Medicare offers pilot program that covers GLP-1 weight loss drugs

A recent Medicare change offers older Americans with obesity concerns a chance at affordable and possibly life-changing weight-loss drugs. The shift is particularly good news for rural Americans, who tend to be older and have higher obesity rates than their urban counterparts.

Beginning in July, Medicare beneficiaries "may be able to get a GLP-1 prescription for weight loss for $50 a month," reports Jackie Fortiér of KFF Health News. "It’s a notable shift for Medicare, which has long been barred from covering weight loss treatments."

Although weight-loss drugs, such as Zepbound and Wegovy, offer chronically overweight patients a way to lose weight that may cause other health issues, their prices have often put them out of reach for many Medicare patients. Fortiér explains, "They’re available in injection or pill form. Even with discounts, current cash prices typically range from $149 to $699 per month."

In an effort to address Medicare enrollees' obesity-driven health problems and budgetary restraints, the Centers for Medicare & Medicaid Services announced a "short-term pilot program known as the Medicare GLP-1 Bridge. It will run from July 1, 2026, through Dec. 31, 2027," Fortiér writes. "It’s meant to 'bridge' the gap before a longer-term program that might — or might not — begin in 2028."

The pilot program will cover most GLP-1 weight loss medicines, including the pill and injectable formulations of Wegovy, the KwikPen formulation of Zepbound, and the Foundayo pill, Fortiér reports.

Medicare enrollees should know that Medicare's GLP-1 Bridge is "not your typical Medicare benefit. Even though Part D enrollment is required, the Bridge program itself works differently," Fortiér explains. "Instead of going through your regular Part D plan, you will need prior authorization" which your doctor can send to CMS for processing. Physicians prescribing GLP-1 to Medicare patients don't have to be, or become, registered Medicare providers.

Read all the requirements and rules for Medicare GLP-1 Bridge coverage here.

U.S. Health and Human Services awards $590 million to aid development of Moderna human bird flu vaccine

Federal funding aims to accelerate
bird flu vaccine development. (A.S)

Despite the limited threat bird flu poses to humans, American pharmaceutical and biotechnology giant Modena received a $590 million federal package to continue its development of a bird influenza vaccine, reports Sabela Ojea of The Wall Street Journal.

The U.S. Health and Human Services Department funding aims to accelerate the company's vaccine research as worries increase about a human bird flu pandemic.

Modena began a "study to generate safety and immunogenicity data of the bird influenza shot in healthy adults ages 18 and older" in 2023, Ojea writes. "The trial included vaccine candidates against two avian influenza viruses, H5 and H7."

Avian bird flu, also known as H5N1, has decimated some global wild bird populations and killed at least 20 million egg-laying chickens in the U.S. during the last quarter of 2024, reports Alexander Tin of CBS News. In March 2024, bird flu infections were detected in U.S. dairy cattle. Since that time, there have been 66 confirmed human cases of H5N1 bird flu in the U.S., including one death from the infection.

A high school public health care boarding school is planned in Alabama; part of its mission is to serve rural counties

Alabama will launch a high school focused on health
care. (Adobe Stock photo)

Amid national health care provider shortages, Alabama is investing in a high school public health care boarding school "to address [the state's] health care staffing crisis, particularly in rural parts of the state, by training students for roles across the medical field," reports Alander Rocha of the Alabama Reflector. The board "overseeing the creation laid the groundwork to select a leader and prepare a curriculum."

With planning under way, the school "is scheduled to enroll its inaugural ninth-grade class in 2026," Rocha writes. "Rob Pearson, interim president of the Alabama School of Healthcare Sciences Foundation, said that the school will offer 'certification levels beyond what’s currently available in Alabama high schools for those looking to become health care professionals.'"

Health disparities between the state's rural and urban populations, which are particularly dire along the Black Belt, motivated health care leaders and stakeholders to work creatively to increase health care access in rural areas. Rocha reports, "The Black Belt experiences some of the state’s worst health outcomes, and Alabama already ranks among the lowest nationally. Life expectancy in every Black Belt county is below the state average of nearly 75 years."

Demopolis is in Marengo
County, Ala. (Wikipedia)

True to its rural service mission, the new Alabama School of Healthcare Sciences will be built in Demopolis, a small town with roughly 7,000 residents in west-central Alabama. State Superintendent Eric Mackey "said the school’s recruitment strategy will focus on drawing students from across the state to build a workforce pipeline beyond those wanting to attend medical school, like nursing," Rocha reports. The school "will join a network of specialized boarding schools, including the Alabama School of Cyber Technology and Engineering."

Through their initiative to establish high schools focused on health care, Bloomberg Philanthropies "is providing $26 million of the estimated $80 million needed," Rocha adds. "A groundbreaking expected by mid-2025. . . . The school is the only rural residential school funded by Bloomberg."

