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Iowa’s rural areas are seeing emergency services volunteers retire without enough new ones to replace them. Nationwide, emergency medical services are seeing high rates of turnover for emergency service technicians and paramedics – with an average of 20 to 30 percent leaving annually. As more emergency service professionals disappear, it puts the state’s rural residents at greater risk. At Shenandoah Medical Center in southwest Iowa, CEO Matt Sells said he’s worried about the rural populations in Fremont and Page counties. He said he’s seen smaller communities lose their volunteers, which translates to longer emergency response times. (Crawford, 4/6)

KHN: The Pandemic Exacerbates The ‘Paramedic Paradox’ In Rural America 

Even after she’s clocked out, Sarah Lewin keeps a Ford Explorer outfitted with medical gear parked outside her house. As one of just four paramedics covering five counties across vast, sprawling eastern Montana, she knows a call that someone had a heart attack, was in a serious car crash, or needs life support and is 100-plus miles away from the nearest hospital can come at any time. “I’ve had as much as 100 hours of overtime in a two-week period,” said Lewin, the battalion chief for the Miles City Fire and Rescue department. “Other people have had more.” (Houghton, 4/7)

CVS Health will sell PayFlex, its provider of flexible spending and health savings accounts, to the financial services firm Millennium Trust, the companies announced Tuesday. The transaction is expected to close in the second quarter, the companies said. CVS Health and the Millennium Trust Company didn't disclose the financial terms of the deal. CVS Health's Aetna insurance subsidiary will retain PayFlex as its preferred provider for HSAs, FSAs and other tax-advantaged consumer accounts. (Tepper, 4/6)

Providers that didn't report on Provider Relief Fund money they received in the first round because of "extenuating circumstances" have an opportunity to request additional time, the Health Resources and Services Administration announced Wednesday. Severe illnesses or deaths of employees responsible for reporting, natural disasters that damaged records or technology near the end of the reporting period, internal miscommunication about reporting and failures to click "submit" count as extenuating circumstances that warrant extra time to report after the deadline, according to HRSA. (Goldman, 4/6)

The Centers for Medicare and Medicaid Services wants to indefinitely delay the start of its radiation oncology payment model and announce a new time line through future rulemaking, the agency disclosed Wednesday. CMS also indicated it may consider scaling down the model's discount factor, which is the amount by which it reduces a episode payments to reserve savings for Medicare. The model cannot start before Jan. 1, 2023, per a law passed last year to forestall pending Medicare reimbursement cuts. The radiation oncology initiative was originally slated to begin Jan. 1, 2021, and had already been pushed back multiple times. (Goldman, 4/6)

Dearborn announced Wednesday it's bringing back a revamped health department and appointing a director, making it what officials say is probably the only city in southeastern Michigan outside of Detroit to have its own health department. Mayor Abdullah Hammoud, elected in November, said Ali Abazeed, 31, who previously worked for the National  Institutes of Health and advised Detroit's health department, will lead the newly established Department of Public Health. (Warikoo, 4/6)

It is one of health care’s most vexing quandaries: Patient data must be shared to develop more effective medicines and artificial intelligence tools, but there’s no way to share it without violating privacy and basic data rights. Or is there? A fresh crop of companies is building a new data economy that enables the exchange of personal health information while enforcing ironclad privacy protections. They are not a monolithic group: each one uses its own methods and technologies, serves different customers, and is motivated by distinct problems and personal philosophies. (Ross, 4/7)

KHN: Never-Ending Costs: When Resolved Medical Bills Keep Popping Up

Every now and then, Suzanne Rybak and her husband, Jim, receive pieces of mail addressed to their deceased son, Jameson. Typically, it’s junk mail that requires little thought, Suzanne said. But on March 5, an envelope for Jameson came from McLeod Health. Jim saw it first. He turned to his wife and asked, “Have you taken your blood pressure medication today?” He knew showing her the envelope would resurface the pain and anger their family had experienced since taking Jameson to McLeod Regional Medical Center two years ago. (Pattani, 4/7)