The U.S. Bureau of Labor Statistics' (BLS) most current occupational employment data put pharmacist employment at more than 315,000 as of May 2020. Just over 25,000 pharmacist jobs were in the seven-state Great Plains region at that time. BLS data reveals a good bit of disparity in the region for pharmacist pay. Minnesota and Missouri ranked 7th and 13th, respectively, for pharmacist annual mean wages. At the same time, however, about 45% of the region's pharmacists lived in a state where the pharmacist annual mean wage level was below the national average. Moreover, two Great Plains states, Nebraska and North Dakota, ranked among the five worst states in the nation for pharmacist annual mean wage levels. BLS data from May 2020 offers the following details about pharmacist pay in Great Plains region of the U.S.:
Pharmacist Pay in the Great Plains Region
State
# Employed
Annual Mean Wages
Wage Rank*
IA
2,880
$121,030
39th
KS
3,420
$122,470
28th
MN
6,730
$130,690
7th
MO
7,000
$127,430
13th
NE
2,580
$118,570
47th
ND
1,260
$103,440
51st
SD
1,200
$121,130
36th
U.S.
315,470
$125,460
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
More than 590 hospitals were evaluated for their effectiveness and proficiency in providing adult cardiac care in the most recent (21-22) U.S. News & World Report rankings of American hospitals. In this analysis, hospitals were graded on multiple metrics related to their adult cardiac care patient outcomes, the scope of their adult cardiac care programs and services, and the degree of professional recognition they've earned from the broader cardiac care community. Among the top 50 ranked U.S. hospitals for adult cardiac care in 21-22, eight were based in Far West states. No Far West hospital outside of California earned a top 50 ranking in the survey. Here's a summary look at these nine Far West institutions and where they ranked nationally for adult cardiac care in the 21-22 survey:
To further examine the metrics used to score adult cardiology and heart surgery hospitals in the 21-22 U.S. News survey, or to find the cardiac care rating of other Far West hospitals, visit Best Hospitals for Adult Cardiology Care and Heart Surgery
The U.S. Bureau of Labor Statistics (BLS) most recently published occupational employment data put licensed practical nurse (LPN) employment at more than 676,000 as of May 2020. Also known as license vocational nurses (LVNs) in some sections of the country, LPNs make up one of the largest healthcare occupations in the U.S. As of May 2020, nearly 108,000 LPNs were working in the Mid-East U.S., a region that includes the District of Columbia and five states. The region is one of the better regions of the country for licensed practical nurse pay, as no state in the Mid-East region recorded an LPN annual mean wage level that was below the national average. Moreover, the District of Columbia and two states ranked among the twelve best states in the nation for LPN annual mean wages. Further examination of May 2020 BLS data reveals the following details about licensed practical nurse pay in the Mid-East U.S.:
Licensed Practical Nurse Pay in the Mid-East U.S.
State
# Employed
Annual Mean Wages
Wage Rank*
DC
1,390
$57,810
8th
DE
2,290
$53,920
17th
MD
8,940
$56,220
12th
NJ
15,590
$57,590
9th
NY
44,440
$51,300
19th
PA
35,240
$50,250
22nd
U.S.
676,440
$50,090
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
The most recently released U.S. Bureau of Labor Statistics (BLS) occupational employment data indicated that there were just over 126,600 occupational therapists (OTs) employed in the U.S. as of May 2020. About 9,300 of those employed as occupational therapists lived in the six-state New England region of the country. BLS data reveals New England to be a region of wide disparity in terms of OT pay, with two states ranked among the top ten in the nation for OT annual mean wage levels, while two other states ranked among the ten worst in the nation for the same pay metric. However, on the whole, the region was a subpar one for OT pay as about two-thirds of the region's occupational therapists lived in a state where the OT annual mean wage was below the national average. A closer review of May 2020 BLS data reveals the following details about occupational therapist pay in New England:
Occupational Therapist Pay in New England
State
# Employed
Annual Mean Wages
Wage Rank*
CT
2,470
$92,000
9th
MA
4,350
$85,150
27th
ME
810
$72,500
51st
NH
1,000
$80,720
39th
RI
520
$93,330
8th
VT
190
$75,330
48th
U.S.