Friday quick hits: Rural top-flick picks; dairy funds; heat can kill; racial voting division; bread debate; hop on a new train

Eita Okuno, Anna Sawai, and Hiromoto Ida in 'Shōgun.' (FX /IMDb image via The Daily Yonder)

On steamy days when the pool is too crowded and you can't handle any more of Mother Nature's energy-sucking heat, it might be time to chill indoors and take in a rural flick. From the "Mad Max Saga" to wrestling's fierce Von Erich family drama to the stunning "craftsmanship and costuming" in "Shōgun," Adam B. Giorgi of The Daily Yonder has some fine movie picks that will make relaxing in the AC much more fun.

In states with the highest number of drug overdose deaths, patients in treatment for mental illness often live with an opioid use disorder that mental health clinics are unable to treat, a study showed. "Despite high rates of opioid use disorder among people with mental health disorders, only a third of community outpatient mental health treatment facilities in 20 high-burden states offered medications for OUD," reports Shannon Firth of MedPage Today. "Among the 450 community outpatient mental health treatment facilities surveyed, weighted estimates showed that 34% offered medications for OUD, reported study co-author Jonathan Cantor, PhD. JAMA Network Open published the study in June.

Jersey Scoops capitalized on the USDA's new small
dairy initiative. (Jersey Scoops photo)

What's better than locally made ice cream or homestead cheeses? More of both. At least that's what the Department of Agriculture seems to think. The USDA is funding a new initiative that "aims to transform and diversify the dairy industry, one small producer at a time," reports Naoki Nitta of Civil Eats. "At 'Jersey Scoops' in Loleta, a small, unincorporated community in Northern California’s Humboldt County, the ice cream is as fresh as it gets. From pasture to parlor, its organic, butterfat-rich milk travels less than 10 miles, produced by a herd of Jerseys pasture-raised on the misty coast. . . . But Jersey Scoops didn’t get here on their own; they leveraged a $60,000 grant from the Pacific Coast Coalition’s Dairy Business Innovation Initiative to secure both the space and equipment." Learn about how local cheese ventures are leveraging this funding here.

As global temperatures continue to spike, awareness of heat-related illnesses is especially vital for outdoor workers and their employers. Heat can make workers sick, but it can also be deadly, reports Seth Borenstein of The Associated Press. "With much of the United States, Mexico, India and the Middle East suffering through blistering heat waves. . . several doctors, physiologists and other experts explained what happens to the human body in such heat." To find out how heat kills, click here.

Handmade bread is much different than mass produced
loaves. (Bluegrass Baking Company photo)

Bread is considered a U.S. family staple for affordable nutrition, but the processing that creates a uniform and stay-fresh loaf has landed "packaged bread in the middle of a fraught debate over 'ultra-processed food,'" reports Jesse Newman for The Wall Street Journal. "Less-processed foods tend to be more expensive and quicker to spoil. . . . For bakers like Jim Betts, owner of Bluegrass Baking Company in Lexington, Ky., most packaged bread is a far cry from the food that has been sustaining humanity for at least 10,000 years." To read why homemade bread is so dramatically different and more pricey than store-bought loaves, click here.

The U.S. rural-urban voter divide primarily exists among whites, a new study published in Politics, Groups, and Identities found. Kate Blackwood for PHYS.org reports, "When it comes to politics, Black and Latino residents of rural America differ far less, if at all, from their urban counterparts than do non-Hispanic white residents, the researchers report." One of the study's authors, Suzanne Mettler, told Blackwood, "Rural and urban Americans began moving apart politically in the late 1990s, and the division has widened and deepened since then. . .We wanted to know whether all Americans, regardless of race and ethnicity, are swept up in this growing cleavage.

A Borealis Amtrak train rounds the corner
surrounded by Midwestern fall colors. (Amtrak photo)

Midwestern states have been busy working to add more train services to their transportation portfolios. The new Amtrak Borealis service between Chicago and St. Paul opened last month after 12 years of planning, reports Daniel C. Volk of Route Fifty. "The new service was also a breakthrough. It is the first new passenger route launched in Minnesota since 1975, and the first in Wisconsin in more than two decades. . . . Officials in both states — like dozens of others across the country — are now planning for even more new passenger routes, because of incentives in President Joe Biden’s 2021 infrastructure law." Borealis trains include wide reclining seats, ample legroom, free Wi-Fi and views of the Mississippi River between St. Paul and La Crosse, Wisc., in daylight in both directions across Wisconsin.

