This brief from the ETSU/NORC Rural Health Research Center examines differences in Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) risk scores between rural and urban Medicare Fee-for-Service beneficiaries across four common chronic conditions:  hypertension, diabetes, depression, and chronic obstructive pulmonary disease.  HCC coding is a risk assessment tool developed by CMS to estimate future health care costs.

The Pennsylvania Health Care Cost Containment Council (PHC4) published a new set of County-Level Utilization Reports today, displaying the overall total number of inpatient hospitalizations and ambulatory/outpatient cases for Pennsylvania residents.

The information reflects outpatient data from hospital outpatient departments and ambulatory procedure data from freestanding ambulatory surgery centers in Pennsylvania from Quarter 3 of 2024. Also reflected is inpatient data for the same time period from acute care, long-term acute care, rehabilitation, psychiatric, and specialty hospitals, presenting a spectrum of focused data, at a county-level.

Barry D. Buckingham, PHC4’s Executive Director, believes that these reports provide a wealth of insight for stakeholders. “Providing these quarterly County-Level Utilization Reports supports a consistent supply of fact-based data. These insights represent a vast range of facility data and are amongst the timeliest reports available to stakeholders.” The reports are updated every quarter and show the number of cases for each county, with breakouts by patient age, sex, and payer.

These quarterly reports portray the current climate of public health in Pennsylvania and provide focus and perspective. The County-Level Utilization Reports are valued resources for local communities, health care professionals, and policymakers. By fostering a data-driven approach to health care, PHC4 envisions a healthier, more resilient society where resources are allocated effectively, and lives are improved. PHC4 aims to continue to serve its mission of empowering Pennsylvanians through transparency.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.

For more information, visit phc4.org or access the reports here.

Among key findings from the WWAMI Rural Health Research Center:

• Overall, the supply of eligible clinicians grew in both rural and urban counties in the five years from 2017 to 2022.
• Despite this growth, more rural counties lacked waivered clinicians (30.1 percent) compared to urban counties (10.4 percent) in 2022, and rural counties had a lower overall supply of clinicians per 100,000 population (25.2) compared to urban counties (32.6).
• Small and remote rural counties had the greatest proportion of counties without a clinician (41.3 percent) compared to other rural counties.

Each year, PPC creates interactive maps for the Pre-K for PA campaign, and the 2025 maps and corresponding fact sheets are now available. Data on pre-k is available at the statewide, county, school district, and legislative district levels.

The maps highlight the unmet need for high-quality, publicly funded pre-k at each geographic level, including data points such as the eligible child population, high-quality, publicly funded enrollment, and the number of high-quality pre-k locations.

Statewide, of the 151,325 eligible children ages 3-4 living in Pennsylvania, only 44% have access to high-quality pre-kindergarten. With workforce challenges in the sector, an additional 8,477 pre-k staff are needed to serve the remaining eligible children.

As part of an enacted 2025-26 budget, the Pre-K for PA campaign is asking the General Assembly to:

• Support the proposed investment of $15 million in Pre-K Counts to help stabilize early learning providers by boosting per-child rates to help combat inflationary pressures and staffing shortages caused by low wages.
• Include an investment of $9.5 million for the Head Start Supplemental Assistance Program to help stabilize the Head Start Workforce.

Access the new fact sheet and online map here.

Leroy Walker arrived at the county hospital short of breath. Walker, 65 and with chronic high blood pressure, was brought in by one of rural Greene County’s two working ambulances.

Nurses checked his heart activity with a portable electrocardiogram machine, took X-rays, and tucked him into Room 122 with an IV pump pushing magnesium into his arm.

“I feel better,” Walker said. Then: Beep. Beep. Beep.

The Greene County Health System, with only three doctors, has no intensive care unit or surgical services. The 20-bed hospital averages a few patients each night, many of them, like Walker, with chronic illnesses.

Greene County residents are some of the sickest in the nation, ranking near the top for rates of stroke, obesity, and high blood pressure, according to data from the federal Centers for Disease Control and Prevention.

Patients entering the hospital waiting area encounter floor tiles that are chipped and stained from years of use. A circular reception desk is abandoned, littered with flyers and advertisements.

But a less visible, more critical inequity is working against high-quality care for Walker and other patients: The hospital’s internet connection is a fraction of what experts say is sufficient. High-speed broadband is the new backbone of America’s health care system, which depends on electronic health records, high-tech wireless equipment, and telehealth access.

Greene is one of more than 200 counties with some of the nation’s worst access to not only reliable internet, but also primary care providers and behavioral health specialists, according to a KFF Health News analysis. Despite repeated federal promises to support telehealth, these places remain disconnected.

During his first term, President Donald Trump signed an executive order promising to improve “the financial economics of rural healthcare” and touted “access to high-quality care” through telehealth. In 2021, President Joe Biden committed billions to broadband expansion.

KFF Health News found that counties without fast, reliable internet and with shortages of health care providers are mostly rural. Nearly 60% of them have no hospital, and hospitals closed in nine of the counties in the past two decades, according to data collected by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill.

Click here for more information and a interactive map that shows where health care shortages and broadband deserts intersect.

With workers paying an average of nearly $6,300 per year toward employer-sponsored family coverage and Every Kid Healthy Week kicking off on April 21, the personal-finance website WalletHub today released its report on 2025’s Best & Worst States for Children’s Health Care, as well as expert commentary.

In order to determine which states offer the most cost-effective and highest-quality health care for children, WalletHub compared the 50 states and the District of Columbia across 33 key metrics. The data set ranges from the share of children aged 0 to 17 in excellent or very good health to pediatricians and family doctors per capita.

Children’s Health Care in Pennsylvania (1=Best; 25=Avg.):

• Overall Rank: 4^th
• 8^th – % of Children in Excellent/Very Good Health
• 27^th – % of Uninsured Children
• 23^rd – Infant-Death Rate
• 11^th – % of Children with Unaffordable Medical Bills
• 3^rd – Pediatricians & Family Doctors per Capita
• 19^th – % of Obese Children
• 11^th – % of Children with Excellent/Very Good Teeth

For the full report, please visit: https://wallethub.com/edu/best-states-for-child-health/34455

Key takeaways and WalletHub commentary are included below in text and video format. Feel free to use the provided content as is or edit the raw files as you see fit.

Please let me know if you have any questions or if you would like to arrange a phone, video or in-studio interview with one of WalletHub’s experts.