126,610
$87,480
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
In the 21-22 U.S. News & World Report study of American hospitals, more than 900 hospitals were examined for their capabilities at providing adult cancer care. In this study, hospitals were assessed on assorted metrics related to cancer care patient outcomes, the scope and breadth of their adult cancer care programs and services, and the level of recognition a hospital has received from the wider cancer care community. Four Great Plains region hospitals made the list of the top 50 rated U.S. hospitals for adult cancer care in the 21-22 survey, including the Mayo Clinic, which ranked among the five highest rated adult cancer care hospitals in the country. Here's a summary look of these four Great Plains medical facilities and how they ranked nationally for adult cancer care:
For a closer look at the measures used to score adult cancer care hospitals in the 21-22 U.S. News survey, or to find cancer care ratings for other Great Plains region hospitals, visit Best Hospitals for Adult Cancer Care.
The U.S. Bureau of Labor Statistics' (BLS) most current occupational employment data put physician assistant (PA) employment at just over 125,000 nationally as of May 2020. Nearly 5,900 of those physician assistant jobs were in the five-state Rocky Mountain region. BLS data painted a generally weak picture for physician assistant pay levels in the region. Although three states in the region registered PA annual mean wage levels above the national average, more than 70% of the region's physician assistants lived in the two states where annual mean wages fell short of that average. A closer examination of BLS data from May 2020 reveals the following details about physician assistant pay in the Rocky Mountain region:
Physician Assistant Pay in the Rocky Mountain Region
State
# Employed
Annual Mean Wages
Wage Rank*
CO
3,080
$110,370
33rd
ID
790
$117,960
16th
MT
650
$117,100
21st
UT
1,100
$108,620
38th
WY
250
$117,660
19th
U.S.
125,280
$116,080
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
According to the most current occupational employment data released by the U.S. Bureau of Labor Statistics (BLS), there were over 34,700 chiropractors working in the United States as of May 2020. As of that time, the twelve-state Southeast region of the country was home to over 8,100 employed chiropractors. For chiropractors, pay levels in the region varied widely from state-to-state. Five states in the region ranked among the top 15 states in the nation for chiropractor annual mean wage levels, yet at the same time four Southeastern states ranked among the 15 worst states nationally for the same pay metric. That dichotomy notwithstanding, about 69% of the region's chiropractors lived in a state where the chiropractor annual mean wage level was above the national average. A closer examination of May 2020 BLS data reveals the following details about chiropractor pay in the Southeast U.S.:
In the 21-22 U.S. News & World Report survey of American hospitals, nearly 600 hospitals were rated for their effectiveness and proficiency at delivering cardiac care to adult patients. Hospitals in the survey were rated on various measures related to their patient outcomes, the scope of their cardiac care services and programs, and the amount of professional recognition earned by these hospitals from their peers within the cardiology care community. Among the top 50 rated U.S. hospitals for adult cardiac care in 21-22 survey, six are based in the Southwest. Here's a quick view of these six Southwestern institutions and where they ranked nationally for adult cardiac care:
For a deeper look at the metrics used to score adult cardiac care and heart surgery hospitals in the 21-22 U.S. News survey, or to find cardiac care ratings for other Southwestern hospitals, visit Best Hospitals for Adult Cardiology and Heart Surgery
The most current occupational employment data from the U.S. Bureau of Labor Statistics (BLS) put the number of health service management jobs in the U.S. at over 402,500 as of May 2020. In May 2020, just over 50,700 were employed as health services managers in the four-state Southwestern U.S. BLS data shows the region to be, on the whole, a subpar one for health services management pay. Arizona and New Mexico both had health services manager annual mean wage levels that beat the national average. However, 80% of the region's health service management jobs were in Oklahoma and Texas. In Texas, the annual mean wage for health services managers was 6.7% below the national average, while in Oklahoma it was 19.9% below. From May 2020 BLS data, health services management pay in the Southwestern U.S. looked as follows:
Health Services Management Pay in the Southwestern U.S.
State
# Employed
Annual Mean Wages
Wage Rank*
AZ
8,240
$123,540
17th
NM
1,680
$128,250
12th
OK
6,430
$95,180
47th
TX
34,380
$110,870
28th
U.S.