Labor costs, drugs and inflation push health care costs up; painful pricetag will be felt by employers and workers

Wall Street Journal graph, from WTW data

Many Americans will see higher health-care coverage costs during fall open-enrollment periods. "Health-insurance costs are climbing at the steepest rate in years, with some projecting the biggest increase in more than a decade will wallop businesses and their workers in 2024," reports Anna Wilde Mathews of The Wall Street Journal. "Costs for employer coverage are expected to surge around 6.5% for 2024, according to major benefits consulting firms Mercer and Willis Towers Watson.

Coverage pricetags will be painful for employers, families and individual participants. Employers "already average more than $14,600 a year per employee," Mathews writes, "driving up health-insurance costs that are among the biggest expenses for many American companies and a drain on families' finances. . . . For people who have individual insurance plans sold under the Affordable Care Act, premiums are also expected to rise by about 6% next year, according to public insurance filings analyzed by health-research nonprofit KFF."

"Among the factors leading to the faster health-insurance cost growth are hospitals' higher labor costs and heavy demand for new and expensive diabetes and obesity drugs," Mathews explains. "The employer-plan increases are expected to strike businesses of all sizes. . . . For several years, health-coverage costs nationally increased relatively slowly, partly because the pandemic chilled doctor and hospital visits. Yet hospitals have had to hike wages for nurses and pay more for other expenses."

Some companies will increase employee costs, bumping up co-pays and deductibles to cover premium costs, but other businesses will opt to pass the expense onto customers. Mathews reports, "Many employers are expected to take on the lion's share of the increase, partly due to a labor market that remains tight in many sectors, benefits consultants said." Inflation has also made its way into the equation. Tim Stawicki, the chief healthcare actuary at Willis Towers Watson, told the Journal: "The inflation we saw a year ago is finally making its way into the [health care] contracts. It's like a delayed reaction."

Opinion: The loss of rural labor and delivery departments means lower-quality health care for mothers and babies

Photo by Jill Sauve, Unsplash

When fewer than half of rural hospitals offer labor and delivery services, what does that mean for rural pregnancies and deliveries? It means less prenatal, postnatal, and postpartum care – and more risk – for moms and babies, Anna Thompson Hajdik writes in an opinion piece for The Daily Yonder. The reasons we got here are complex, but there are solutions to consider. Here's a gently edited version:

"The accelerated closure of rural hospitals has touched every part of the country, and even if the hospitals themselves stay open because of a Critical Access designation, their labor and delivery units are disappearing. Multiple media outlets have reported on the dire situation. Families driving over four hours in blizzard conditions in the middle of the night because their local hospital ceased delivering babies 18 months earlier. A mom in rural Illinois was forced to deliver a baby on an Interstate 55 off-ramp a month after the labor and delivery unit in the small town of Lincoln, Illinois, closed. A soon-to-be mom in labor who navigated an isolated mountain pass in rural Washington on her way to the hospital with barely enough gas to get there.

At the same time, maternal mortality rates across the United States have increased significantly. In 2021, the rate of maternal deaths that occurred while pregnant or within 42 days of being pregnant was 32.9 per 100,000 live births, 10 times the rate for countries of comparable high income. The proliferation of "maternity care deserts" in rural America is an adjacent issue to overall maternal mortality; the March of Dimes defines maternity deserts as counties where there are no hospitals providing obstetric care, no birth centers, no ob/gyn and no certified nurse midwives.

Three major factors seem to drive closurs of maternity units: Labor and delivery departments are expensive to operate, risk and liability to doctors and medical staff have become untenable in a much more litigious environment, and it is challenging to recruit new obstetricians and other reproductive professionals like certified nurse midwives to rural areas.

If policymakers care about fostering a vibrant and resilient future for rural America, they would safeguard rural hospitals by creatively and sustainably funding labor and delivery departments in rural places. And while many rural health-care stakeholders advocate increased reliance on technology like telehealth and mobile health clinics, expectant mothers shouldn't have to deliver their babies over Zoom or drive more than two hours to receive care. A recent study demonstrates that the closure of labor and delivery units in rural areas is linked to the reduced quality of prenatal care, even if health-care institutions are providing it.

States like Texas (where rural hospitals more broadly are in especially dire circumstances) that have opted not to expand Medicaid should reconsider that decision as the rate of rural hospitals at risk of closure steadily increases each year. But a simple federal solution exists as well – significantly increasing Medicare and Medicaid reimbursement rates that actually reflect the skyrocketing costs of healthcare and maternity care in particular in a post-pandemic America. The American Hospital Association supports this action, among many other initiatives, in their call for Congress to pass the Rural Hospital Support Act, which is a piece of legislation that has broad bipartisan backing.

Ultimately, a national reckoning is playing out across the country when it comes to rural healthcare, exposing so much that is broken. . . . Unless policymakers (regardless of their political affiliations) and civic leaders take action to solve this crisis, rural people are left with limited options, while the future of the nation's rural communities more broadly is one of precarity and accelerated population loss.

