The Colorado legislature passed numerous bills in the healthcare space that primarily focused on reducing the cost of care for consumers and improving accountability for quality care, according to the National Law Review. Some of these laws include HB 19-1174, which requires insurance carriers, providers and facilities to begin providing patients with information on the potential impact of receiving services from an out-of-network provider, prohibits “balance billing” patients who receive covered services from out-of-network providers at an in-network facility or emergency services from out-of-network providers or facilities, and establishes the reimbursement amount insurance carriers must pay to out-of-network providers that provide health care services to covered persons at an in-network facility or out-of-network providers for emergency services. HB 19-1131 requires that manufacturers and their representatives provide information about the wholesale acquisition cost of a prescription drug when providing information to a health care provider licensed to prescribe controlled substances or prescription drugs, and that when providing wholesale prescription drug price information, the manufacturer and representatives must also provide a list of at least three generic prescription drugs from the same therapeutic class and their wholesale acquisition costs. HB 19-1320 requires certain hospitals to complete an annual community health needs assessment and annual community benefit implementation plan.
Florida has enacted several healthcare laws geared towards affordability. One such law would allow health insurance companies to work with providers — like hospitals — to setup a website with lists of shoppable, non-emergency services such as lab work or outpatient surgical procedures, according to Florida Voices for Health. Another bill would establish a Canadian drug-import program for state healthcare coverage, which includes 3.8 million Medicaid recipients and 100,000 state prisoners.
A 10-year project of the University of Wisconsin-Madison Population Health Institute and the Robert Wood Johnson Foundation shows the health disparities among populations in Wisconsin, according to The Milwaukee Independent. The interactive tool displays different health measures for the different counties in Wisconsin, from air pollution-particular matter to income inequality to ratio of population to primary care physicians.
Florida has passed legislation authorizing the state to import prescription drugs from Canada and other countries, potentially lowering the cost of lifesaving medicines that millions of people take every day, according to AARP. The law creates two prescription drug importation programs: The Canadian Drug Importation Program focuses on bringing down the cost of drugs to state-funded programs, such as Medicaid and the state prison system; and The International Prescription Drug Importation Program allows medicines to be imported from Canada and other countries, and then purchased by consumers through wholesale distributors and pharmacies. In order to implement these programs, states need approval from the U.S. Department of Health and Human Services (HHS) to begin their programs.
Twenty percent of Massachusetts residents have experienced a recent medical error and most of them said they “feel abandoned or betrayed by their doctor,’’ according to a survey summarized in the Boston Globe. Researchers estimated that 61,982 errors occurred in a single year, costing $617 million in follow-up care patients needed as a result of the mistakes. Despite a law that requires healthcare providers to disclose medical errors that cause significant harm and encourages them to apologize, only 19 percent of residents who reported an error said they received an apology. The survey, conducted by the Betsy Lehman Center for Patient Safety – a state agency – is one of the most comprehensive statewide examinations of medical errors to date.
LifeBridge and Johns Hopkins are among the local health systems partnering with ride-hailing service firms to provide on-demand transportation to patients in need and reduce overall care costs, according to the Baltimore Business Journal. The program targets specific patient populations who demonstrate the most need, and do not have easy access to reliable transportation options, namely patients residing in areas of West Baltimore who need access to services at LifeBridge's Sinai and Levindale Hebrew hospitals. The goal is to ensure community members are able to get to preventative care appointments more easily, reducing the costs associated with missed healthcare appointments and helping community members remain healthy.
Nevada passed a law creating a Patient Protection Commission (PPC) that will examine healthcare costs and the primary factors that are driving those costs, reports KTV News. The PPC will also review the roots of disparities in care among different communities, including the adequacy of healthcare providers and availability of health insurance plans. The PPC will have 11 members appointed by the governor with recommendations from legislative leadership. Membership will include representation from across the industry – health plans, providers, hospitals, and pharmaceuticals – an academic experienced in healthcare policy and patient advocates to represent healthcare consumers.
Vermont is eyeing birth control, insulin and pricey medications for HIV and multiple sclerosis as possible candidates for the state's landmark program to import cheaper drugs from Canada, reports Politico. State officials determined that the importation program could save insurers up to $5 million annually, based on this list of drugs, which the state has yet to finalize. A potential barrier is that Vermont must prove that the importation program wouldn’t pose additional risks to patient safety and that consumers will pay less for drugs under the new model in order to receive approval from HHS. HHS set up a working group last summer to study importation, but many of the details have been kept secret.
A resolution, passed in 2017, directed the Cabinet Secretary for Health and Social Services to develop a strategy to reduce healthcare cost growth and improve health outcomes in Delaware, according to a Health Affairs blog. Delaware was the first state to set both a healthcare spending growth target and implement a suite of associated quality and population health measures. This article describes the evolution and implementation of the cost and quality benchmarks and the use of transparency (rather than incentives, penalties or regulatory levers) as the primary strategy for meeting the initiative’s goals. It is currently unclear whether transparency alone will help stakeholders lower cost growth and seek strategies to improve primary prevention and better manage care for high-risk patients.
A new West Virginia will enable residents to access life-saving medicines when their supply runs out, the prescription is expired and the doctor can’t be reached to 'OK' it, according to WV Metro News. HB 2524 grants pharmacists the discretion to fill those prescriptions under specified conditions and certain circumstances. This bill allows pharmacists, under specified conditions, to extend 30-day prescriptions to 90 day and requires payers to cover the cost if it is consistent with the patient's benefit plan.