402,540
$118,800
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
Occupational employment data published most recently by the U.S. Bureau of Labor Statistics (BLS) revealed that over 107,000 surgical technologists were working in the United States as of May 2020. With just over 14,400 surgical technologists employed, the six-state Far Western U.S. accounted for about 13.4% of surgical technologist employment nationally. BLS data reveals the Far Western U.S. to be the premier region in the country for surgical technologist pay. Not only did all states in the region have a surgical technologist annual mean wage level that topped the national average, but five Far West states ranked among the ten best states in the nation for surgical technologist annual mean wages. From May 2020 BLS data, here is a state-level look at surgical technologist pay in the Far Western U.S.:
Surgical Technologist Pay in the Far Western U.S.
State
# Employed
Annual Mean Wages
Wage Rank*
AK
230
$67,120
1st
CA
9,140
$64,570
3rd
HI
300
$56,080
14th
NV
1,100
$67,000
2nd
OR
1,330
$59,480
8th
WA
2,330
$60,450
7th
U.S.
107,400
$51,510
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
In the 21-22 U.S. News & World Report ratings of American hospitals, over 900 hospitals were examined for their proficiency and effectiveness at delivering cancer care to adult patients. The study rated hospitals on various measures related to their cancer patient outcomes, the scale of their cancer care services and programs, and the level of professional recognition a hospital earned from their peers within the cancer care community. Three New England hospitals rated among the top 50 U.S. hospitals for adult cancer care in the 21-22 survey. Here's a quick view of these three New England institutions and where they rated nationally for adult cancer care in the 21-22 U.S. News survey:
To further examine the metrics used to grade adult cancer care hospitals in the 21-22 U.S. News survey, or to find cancer care ratings for other New England hospitals, visit Best Hospitals for Adult Cancer Care
Demand for Service Dogs Unleashes a ‘Wild West’ Market
Markian Hawryluk
Jenni Mahnaz admits she’s not much of a dog person. She’s mildly allergic and the only pet she had as a child was a hermit crab. But once she learned that specially trained dogs could help her daughters with their medical needs, she was willing to do anything to make it happen.
Her oldest daughter, Suraiya, 6, was diagnosed with autism and sensory processing challenges. Soon after, 4-year-old Phoenix was diagnosed with epilepsy.
“Our family is very likely to end up with two service dogs,” Mahnaz said. “I think we’re probably looking at $10,000 per dog.”
That’s a serious hurdle for the Troy, New York, family of five whose income is below the federal poverty line, even though they’ll save money by buying pups from a breeder and then paying a local trainer to train them as service dogs.
Organizations charge from $15,000 to $40,000 for a fully trained service dog, which they have bred, raised, and trained for a year and a half. None of that cost is covered by health insurance. Other trainers have long waiting lists or won’t place dogs with young children.
“This is very expensive for us, but I am my girls’ parent, and it is my job to do whatever I can to make their standard of living as good as I can,” Mahnaz said. “It is a need for them and it will make a big difference in their lives.”
Demand for service dogs has exploded in recent years as dogs have proved adept at helping children and adults with an increasing range of disabilities. While dogs once served primarily people with vision or mobility impairments, they now help people with autism, diabetes, seizures, and psychiatric disorders. That has overwhelmed nonprofit service dog trainers, who generally donate dogs to patients for at most a small application fee. But unmet needs have helped launch a for-profit service dog industry with hefty price tags.
Rapid growth, however, has come with little oversight, potentially subjecting people who have complex medical issues to huge financial barriers, poorly trained dogs, and outright fraud. Those pitfalls are only exacerbated by social media, including fundraising sites like GoFundMe that allow families to meet pricing thresholds they wouldn’t be able to afford on their own. The flourishing market emboldens trainers to charge more for their services, confident that the funds will be donated.
Some, like the Mahnaz family, gamble by training their own dogs to lower the cost. But trainers say that the success rate for self-trained dogs is lower than their own — and that families could be out thousands of dollars.
“The dog could absolutely fail. We could end up with an adult dog who cannot be a service animal,” Mahnaz said. “The reality is we don’t have a choice.”
The lack of regulations for service dog trainers has opened the door for scores of backyard trainers who may or may not be qualified to train service dogs, said Lynette Hart, a professor of veterinary medicine at the University of California-Davis. There is no certification process for service dogs, either.