Anna Thompson Hajdik is a senior lecturer at the University of Wisconsin-Whitewater in the Languages and Literatures department. Her rural background and continued interest in agriculture inform her research and writing, as well as her "extracurriculars," including serving as vice president of the Wisconsin Dairy Goat Association.

Churches in Georgia become telehealth hubs to help rural residents expand their limited access to health care

Church leaders discuss health and wellness outreach in rural Georgia. (Photo by Chamberlain Smith, UGA)

Churches often serve as a rural area's central hub. Some in rural Georgia are adding a telehealth partnership to their community outreach, reports Leigh Beeson of the University of Georgia. The program "Fishers of Men" was developed to address lack of access to health care; its mission "is to create telehealth hubs at participating churches, with support from the UGA Archway Partnership. These hubs have widescreen TVs, computers, internet capabilities, and various other devices, such as scales, to facilitate medical appointments and educational seminars on health and managing chronic conditions."

The program's began with a pharmacist, Henry Young, and an IT professional, Sarah Jones, who wanted to address lack of access to health care. "With a Department of Agriculture grant of just under $1 million in 2020, the Fishers of Men project—a partnership encompassing more than 20 different churches from the Interdenominational Ministerial Alliance and the Georgia Union Missionary Baptist Association—was born." The program faces the challenges of limited broadband access and adoption, but churches are using hotspots while Young's team continues to chisel out workarounds.

An additional grant "is helping the Fishers implement a new branch of the program: the Centers for Disease Control's Diabetes Prevention Program." Caleb Snead, who works on the Fishers project, told Beeson, "We study how people can't get to the resources they need, but that's not an excuse for us. We have to bring ourselves, that education, those preventive measures to the community."

"Young is thinking of advertising the new diabetes prevention program in local papers," Beeson adds. "And he and the pastors and deacons of an ever-growing list of churches are setting up workshops to train diabetes program facilitators who will help guide people on their health journey." Young told Beeson, "It's a true community-academic partnership. We're aligning what the community wants and needs with our strengths. We're reducing the barriers that prevent people from getting the health care and resources they need when they need it."

Georgia is one of the 10 states, mostly in the South, that have not expanded Medicaid under the 2010 Patient Protection and Affordable Care Act, which advocates say would be the best way to expand rural health care.

If you need a rural ride, it may be hard to schedule, or it may not; states, localities work to find transportation solutions

A Cedar County Transit van makes its way down a Nebraska road.
(Photo by Forrest Czarnecki, Special to Harvest Public Media)

In rural areas, getting from here to there without a vehicle can be tough. "In rural areas, residents can be miles away from essentials like doctors and grocery stores instead of minutes. Absent transportation, people who don’t have a car or can’t drive often have to move closer to service," reports Elizabeth Rembert of Harvest Public Media. "More than a third of state rural-health offices reported lack of transit was the biggest barrier to elderly people staying in their homes, according to research by Carrie Henning-Smith, who studies rural health at the University of Minnesota. . . . Rural America tends to be sicker, poorer and older than its urban counterparts. Henning-Smith said the negative-but-true statistics make it even more important for rural residents to be able to access transit."

Rembert provides an example: "Joel Tyndall lives off a gravel road in northeast Nebraska, miles away from the nearest town. As a double amputee, some have suggested he could move closer to the biggest town, Norfolk, where he has three dialysis appointments a week to manage his diabetes. . . . But it hasn’t come to that — thanks in part to the Cedar County Transit — which works a little like a rural Uber; anyone can call to schedule a ride. Tyndall told Rembert he doesn't plan on leaving his home, "as long as this transit continues to run I'll be using it for just about everything. These guys help me out more than you would believe.”

Cedar Country Transit was designed to support rural citizens, "The northeast Nebraska county has had some level of public transportation since about 1980 . . . They now have 15 vans, 15 drivers and a full-time scheduler. The operation recently launched services into a bordering county and moved into its own building," Rembert writes. "Anyone living in Cedar County and parts of Knox County can schedule a ride, as long as it’s within 200 miles and on a weekday from 6 a.m. to 6 p.m. . . . The service runs on money from the state and federal government, grants and contracts and local community funding, as well as fare for rides."

Nebraska isn't alone in seeking rural transportation alternatives. "Providing public transit in rural areas is a difficult task, but a patchwork of services serves towns and counties throughout the Midwest and Great Plains," Rembert reports. "Kansas was tied in 2019 for the most rural transit agencies in the nation, and in Iowa 35 providers serve riders across the state’s 99 counties. In 2020, Oklahoma developed a transit plan to help it become a 'top 10 state in transit' by 2040. . . . Missouri’s 'Operating Above the Standard' Transit is the largest agency in the country and operates in 87 counties. But it doesn't reach every corner of the state."