- Request for Information (RFI): Evolving the Network of the National Library of Medicine
- Dental Therapists, Who Can Fill Cavities and Check Teeth, Get the OK in More States
- 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
Pennsylvania Health Care Providers Tell Lawmakers the State’s Rural Hospitals Are in Crisis
Pennsylvania’s rural hospitals are dealing with a shortage of physicians and mental health providers that has become dire, leaving patients in rural communities with dwindling options for care.
That was the message members of the Center for Rural Pennsylvania heard on Thursday during a hearing with hospital and health care center executives, and public health experts.
The center, a bicameral, bipartisan legislative agency, heard from hospital and health center executives, as well as public health experts about the challenges facing rural health care providers at a public hearing in Bradford.
Dr. Jill Owens, president of Upper Allegheny Health System, put it bluntly: “Rural hospitals are in crisis,” she told the panel.
Owens said that difficulty attracting and retaining health care providers, low Medicaid and Medicare reimbursement and other challenges have led to care deserts and declining health outcomes for rural Pennsylvanians. And without action to reform the struggling health care system and more funding and resources for local providers, the situation is unlikely to improve any time soon.
Attracting Providers
Jeannine McMillan, executive director of the Center for Population Health, a nonprofit focused on population and public health initiatives in rural Cambria and Somerset counties, said that both counties suffer from a lack of primary care physicians and mental health providers.
“Extreme challenges, including lack of adequate public transportation, availability of broadband, food deserts and difficulty recruiting clinicians are magnified in rural communities,” McMillan said.
While her organization has been fortunate to receive funding from philanthropic groups, McMillan said that “significant investments are needed” to improve health outcomes in rural communities.
A study conducted by the Hospital and Healthsystem Association of Pennsylvania (HAP) found that rural hospitals have struggled to fill 39% of vacant registered nurse positions. By comparison, HAP found the average vacancy rates for direct care RNs to be more than 30% statewide.
Kate Slatt, vice president of Innovative Payment and Care Delivery for the Hospital and Healthsystem Association of Pennsylvania, said that HAP supports efforts to strengthen the education and training pipeline for those pursuing health care careers and the creation of an office within Democratic Gov. Josh Shapiro’s administration to focus on “health care workforce innovation and reform,” it does not support legislative attempts to limit the staff-to-patient ratios at Pennsylvania hospitals.
In late June, the House passed HB 106, also known as the “Patient Safety Act.” The bill, co-sponsored by state Reps. Thomas Mehaffie, R-Dauphin, and Kathleen Tomlinson, R-Bucks, would outline the number of patients per-nurse required in different hospital settings.
Supporters of the legislation, including nurses who weathered unmanageable caseloads during the COVID-19 pandemic and the unions representing them, said the legislation protects patients and improves health care outcomes.
In July, the bill was referred to the Senate Health and Human Services Committee.
Maternal Health Deserts
Public health officials also warned lawmakers at the hearing about an “alarming” trend in rural health — a lack of labor and delivery services.
From January 2010 to April 2022, 30 Pennsylvania hospitals closed their doors. Many others were forced to cut specific services — such as OB/GYN — in order to remain financially viable, according to HAP.
Similarly, of Pennsylvania’s 42 rural hospitals, 60% do not have labor and delivery services, an analysis from the Center for Healthcare Quality and Payment Reform found.
“Many pregnant persons in rural areas need to drive almost 40 minutes to reach a hospital that can assist them during birth, which exceeds the recommended 30-minute travel time once a person begins labor,” Lisa Davis, director of the Pennsylvania Office of Rural Health and Outreach explained. “These challenges also contribute to increases in births outside of hospitals versus in hospitals without OB units and in preterm birth, all of which carry greater risks for both mothers and newborns.”
A 2022 report from the March of Dimes found that six of Pennsylvania’s 67 counties — Cameron, Forest, Greene, Juniata, Sullivan, and Wyoming counties — classified as “maternal health deserts” because they lacked hospitals providing obstetric care and birth centers, and had no OB/GYN or certified nurse midwives.
State Sen. Judy Schwank, D-Berks, said she was “very concerned” about the impact maternal health care deserts in rural Pennsylvania could have on the commonwealth’s maternal mortality rate.
“There are hospitals in the state that close maternity care that send persons in labor to another facility by either lifeflight helicopter or ambulance during the times when they can go but those are really expensive, or they may end up just having to deliver in the emergency department if they can’t travel,” Davis explained. “So this is something I think we really need to focus on.”
Davis offered that alternative services, such as birthing centers, may be an effective option for rural communities across the commonwealth.
New Public Health Resource Published: Understanding Air Quality
The ongoing wildfires in Canada (including a blaze that crossed the U.S.-Canada border this past weekend) and an intense nationwide heat wave are having harmful effects on air quality–putting public health at risk. Although a decrease in air quality affects everyone, certain communities and individuals are more vulnerable to its harmful effects.
