The proposed Increasing Organ Transplant Access Model is designed to address these challenges by improving the overall quality of care for patients with ESRD and increasing the number of transplants performed.

“Requiring participation in the proposed Increasing Organ Transplant Access Model would be a promising opportunity to engage participating transplant hospitals and collaborators in the model in seeking to reduce fragmentation in kidney transplantation while improving care, access, and affordability,” said Liz Fowler, CMS Deputy Administrator and Director of the CMS Innovation Center. “If finalized, CMS will work with selected participating transplant hospitals and providers to provide technical assistance so they can succeed in the model, putting us on the path to using all available kidneys and ultimately improving the quality of life for hundreds of thousands of individuals and their families.”

CMS has proposed the Increasing Organ Transplant Access Model be a mandatory model to aim to achieve a sufficient and representative national sample of participating kidney transplant hospitals that represent diverse geographic locations, familiarity with designing care focused on quality, provider performance, and the patient experience, and success with increasing transplants. CMS is prepared and ready to partner together with transplant hospitals to be successful in their improvement efforts and will support them with additional resources and assistance. By focusing on the problem together, we will be on the path to using all available kidneys and ultimately improving the quality of life for hundreds of thousands of individuals and their families.

The proposed rule on the Increasing Organ Transplant Access Model can be accessed from the Federal Register at https://www.federalregister.gov/public-inspection/current. Standard provisions are included in the proposed rule that would be applicable to all Innovation Center model participants that begin participation in a model on or after January 1, 2025.

View a fact sheet on the Increasing Organ Transplant Access Model.

More information on the Increasing Organ Transplant Access Model is available on the model webpage.

Explore New Data on the Anchor Economy Dashboard

The Federal Reserve Bank of Philadelphia launched new data on the Anchor Economy Dashboard. You can now explore anchor institution economic impacts and reliance measures for the years 2004 and 2019 for all 524 U.S. regions.

In the coming weeks, they are releasing an accompanying research brief that delves deeper into the change in anchor institution reliance in the United States between 2004 and 2019. The brief will be posted to  their website and discussed at the upcoming 2024 Anchor Economy Conference in Philadelphia on May 15–16.

If you have any questions on the dashboard or this new data set, please feel free to get in touch Deborah Diamond at deborah.diamond@phil.frb.org.