Home Health Services For Older Adults And Individuals With Disabilities

The Centers for Medicare & Medicaid Services (CMS) issued a final rule that furthers CMS’ strategic commitment to drive innovation that promotes comprehensive, person-centered care for older adults and individuals with disabilities by accelerating the shift from paying for home health services based on volume, to a system that incentivizes value and quality.

The rule can be obtained at https://www.federalregister.gov/public-inspection/2021-23993/medicare-and-medicaid-programs Home Health Services For Older Adults And Individuals With Disabilities -cy-2022-home-health-prospective-payment-system-rate-update-home.

White House Announces Build Back Better Framework

Today, the White House announced a framework for the Build Back Better Act which includes 1.85 trillion in investments and up to 1.995 trillion in offsets. According to the White House, the framework is “the biggest expansion of affordable health care coverage in a decade. The framework will reduce premiums for more than 9 million Americans by extending the expanded Premium Tax Credit, deliver health care coverage to up to 4 million uninsured people in states that have locked them out of Medicaid, and help older Americans access affordable hearing care by expanding Medicare.” Furthermore, “the framework will increase the maximum Pell Grant by $550 for more the more than 5 million students enrolled in public and private, non-profit colleges and expand access to DREAMers. It will also make historic investments in Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), and minority-serving institutions (MSIs) to build capacity, modernize research infrastructure, and provide financial aid to low-income students. And, it will invest in practices that help more students complete their degree or credential.”

More details may be accessed here: https://www.whitehouse.gov/briefing-room/statements-releases/2021/10/28/president-biden-announces-the-build-back-better-framework/.

House Committee Considers Seven Health Bills

On Tuesday, the Subcommittee on Health of the Committee on Energy and Congress held a hearing entitled, "Caring for America: Legislation to Support Patients, Caregivers, and Providers", in which they considered seven pieces of health care legislation:

H.R. 1474, the "Alzheimer's Caregiver Support Act"

H.R. 1667, the "Dr. Lorna Breen Health Care Provider Protection Act"

H.R. 3297, the "Public Health Workforce Loan Repayment Act of 2021"

H.R. 3320, the "Allied Health Workforce Diversity Act of 2021"

H.R. 5583, the "Helping Enable Access to Lifesaving Services Act" or the "HEALS Act"

H.R. 5594, the "Enhancing Community Health Workforce Act"

H.R. 5602, the "Bolstering Infectious Outbreaks Preparedness Workforce Act of 2021" or the "BIO Preparedness Workforce Act of 2021"

Subcommittee Chairwoman Anna G. Eshoo (D-CA) said she intends to move the bills through the subcommittee “as swiftly as possible.”

The hearing and related documents may be accessed here.

Basics Of Evidence

Emphasis on using evidence in federal policymaking and implementation is increasing, especially since the Foundations for Evidence-Based Policymaking Act of 2018 passed. It is important to find, build, share, and appropriately apply evidence. A new brief from the Urban Institute describes different types and sources of evidence, explore the purposes and potential uses of evidence, and discuss what makes good evidence in federal policy and practice.

The brief can be obtained at https://www.urban.org/sites/default/files/publication/104968/what-is-evidence-basics-of-evidence-brief-1.pdf.

Senate Appropriations Committee Releases Funding Bills

Today, the Senate Appropriations Committee released their remaining nine Fiscal Year 2022 appropriations bills, including the Labor, Health and Human Services, Education, and Related Agencies bill. The bill includes $98.4 billion in base discretionary funding for the Department of Education, an increase of $24.9 billion over the FY 2021 level and $4.4 billion less than the budget request. The bill increases the discretionary portion of the maximum Pell grant award by $400 and includes $1.1 billion for HBCUs and MSIs. The bill includes $117.6 billion in base discretionary funding for the Department of Health and Human Services, an increase of $20.9 billion over the FY 2021 level and $1.8 billion less than the budget request. The bill includes $9.2 billion for HRSA, an increase of $1.7 billion above fiscal year 2021 and $1 billion above the President’s budget request. The bill includes a 53% increase for the Behavioral Health Workforce Education & Training (BHWET) program, a 16% increase for Mental and Behavioral Health, and a 9% increase for geriatric programs compared to the FY 21 enacted levels.

A bill summary may be accessed here, along with the bill text and an explanatory statement. A HRSA Title VII and VIII Health Workforce Programs funding chart may be accessed here.

Medicare Advantage Vs. Traditional Medicare

Medicare Advantage and traditional Medicare are serving similar populations, with beneficiaries having comparable health care experiences. According to an issue brief from the Commonwealth Fund, the care management services provided by Medicare Advantage plans appear to neither impede access to care nor reduce concerns about costs. Overall, the analysis highlights substantial barriers to care that all beneficiaries seem to be experiencing. 

The issue brief can be obtained at https://www.commonwealthfund.org/publications/issue-briefs/2021/oct/medicare-advantage-vs-traditional-medicare-beneficiaries-differ.

Decline In Hospital And Health System Employment In September 2021

Employment at hospitals and health systems fell by more than 8,000 jobs in September 2021. Overall, employment in the United States increased by 194,000, according to preliminary data released by the Bureau of Labor Statistics. Health care jobs overall fell by 17,500 and remain under 16 million, seasonally adjusted. Although outpatient care centers, physicians, and dentists continued to add jobs, nursing and residential care facility employment fell by 37,600. Since the beginning of the start of the COVID-19 pandemic, jobs in hospitals and health systems have stayed below their peak in February 2020.  

