Is the Nation’s Primary Care Shortage as Bad as Federal Data Suggest?

Posted on by lad3

Federal policymakers have been trying for a long time to lure more primary care providers to understaffed areas. The Biden administration boosted funding in 2022 to address shortages and Sen. Bernie Sanders (I-Vt.) pushed sweeping primary care legislation in 2023.

But when KFF Health News set out last year to map where the primary care workforce shortages really are — and where they aren’t — we encountered spotty data and a whole lot of people telling us the absence of better information makes it hard to know which policies are working. Turns out, consistent national data is a pipe dream.

We analyzed the public data that does exist: the federal government’s official list of primary care health professional “shortage areas,” created to help funnel providers where they’re most needed. We found that more than 180 areas have been stuck on the primary care shortage list for at least 40 years.

Read more.

CMS Finalizes DSH Payment Cuts for Some Safety-Net Hospitals: 8 Things to Know

Posted on by lad3

From Becker’s Healthcare

CMS will cut Medicaid disproportionate share hospital payments for some safety-net hospitals in fiscal year 2024, which began Oct. 1, 2023, according to a final rule published Feb. 20.

The rule will result in an $8 billion reduction in DSH payments annually from fiscal year 2024 to 2027, culminating in a $32 billion overall cut over the four-year period, according to CMS.

Eight things to know:

  1. Following a congressional directive from the Consolidated Appropriations Act of 2021, the final rule outlines how hospital-specific payment limits will be calculated and clears up ambiguities within the DSH program to improve administrative efficiency, according to Bloomberg.
  2. Hospitals previously calculated Medicaid shortfalls (the difference between costs and payments for Medicaid-eligible patients) by projecting yearly treatment costs for Medicaid patients alone as well as those with other types of coverage, including Medicare or commercial coverage.
  3. Under the new rule, hospitals can only include costs and payments for services provided to beneficiaries for whom Medicaid is the primary payer for such services. The limit excludes costs and payments for services provided to Medicaid beneficiaries with other sources of coverage.
  4. The final rule does not apply to safety-net hospitals serving the highest percentage of low-income patients. Hospitals in and above the 97th percentile of inpatient days comprising  patients who are entitled to Medicare Part A benefits and Supplemental Security Income benefits are exempt.
  5. The exception provides qualifying hospitals with a hospital-specific limit that is the higher of that calculated under the methodology in which costs and payments for Medicaid patients are counted only for beneficiaries for whom Medicaid is the primary payer, or the methodology in effect on Jan. 1, 2020.
  6. New York ($3.9 billion) spends the most on Medicaid DSH payments annually, followed by Texas, Pennsylvania and Louisiana, which pay $1.2 billion, according to data published in November by KFF.
  7. Hospital groups have pushed back against DSH cuts set out in the Affordable Care Act, arguing that the need for DSH funding is even greater now as hospital expenses per patient have increased significantly since the pandemic.
  8. The American Hospital Association said it is concerned about the effect that DSH cuts will have on hospital finances. “This policy was based in-part on the flawed notion that hospitals receive the entirety of a Medicare or Medicaid payment rate when in reality most state Medicaid programs pay less than that,” Ben Finder, AHA’s vice president of coverage policy, said in a statement provided to Becker’s. “That means that many hospitals are not compensated fully for care provided to patients dually eligible for Medicare and Medicaid and this policy would reduce their ability to offset those cuts and potentially create additional financial strain at a time when many hospitals are already struggling.”

These changes will take effect April 27, 60 days after the final rule’s publication in the federal register.

Click here for more details on the final rule.

Improving Access to Pulmonary Rehab Programs

Posted on by Alyssa Kane

Two new educational videos from the National Rural Health Resource Center highlight the prevalence of chronic obstructive pulmonary disease (COPD) in the country’s rural communities and the steps that Critical Access Hospitals and other small rural hospitals can take to improve access to much-needed pulmonary rehabilitation services.  The first video, Understanding COPD and Pulmonary Rehabilitation, provides an overview of COPD — its symptoms and causes — and explains how rural-based pulmonary rehabilitation services help to restore independence and quality of life in COPD patients. The second video, How to Launch a Pulmonary Rehab Program, highlights the benefits — to hospitals and their communities — of operating pulmonary rehab programs, and shares practical advice and tips.

Read the full article here.