“There’s a big opportunity for people who are dog trainers to say, ‘Oh, I will sell you one for tens of thousands of dollars,” she said. “It’s a kind of a wild West issue.”
But that also leaves families open to getting burned with little recourse.
“Sometimes they’re sold a bill of goods,” said Sheila O’Brien, chairperson of the North American board of Assistance Dogs International. The group accredits service dog trainers, but the accreditation is voluntary and only nonprofit organizations are eligible. The group has 80 accredited members and 25 candidate programs in North America. But nobody knows how many unaccredited dog trainers are operating in the U.S.
“It’s so easy to defraud people over the internet. There’s a lot of money to be made here,” said David Favre, a Michigan State University law professor specializing in animal law. “It’s never been controlled, and it’s gotten worse.”
In 2018, for example, Virginia’s attorney general filed a lawsuit alleging a company named Service Dogs by Warren Retrievers charged families up to $27,000 per dog but often delivered “poorly-trained puppies with significant behavioral issues and inadequate skills or training.” The trainer settled the lawsuit last year for $3 million.
In 2020, North Carolina’s attorney general filed a similar suit against the owner of Ry-Con, a nonprofit service dog trainer. The suit alleged that Ry-Con charged families up to $16,710 per dog despite knowing the dogs were not adequately trained.
Both training companies are now out of business and the former owners could not be reached for comment.
O’Brien estimates the average training cost in the U.S. is $30,000 per dog. But trainers must also account for the costs of the 60% of dogs who won’t make it through the training.
Sometimes dogs wash out because of health or temperament issues. “Some are just lovers and not workers,” O’Brien said.
Jennifer Arnold, founder of Canine Assistants, a Milton, Georgia, nonprofit training organization, said much work remains after a dog graduates, but many for-profit trainers end their involvement when they sell the dog. Many people need help troubleshooting issues such as housebreaking or leash-walking difficulties.
“Clients can get dogs that aren’t prepared, and sometimes, when dogs are prepared, they end up with families who don’t follow through,” Arnold said. “It’s difficult on both sides, but families get taken advantage of a lot more than the other way around.”
Canine Assistants has the ability to train and place a maximum of 100 dogs per year but receives about 1,400 applications.
“The need is overwhelming,” Arnold said. “It made the industry perfect for folks who want to make a little money.”
In most cases, that money isn’t coming directly out of patients’ pockets.
Kelly Camm, development director with the Xenia, Ohio-based nonprofit 4 Paws for Ability, said only about 5% of families can write the $17,000 check required for a service dog. The rest rely on their community, family, friends, or sometimes complete strangers for donations.
Medical Mutts Service Dogs in Indianapolis trains about 30 service dogs a year, about a third of which are dogs that board with them for training.
“There is no guarantee for any of those dogs to go through,” said Eva Rudisile, Medical Mutts’ director of client services. “As you start training and you take them out in public places, you start practicing certain behaviors, it’s quite stressful. And some dogs, they just can’t handle that.”
Medical Mutts charges $15,000 to $17,000 for a program dog depending on what type of disability is involved. It’s $11,000 to board and train a dog. If that dog washes out, the family is out that money. Families that opt for a program dog, on the other hand, are guaranteed to get a dog that completes the training.
“That’s the biggest plus for a program dog,” Rudisile said. “They don’t have the risk of, ‘OK, I got a dog and now I’m stuck with it and it’s not working.’”
For the Mahnaz family, that’s a gamble worth taking. A friend has set up a GoFundMe page to raise the initial $4,000 to get their first dog, a goldendoodle, from a breeder. They’ll start with basic obedience training and, when the dog is old enough, begin its service dog training.
An autism service dog, they hope, will help Suraiya deal with uncomfortable social situations and settle her down when she is on the verge of a meltdown. Eventually, they’ll get a second dog trained to alert them when Phoenix experiences a seizure.
Suraiya, who cannot write yet, has nonetheless created a list of potential dog names that only she can read: Blueberry, Alex, Stardust, Jelly-Jam. Phoenix has settled on Pancake.