PHCC’s newest resource, Protect Your Health: Understanding Air Quality, will help you communicate about air quality and protective measures people can take to stay safe. This resource is available in English and Spanish and includes:
- The fundamentals of understanding air quality and the Air Quality Index (AQI)
- A visual guide to the major sources of air pollution
- Recommendations for protecting your health routinely and during air-quality alert days
Download and share the guide with your community to promote the importance of understanding air quality and protecting your health
The Interactive Medicare Telehealth Dashboard is Now Available
The use of telehealth among Medicare beneficiaries peaked in 2020 and decreased slightly in 2021; the highest telehealth use was for behavioral health and primary care visits. View this and other trends in the Office of the Assistant Secretary for Planning and Evaluation’s recently released interactive Medicare Telehealth Trends Dashboard, report, upcoming demo, and supplemental documents. You can see Medicare fee-for-service claims data aggregated by beneficiary characteristics visit specialty, year, state, and more. For additional information on telehealth research, visit Telehealth.HHS.gov.
A New Guide Helps You “Grow Your Own”
The Growing Provider Shortage: Building the Case for Developing an HP-ET Program is a new resource from the Association of Clinicians for the Underserved to help you “grow your own” workforce. Understanding what roles are currently in demand, and which are likely to increase in demand soon, is critical to assessing what type of Health Professions Education and Training (HP-ET) or other recruitment programs can most benefit a health center. This newly produced ACU STAR² Center document is designed to highlight projected workforce needs based on National Health Service Corps vacancy data and provides an overview of options available to develop or sustain HP-ET programs to meet these needs.
The Network Adequacy Report Has Been Released for Pennsylvania
By law, health plans must provide their members with reasonable access to in-network providers and services. Yet many Pennsylvanians face delays of months or even years in scheduling appointments as well as excessively long driving distances to treatment locations. The Pennsylvania Health Action Network (PHAN) released a new report, Healthcare Network Inadequate to Serve All: Causes and Solutions in Pennsylvania, which discusses what happens when health plan networks are inadequate to serve their members, why this happens, and what the Commonwealth of Pennsylvania can do about it.
Pennsylvania Offers Consumers Resources on Mental Health and SUD Parity Rights
Pennsylvania Insurance Commissioner Michael Humphreys announced the Pennsylvania Insurance Department (PID) has updated its resources available for consumers to learn about mental health and substance use disorder (SUD) coverage parity and their benefits and rights under the law. Commissioner Humphreys reiterated that PID’s enforcement of the protections found under parity law is a top priority for the Shapiro Administration. He also encouraged consumers to explore the resources PID has available and to file a complaint with the department if they believe they are not receiving the proper coverage. The updated resources include a new web page designed to help guide consumers to their coverage options, as well as new outreach materials that will help consumers spot red flags in their health plan’s coverage of mental health substance use disorder treatment. The new parity website can be accessed at www.insurance.pa.gov/parity.
Pharma Earnings Have Jumped Over 10%
The five largest U.S. pharmaceutical companies by market cap — Eli Lilly, Johnson & Johnson, Merck, AbbVie, and Pfizer — reported combined earnings of $81.9 billion in 2022, an $8 billion increase from 2021, according to a new analysis by Accountable. The US. The report comes as major players in the pharmaceutical industry try to buck provisions in the Inflation Reduction Act (IRA) that would allow Medicare to directly negotiate the prices of certain drugs with manufacturers in an effort to cut costs for older Americans. An analysis by the nonpartisan Congressional Budget Office found the IRA drug pricing provisions will reduce the federal deficit by $237 billion from 2022 to 2031. The Centers for Medicare and Medicaid Services (CMS) is set to announce the first 10 drugs by Sept. 1, and their newly negotiated prices will take effect in 2026.
Shortages of Sterile Injectable Drugs Are Likely to Get Worse
Current shortages of sterile injectable drugs are likely to worsen, following a tornado that seriously damaged a Pfizer plant in North Carolina that manufactures nearly 25% of the nation’s supply of these drugs. In recent months providers have reported a shortage of around 300 drugs, many of which are sterile injectable ones, such as painkillers, anti-infectives, surgical muscle relaxants, anesthesia, and therapeutics. It is currently unclear which specific drugs will be most impacted by the tornado damage.
The White House Puts Insurance Companies on Alert for Mental Health Care
The Biden administration announced new proposed rules to reinforce legislation requiring insurance companies to cover mental health benefits to the same degree as medical and surgical benefits, with administration officials citing the stark lack of access Americans have to mental health care. The proposed rule reinforces the Mental Health Parity and Addiction Equity Act’s (MHPAEA) fundamental goal of ensuring that families have the same access to mental health and substance use benefits as they do physical health benefits. Specifically, the proposed rule would require health plans to make changes when they are providing inadequate access to mental health care, make it clear what health plans can and cannot do, and close existing loopholes.
The Centers for Medicare and Medicaid Services Releases New Fact Sheets
The Centers for Medicare and Medicaid Services (CMS) released a detailed summary of the mitigation strategies states are using to address areas of non-compliance with Medicaid renewal requirements. This includes a summary of the top 10 mitigation strategies and information on each state’s area(s) of non-compliance and the adopted strategies to address non-compliance. This information is current as of March 31, 2023. CMS also released a three-page summary on CMS authority and oversight on returning to regular Medicaid renewals. This document outlines the data monitoring strategy CMS is implementing, actions CMS can take when states are not complying with federal requirements and technical assistance opportunities from CMS.