CMS Changing Policy for Research Data Access – Comment by March 29

Posted on by Alyssa Kane

The Centers for Medicare & Medicaid Services (CMS) plans to change the way that data is made available to researchers and seeks feedback from stakeholders who may be affected.  Currently, CMS offers researchers two options for accessing CMS data: 1) have physical Research Identifiable File (RIF) data shipped to their institution, and 2) a secure online resource called the Chronic Conditions Warehouse Virtual Research Data Center (CCW VRDC).  Because of growing concerns about data security, CMS will no longer ship physical data for new research.  Beginning on August 19 of this year, researchers will be required to use the CCW VRDC. CMS will accept feedback on these plans via email at VRDCRFI@cms.hhs.gov until March 29.

Read the full article here.

Article Released Discussing Support for Vulnerable Rural Hospitals: Lessons Learned

Posted on by Alyssa Kane

An overview of state and federal programs and models designed to support Critical Access Hospitals (CAHs) and other rural hospitals describes challenges – including chronic workforce shortages, high operating and staffing costs, inadequate reimbursement, operational and regulatory issues, and the diverse demographics of rural communities. The information comes from the FORHP-supported Flex Monitoring Team, a consortium of researchers evaluating the effectiveness of the Medicare Rural Hospital Flexibility Program.

Read the full article here.

CareQuest Releases New Teledentistry Toolkit

Posted on by lad3

The CareQuest Institute for Oral Health has released Teledentistry Regulation and Policy Guidance: A Toolkit to Promote Access and Quality Care Through Teledentistry. This document identifies primary considerations for regulators and policymakers regarding teledentistry and includes key recommendations. Model teledentistry rules within the toolkit can form a basis for discussions on how to improve the regulatory climate for teledentistry moving forward.

In Pennsylvania, there is legislation pending in the Senate Banking and Insurance Committee (HB1585) that would direct our State Board of Dentistry to develop guidelines for Pennsylvania.

Policy Statement Released on Integrating Oral Health into Primary Care

Posted on by lad3

The ASTDD Dental Public Health policy committee is pleased to announce the availability of a new ASTDD policy statement, Integrating Oral Health into Primary Care. They extend their appreciation to Katrina Holt, MPH, MS, RD, FAND; Katy Battani, RDH, MS; and Ruth Barzel, MA, of the National Maternal and Child Oral Health Resource Center for their support and collaboration in the development of this document.

Click here to view the statement.

New Research Explores Influences of Online Information for Aspirin Use

Posted on by lad3

The Heterogeneous Influences of Online Health Information Seeking on Aspirin Use for Cardiovascular Disease Prevention

Authors: Jingrong Zhu, PhD; Yunfeng Shi, PhD; Yi Cui, PhD; Wei Yan, Ph.D., Penn State

Making decisions related to health and healthcare is an important part of life for most consumers. As sources of health information have expanded explosively, consumers’ information seeking and processing in the context of health decision making have also become increasingly complicated.

Previous research has shown that online health information seeking is associated with medication adherence. However, less is known about the factors that moderate such a relationship. This study examines four different sources of health information jointly and their interactive roles in consumers’ decisions on using aspirin for cardiovascular disease (CVD) prevention: the advice from health care providers, prior CVD diagnosis, CVD risk factors due to co-morbidities, and online health information.

Our results indicated that online health information seeking had heterogeneous influences on aspirin use for CVD prevention, depending on other factors such as provider advice, prior CVD diagnoses, and CVD risk factors, and potentially leading to both overuse and underuse.

Find more details about the article here.

No-Cost Program Offered – AHRQ Telemedicine Safety Program: Improving Antibiotic Use

Posted on by Alyssa Kane

The Agency for Healthcare Research and Quality (AHRQ) Safety Program for Telemedicine: Improving Antibiotic Use is a no-cost program that seeks to promote appropriate antibiotic use while maintaining patient satisfaction and reducing potential side effects in patients seen via telemedicine. They are currently recruiting primary and urgent care facilities, including community health centers, to participate in the program. This program, beginning in June 2024, consists of brief educational presentations about best practices to optimize antibiotic prescribing in the telemedicine environment. Participants will have access to technical assistance, coaching, webinars, and practical tools to implement improvements in their practice. The program is offering credit via the American Medical Association (AMA), American Nurses Credentialing Center (ANCC), American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC), American Association for Physician Assistants (AAPA), and Interprofessional Continuing Education (IPCE) to participants at no charge.

Webinars Being Offered on Population Health Management: A National Learning Series

Posted on by Alyssa Kane

More than a dozen HRSA-funded National Training and Technical Assistance Partners (NTTAPs) are collaborating on a webinar series throughout March. Each webinar will focus on strategies for developing, evaluating, and supporting effective healthcare delivery models. Coordinators will ensure that webinar materials are practical, enhancing skills directly related to the training recipients. Visit the Population Health Management Task Force’s website for session details and registration.