The most current occupational employment data available from the U.S. Bureau of Labor Statistics (BLS) put May 2020 employment numbers for massage therapists (MTs) at more than 85,000. Nearly 10,900 massage therapist jobs were in the five-state Great Lakes region. A review of BLS data reveals the region to be a relatively good one for massage therapist pay, with about 88% of the region's MTs living in four Great Lakes states that recorded massage therapist annual mean wage levels above the national average. A closer look at BLS data from May 2020 reveals the following details about massage therapist pay in Great Lakes region:
Massage Therapist Pay in the Great Lakes Region
State
# Employed
Annual Mean Wages
Wage Rank*
IL
3,870
$50,690
13th
IN
1,260
$45,610
27th
MI
1,950
$50,500
14th
OH
2,240
$49,590
16th
WI
1,540
$47,490
19th
U.S.
85,040
$47,350
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
The U.S. Bureau of Labor Statistics' (BLS) most current occupational employment data indicated that nearly 148,500 speech language pathologists (SLPs) were working in the United States as of May 2020. More than 10,100 of those employed in the U.S. as SLPs resided in the seven-state Great Plains region. BLS data indicated that the region is one of the weakest in the country for speech language pathologist pay, as no state in the region registered a SLP annual mean wage level above the national average. Moreover, three Great Plains states ranked among the ten worst states in the country for SLP annual mean wages. More examination of BLS data from May 2020 reveals the following details about speech language pathologist pay in the Great Plains region:
Speech Language Pathologist Pay in the Great Plains Region
State
# Employed
Annual Mean Wages
Wage Rank*
IA
1,230
$75,950
32nd
KS
1,500
$75,880
33rd
MN
2,890
$75,680
34th
MO
2,660
$81,390
19th
NE
970
$71,940
44th
ND
560
$67,790
47th
SD
360
$59,270
51st
U.S.
148,450
$83,240
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead
Rachana Pradhan
The Biden administration and state officials are bracing for a great unwinding: millions of people losing their Medicaid benefits when the pandemic health emergency ends. Some might sign up for different insurance. Many others are bound to get lost in the transition.
State Medicaid agencies for months have been preparing for the end of a federal mandate that anyone enrolled in Medicaid cannot lose coverage during the pandemic.
Before the public health crisis, states regularly reviewed whether people still qualified for the safety-net program, based on their income or perhaps their age or disability status. While those routines have been suspended for the past two years, enrollment climbed to record highs. As of July, 76.7 million people, or nearly 1 in 4 Americans, were enrolled, according to the Centers for Medicare & Medicaid Services.
When the public health emergency ends, state Medicaid officials face a huge job of reevaluating each person’s eligibility and connecting with people whose jobs, income, and housing might have been upended in the pandemic. People could lose their coverage if they earn too much or don’t provide the information their state needs to verify their income or residency.
Medicaid provides coverage to a vast population, including seniors, the disabled, pregnant women, children, and adults who are not disabled. However, income limits vary by state and eligibility group. For example, in 2021 a single adult without children in Virginia, a state that expanded Medicaid under the Affordable Care Act, had to earn less than $1,482 a month to qualify. In Texas, which has not expanded its program, adults without children don’t qualify for Medicaid.
State Medicaid agencies often send renewal documents by mail, and in the best of times letters go unreturned or end up at the wrong address. As this tsunami of work approaches, many state and local offices are short-staffed.
The Biden administration is giving states a year to go through the process, but officials say financial pressures will push them to go faster. Congress gave states billions of dollars to support the coverage requirement. But the money will dry up soon after the end of the public emergency — and much faster than officials can review the eligibility of millions of people, state Medicaid officials say.
In Colorado, officials expect they’ll need to review the eligibility of more than 500,000 people, with 30% of them at risk of losing benefits because they haven’t responded to requests for information and 40% not qualifying based on income.
In Medicaid, “typically, there’s always been some amount of folks who lose coverage for administrative reasons for some period of time,” said Daniel Tsai, director of the CMS Center for Medicaid and CHIP Services. “We want to do everything possible to minimize that.”
In January the eligibility of roughly 120,000 people in Utah, including 60,000 children, was in question, according to Jeff Nelson, who oversees eligibility at the Utah Department of Health. He said that 80% to 90% of those people were at risk because of incomplete renewals. “More often than not, it’s those that just simply have not returned information to us,” he said. “Whether they didn’t receive a renewal or they’ve moved, we don’t know what those reasons are.”