Bureau of Labor Statistics data can be obtained at Table B-1. Employees on nonfarm payrolls by industry sector and selected industry detail (bls.gov).

COVID Snapshot

The American Hospital Association released the latest edition of the COVID-19 Snapshot, underscoring the persisting challenges facing hospitals and health systems during the ongoing public health emergency. The Snapshot combines important data points with news articles and testimonials from the field to illustrate the importance of providing hospitals and health systems with additional resources and support so that they can continue to deliver care to patients and families. 

The Snapshot can be obtained at https://www.aha.org/system/files/media/file/2021/10/snapshot-10-7-21.pdf.

Clinical Labor Costs Increase Amid The Pandemic

As the delta variant pushes COVID-19 caseloads to all-time highs, hospitals and health systems across the country are paying $24B more per year for qualified clinical labor than they did pre-pandemic, according to a new PINC AI analysis. The analysis found that clinical labor costs are up by an average of 8% per patient day when compared to a pre-pandemic baseline period in 2019. For the average 500 bed facility, it translates to $17M in additional annual labor expenses since the pandemic began. 

Additional information can be obtained at PINC AI Data Shows Hospitals Paying $24B More for Labor Amid COVID-19… | Premier (premierinc.com).

U.S. Department of Education Action on the Public Service Loan Forgiveness Program

Today, the U.S. Department Education announced several actions they are taking over the next year to make changes to the Public Service Loan Forgiveness (PSLF) program.

The U.S. Department of Education press release may be accessed here and their fact sheet may be accessed here. Reporting from Inside Higher Ed may be accessed here.

COVID Snapshot

The American Hospital Association released the latest edition of the COVID-19 Snapshot today, underscoring the persisting challenges facing hospitals and health systems during the ongoing public health emergency. The Snapshot combines important data points with news articles and testimonials from the field to illustrate the importance of providing hospitals and health systems with additional resources and support so that they can continue to deliver care to patients and families. 

The Snapshot can be obtained at https://www.aha.org/the-snapshot.

 

Portal For Additional COVID-19 Relief Funding Opens

The Health Resources and Services Administration (HRSA) opened the portal for health care providers to apply through October 26, 2021 for a portion of $25.5 billion in COVID-19 relief funds. Providers can submit a single application to request payments from both the $17 billion “Phase 4” Provider Relief Fund distribution and $8.5 billion in American Rescue Plan Act funds for rural providers. HRSA will host the first of four webinar sessions on September 30 at 3:00 P.M. ET about funding and how to navigate the application portal.  

More information about funding and how to participate in the webinar sessions can be obtained at https://www.hrsa.gov/provider-relief/future-payments.

Assessing America’s Hospitals’ Capacity To Provide Care During COVID-19

A Snapshot from the American Hospital Association provides a look at America’s hospitals’ capacity to provide care during COVID-19. America’s hospitals and health systems continue to face historic challenges, including unprecedented financial pressures.  

The Snapshot can be obtained at https://www.aha.org/the-snapshot.

mRNA Covid-19 Vaccine Effectiveness Among U.S. Health Care Personnel

According to an article published on September 23, 2021 in the New England Journal of Medicine, the BNT162b2 and mRNA-1273 vaccines were highly effective under real-world conditions in preventing symptomatic Covid-19 in health care personnel, including those at risk for severe Covid-19 and those in racial and ethnic groups that have been disproportionately affected by the pandemic.  

The article can be obtained at https://www.nejm.org/doi/full/10.1056/NEJMoa2106599?query=featured_coronavirus.

Exploring the Role of Health Professional Students and Trainees as Members of the Health Professions Workforce: Part 1

Join the planning committee from the National Academies Global Forum on Innovation in Health Professional Education through a series of workshops and events to explore the roles of health professions students and trainees in times of emergency. The first event will spark the discussion and inform future meetings.

Learn more and register here.

Call for Pilot Testers: IPEC Competency Framework

IPEC has partnered with the University of Texas Health Science Center at San Antonio (UT Health San Antonio) to develop an IPEC Institutional Assessment Instrument.

This instrument will leverage the IPEC competency framework to identify institutional characteristics tied to successful implementation of programmatic interprofessional education (IPE), including the capacity for students to engage meaningfully on teams in interprofessional clinical learning environments.

As a next step, IPEC is seeking individuals who serve as the designated IPE leader at their respective institution to provide responses as part of an initial validation process.

For the full open call, click here.  

If you are passionate about advancing IPE and would like to participate, please RSVP by 6:00 p.m. PDT on Friday, October 1, 2021.

HRSA Releases New Health Workforce Projections and Dashboard

HRSA’s National Center for Health Workforce Analysis (NCHWA) has released a new dashboard with new health workforce projections. For the first time, HRSA’s health workforce projections are now available on data.hrsa.gov as part of an interactive dashboard. The dashboard includes the just released Primary Care projections, as well as previously released health workforce projections for Allied Health, Behavioral Health, Long-Term Care, Oral Health, and Women’s Health. This interactive virtual dashboard displays U.S. healthcare workforce projections and shows the projection of the supply of, and demand for, healthcare workers across the United States.

HRSA will be hosting a webinar tomorrow, September 20 from 10-11am ET, to share more details about the dashboard. Zoom link is available here.

The interactive dashboard may be accessed here.