The U.S. Preventive Services Task Force released a final recommendation statement on interventions for high body mass index in children and adolescents. The Task Force recommends that healthcare professionals provide or refer children and teens to behavioral interventions to help them manage their weight and stay healthy. To view the recommendation, the evidence on which it is based, and a summary for clinicians, please go here.

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify healthcare providers, public health authorities and the public of an increased risk of dengue virus (DENV) infections in the United States in 2024. In the setting of increased global and domestic incidence of dengue, healthcare providers should take steps including:

·     Maintain a high suspicion for dengue among patients with fever and recent travel (within 14 days before illness onset) to areas with frequent or continuous dengue transmission.

·     Consider locally acquired dengue among patients who have signs and symptoms highly compatible with dengue in areas with competent mosquito vectors.

·     Order appropriate FDA-approved dengue tests and do not delay treatment waiting for test results to confirm dengue.

·     Know the warning signs for progression to severe dengue.

·     Recognize the critical phase of dengue. The critical phase begins when fever starts to decline and lasts for 24–48 hours. During this phase, some patients require close monitoring and may deteriorate within hours without appropriate intravenous (IV) fluid management.

·     Hospitalize patients with severe dengue or any warning sign of progression to severe dengue and follow CDC/WHO protocols for IV fluid management. 

From Becker’s Financial Management

Since January 2005, 192 rural hospitals have closed or converted, according to data compiled by the University of North Carolina’s Cecil G. Sheps Center for Health Services Research.

Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. Find the list here.

Here are the states along with their number of rural hospital closures or conversions since 2005:

Alabama

• Closure: 5
• Conversion: 2

Alaska

• Closure: 1

Arkansas

• Closure: 2

Arizona

• Closure: 2
• Conversion: 2

California

• Closure: 3
• Conversion: 6

Florida

• Closure: 4
• Conversion: 4

Georgia

• Closure: 2
• Conversion: 7

Illinois

• Closure: 1
• Conversion: 3

Indiana

• Closure: 2
• Conversion: 2

Iowa

• Closure: 1

Kansas

• Closure: 5
• Conversion: 5

Kentucky

• Closure: 4

Louisiana

• Closure: 2

Maine

• Closure: 2
• Conversion: 1

Maryland

• Closure: 1

Michigan

• Closure: 2
• Conversion: 2

Minnesota

• Closure: 3
• Conversion: 3

Mississippi

• Closure: 3
• Conversion: 3

Missouri

• Closure: 9
• Conversion: 1

Nebraska

• Closure: 2

Nevada

• Closure: 1
• Conversion: 1

New Jersey

• Closure: 1

New Mexico

• Closure: 1

New York

• Closure: 3
• Conversion: 2

North Carolina

• Closure: 6
• Conversion: 6

North Dakota

• Conversion: 1

Ohio

• Closure: 1
• Conversion: 2

Oklahoma

• Closure: 5
• Conversion: 3

Pennsylvania

• Closure: 3
• Conversion: 3

South Carolina

• Conversion: 4

South Dakota

• Closure: 2
• Conversion: 1

Tennessee

• Closure: 7
• Conversion: 8

Texas

• Closure: 14
• Conversion: 11

Virginia

• Closure: 1
• Conversion: 1

Washington

• Conversion: 1

West Virginia

• Closure: 3
• Conversion: 2

Wisconsin

• Closure: 1

 

As part of its mandate from Congress, the Medicare Payment Advisory Commission (MedPAC) reports each June on improvements to Medicare payment systems and issues affecting the Medicare program, including changes to health care delivery and the market for health care services. This year’s report addresses approaches for updating clinician payments and incentivizing participation in alternative payment models, rural considerations for network adequacy standards and prior authorization in Medicare Advantage, assessing health care utilization data sources for Medicare Advantage enrollees, paying for software technologies in Medicare, and Medicare’s Acute Hospital Care at Home program.

New data we released today (June 26, 2024) show that income, labor force participation and employment, educational attainment, and more continue to improve in Appalachia, while rates of poverty decline.

These new data come as part of our 14th annual update of The Appalachian Region: A Data Overview from the 2018-2022 American Community Survey, also known as “The Chartbook.”

For the third year in a row, more than half of small businesses in Pennsylvania, New Jersey, and Delaware said their financial conditions were poor or fair. Their top operational challenges? Hiring or keeping qualified staff. Reaching customers or growing sales. Supply chain issues.

Distilling data from the Fed’s national 2024 Report on Employer Firms: Findings from the 2023 Small Business Credit Survey, these briefs offer a view into business conditions in Pennsylvania, New Jersey, the Philadelphia metro, and the Third District states overall (Delaware, New Jersey, and Pennsylvania).

Additional findings from the survey for Delaware, New Jersey, and Pennsylvania:

• More firms said they experienced no change in their revenues between 2022 and 2023 than did between 2021 and 2022.
• Fewer firms carried debt, although about the same number of firms applied for loans, lines of credit, or merchant cash advances compared with the previous year.

Read the briefs.

In March 2021, Jellico, TN, a town of about 2,000 residents in the hills of east Tennessee, lost its hospital, a 54-bed acute care facility. Campbell County, where Jellico is located, ranks 90th of Tennessee’s 95 counties in health outcomes and has a poverty rate almost double the national average, so losing its health care cornerstone sent ripple effects through the region.

“Oh, my word,” said Tawnya Brock, a health care quality manager and a Jellico resident. “That hospital was not only the health care lifeline to this community. Economically and socially, it was the center of the community.”

Since 2010, 149 rural hospitals in the United States have either closed or stopped providing in-patient care, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. Tennessee has recorded the second-most closures of any state, with 15, and the most closures per capita. Texas has the highest number of rural hospital closures, with 25.

Each time a hospital closes there are health care and economic ripples across a community. When Jellico Medical Center closed, some 300 jobs went with it. Restaurants and other small businesses in Jellico also have gone under, said Brock, who is a member of the Rural Health Association of Tennessee’s legislative committee. And the town must contend with the empty husk of a hospital.

Dozens of small communities are grappling with what to do with hospitals that have closed. Sheps Center researchers have found that while a closure negatively affects the local economy, those effects can be softened if the building is converted to another type of health care facility.

Read more.

Among the key findings in this brief from the University of Minnesota Rural Health Research Center:

• Rural hospitals experienced an increasing number of ransomware attacks from 2016 to 2021.
• From 2016 to 2021, 43 rural hospitals across 22 states experienced a ransomware attack.
• Ransomware attacks afflicted all types of rural hospitals, including Critical Access Hospitals (N=9), Sole Community Hospitals (N=13), Rural Referral Centers (N=3), and hospitals paid under Medicare’s Inpatient Prospective Payment System (N=18).
• Eighty-four percent of ransomware attacks on rural hospitals resulted in operational disruptions. Common disruptions included electronic system downtime (81%), delays or cancellations in scheduled care (42%), and ambulance diversion (33%). Operational disruptions were similar in rural and urban hospital settings.

A recent study from the Pennsylvania Department of Health (DOH) has found that Black people who died from opioid overdoses were half as likely as white people to receive the life-saving drug naloxone, otherwise known as Narcan. The study also found that Black overdose deaths in Pennsylvania increased by more than 50% between 2019 and 2021, compared with no change in white overdose deaths. A DOH representative said that similar rises in overdose deaths are being seen across the country, especially among Black, American Indian and Alaska Native populations, but researchers are still investigating what’s behind the spike. Read more.

This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.

This study summary provides a quick overview of the study published by the Journal of Rural Health.

View the Study Summary here.