Arizona Medicaid director Jami Snyder said 500,000 people are at risk of losing Medicaid for the same reasons. She said that processing all the eligibility redeterminations takes at least nine months and that the end of the federal funding bump will add pressure to move faster. However, she said, “we’re not going to compromise people’s access to care for that reason.”
Still, officials and groups who work with people living in poverty worry that many low-income adults and children — typically at higher risk for health problems — will fall through the cracks and become uninsured.
Most might qualify for insurance through government programs, the ACA insurance marketplaces, or their employers — but the transition into other coverage isn’t automatic.
“Even short-term disruptions can really upend a family,” said Jessie Mandle, deputy director of Voices for Utah Children, an advocacy group.
‘More Marginalized People’
Low-income people could still be in crisis when the public health emergency ends, said Stephanie Burdick, a Medicaid enrollee in Utah who advocates on behalf of patients with traumatic brain injuries.
In general, being uninsured can limit access to medical care. Covid vaccination rates among Medicaid enrollees are lower than those of the general population in multiplestates. That puts them at higher risk for severe disease if they get infected and for exorbitant medical bills if they lose their insurance.
“They’re more marginalized people,” Burdick said. She said she worries “that they’re going to fall off and that they’re going to be more excluded from the health care system in general and just be less likely to get care.”
Burdick knows this firsthand as someone who experienced traumatic brain injury. Before covid-19, she would periodically lose her Medicaid benefits because of byzantine rules requiring her to requalify every month. The gaps in coverage kept her from seeing certain specialists and obtaining necessary medicines. “I really do remember being at the pharmacy not being able to afford my medication and just sobbing because I didn’t know what to do about it,” she said. “It was horrible.”
The covid Medicaid continuous coverage requirement was enacted under the Families First Coronavirus Response Act, which gave states an increase of 6.2 percentage points in federal funds if they agreed to maintain eligibility levels in place at the time.
The boost meant tens of billions of additional dollars would flow to states, estimates from KFF show. The U.S. Department of Health and Human Services can extend the public health emergency in 90-day increments; it is currently set to end April 16.
Groups that advocate for the needs of low-income Americans say the renewal tidal wave will require outreach rivaling that of almost a decade ago, when the ACA expanded Medicaid and created new private insurance options for millions of people.
Independent research published in September by the Urban Institute, a left-leaning think tank based in Washington, D.C., estimated that 15 million people younger than 65 could lose their Medicaid benefits once the public health emergency ends. Nearly all of them would be eligible for other insurance options, including heavily subsidized plans on the ACA marketplaces.
Tsai said the 15 million estimate provides a “helpful grounding point to motivate everybody” but declined to say whether the Biden administration has its own estimates of how many people could lose benefits. “I don’t think anyone knows exactly what will happen,” he said.
Tsai and state officials said they have worked hand in hand for months to prevent unnecessary coverage loss. They’ve tried to ensure enrollees’ contact information is up to date, monitored rates of unreturned mail, worked with insurers covering Medicaid enrollees, and conducted “shadow checks” to get a sense of who doesn’t qualify, even if they can’t disenroll people.
Some enrollees could be renewed automatically if states verify they qualify by using data from other sources, such as the Internal Revenue Service and the Supplemental Nutrition Assistance Program.
For others, though, the first step entails finding those at risk of losing their coverage so they can enroll in other health benefits.
“It’s a big question mark how many of those would actually be enrolled,” said Matthew Buettgens, a senior fellow in Urban’s Health Policy Center and author of the September report. One factor is cost; ACA or job-based insurance could bring higher out-of-pocket expenses for the former Medicaid enrollees.
“I am particularly worried about non-English speakers,” said Sara Cariano, a policy specialist with the Virginia Poverty Law Center. “Those vulnerable populations I think are at even higher risk of falling out improperly.” The law center is planning enrollment events once the unwinding begins, said Deepak Madala, its director of the Center for Healthy Communities and Enroll Virginia.
Missouri, already sluggish in enrolling eligible people into the state’s newly expanded Medicaid program, had 72,697 pending Medicaid applications as of Jan. 28. Enrollment groups worry the state won’t be able to efficiently handle renewals for nearly all its enrollees when the time comes.
By December, the Medicaid rolls in the state had swelled to almost 1.2 million people, the highest level since at least 2004. The state — one of several with histories of removing from the program people who were still eligible — did not say how many people could lose their benefits.
“I want to make sure that everybody that is entitled to and is eligible for MO HealthNet is getting the coverage that they need — all the way from babies to older individuals to individuals on disability,” said Iva Eggert-Shepherd of the Missouri Primary Care Association, which represents community health centers.
‘No End in Sight’
Some people argue the current protections have been in place long enough.
“There’s no end in sight. For two years, it’s still a quote-unquote ‘emergency,’” said Stewart Whitson, a senior fellow with the Foundation for Government Accountability. The conservative think tank has argued that states can legally begin trimming people from Medicaid rolls without jeopardizing their funding.
“This is the kind of problem that just grows worse every day,” he said of not removing ineligible people. “At the beginning of the pandemic, people were in a different position than they are now. And so responsible legislators and government officials in each state have to look at the facts as they are now.”
Tsai said “it’s quite clear to us” that for states to be eligible for the covid relief bill’s enhanced Medicaid funding, they must keep people enrolled through the emergency. “Those two things are interlinked,” he said.
Meanwhile, states still have no idea when the renewal process will begin. HHS has said that it would give states 60 days’ notice before ending the emergency period. The additional Medicaid funds would last until the end of the quarter when the emergency expires — if it ended in April, for example, the money would last until June 30.
“It’s hard to do a communication plan when you say, ‘You’ve got 60 days, here you go,’” Nelson of Utah’s Department of Health said.
Colorado officials had debated sending letters to enrollees when the public health emergency was nearing its scheduled end on Jan. 16 but held off, expecting that it would be extended. HHS announced a 90-day extension only two days before it was set to expire.
“Those kinds of things are really confusing to members,” Medicaid Director Tracy Johnson said. “OK, your coverage is going to end. Oh, just kidding. No, it’s not.”
KHN senior Colorado correspondent Markian Hawryluk and Midwest correspondent Bram Sable-Smith contributed to this report.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
In the most recent (21-22) U.S. News & World Report survey of American hospitals, 592 hospitals were evaluated for their proficiency in providing adult cardiology care to patients. This analysis scored hospitals on various metrics related to their cardiac patient outcomes, the scope of their cardiology programs and services, and the level of recognition earned by these hospitals within the cardiology care community. In the 21-22 rankings, four Southeastern hospitals, three fewer than in the prior year survey, rated among the 50 best U.S. hospitals for adult cardiology care. Here's a quick look at these four Southeastern institutions and where they ranked nationally for adult cardiology care and heart surgery in the 21-22 survey:
For a closer examination of the scoring metrics for adult cardiology and heart surgery hospitals in the 21-22 U.S. News survey, or to find the cardiac care rating of other Southeastern hospitals, visit Best Hospitals for Adult Cardiology Care and Heart Surgery
The most recent occupational employment data released by the U.S. Bureau of Labor Statistics (BLS) reported that over 20,000 recreational therapists were employed in the United States as of May 2020. Just under 3,500 of those recreational therapist jobs were in the five-state U.S. Mid-East region, which encompasses the District of Columbia and five states. Relative to the rest of the country, BLS data shows the region to be one of much disparity for recreational therapist pay. The District of Columbia and two states, which collectively hold about 55% of the region's recreational therapist jobs, all ranked among the top ten states in the country for recreational therapist annual mean wage levels. However, the remaining 45% of region's employed recreational therapists lived in states where the annual mean wage level for recreational therapists was below the national average. A closer examination of May 2020 BLS data details the following about recreational therapist pay in the U.S. Mid-East region:
Recreational Therapist Pay in the U.S. Mid-East
State
# Employed
Annual Mean Wages
Wage Rank*
DC
70
$78,630
1st
DE
110
$48,160
28th
MD
460
$46,610
33rd
NJ
400
$61,090
4th
NY
1,430
$58,010
6th
PA
990
$48,350
26th
U.S.
20,080
$51,260
-------
(*) annual mean wage ranking among the 50 states and the District of Columbia
