State News

Indiana and Minnesota offer examples of how state policymakers are using budget appropriations, executive orders and legislation to improve social equity and reduce disparities, according to NASHP. In Indiana, the governor and legislators are tackling disparities in infant mortality, aiming to reduce the state’s infant mortality across all zip codes by improving services for expecting mothers by establishing a perinatal navigator program. The program provides wraparound services and community-based, home-visiting programs, while a new law also establishes a program to provide more nurses and community health workers to help young women throughout pregnancy. In Minnesota, initiatives proposed in the budget or enacted through executive orders are designed to reduce disparities in educational attainment and employment among racial minorities in Minnesota. Though not directly tied to health, these disparities can lead to income inequality and other stressors strongly associated with poor health outcomes. The approaches taken by Minnesota’s and Indiana’s governors demonstrate how state leaders can push for social equity with targeted or broad systemic changes to improve overall social conditions.

A new law requires clinics that are part of a larger hospital or health system to publicly disclose that patients may receive a separate charge for the facility, resulting in higher out-of-pocket costs, according to the Grand Forks Herald. The hope is that these disclosures will lower the number of Minnesotans who experience surprise medical bills. A Healthcare Value Hub survey of adult Minnesotans in 2019 revealed that nearly half experienced healthcare affordability burdens in the past year.

The Illinois Department of Public Health will be adding maternal and child health data to its public health community map. According to the U.S. News & World Report, this data will be available to the public, and can also be used by clinicians, legislators and healthcare administrators. Data categories include low birth weight, teen birth rate, breastfeeding, prenatal care and smoking during pregnancy. The map includes numerous other topics and state officials say they're updating other categories including asthma, heart failure and pneumonia.

Oregon has passed legislation creating the Oregon Health Care Cost Growth Benchmark Program, which will set a state spending growth target that all insurance companies, hospitals and healthcare providers would have to stay within, according to The Lund Report. Oregon is the fourth state to set a spending benchmark intended to rein in the rising cost of healthcare. In Massachusetts, the policy saved $5.5 billion for consumers between 2013 and 2016. Currently, Oregon has the third highest health insurance deductibles in the country and is in the top 10 highest states for family budgets spent on out-of-pocket hospital costs.

After an audit revealed that a 8.8 percent spread between what pharmacy benefit managers (PBMs) charged Medicaid managed care plans and what they paid to pharmacies, Ohio Medicaid directed managed care plans to end their contracts with pharmacy benefit managers, effective January 2019. Plans were instead asked to adopt a transparent “pass-through” pricing model whereby the managed care plan would pay the PBM the exact amount paid to the pharmacy for the prescription drug, a dispensing fee, and, in lieu of spread-based revenue, an administrative fee, according to JAMA. Ohio policymakers also pursued the prohibition of gag clause by PBMs, which prevent pharmacies from sharing with patients the most cost-effective option when purchasing medications. Uniquely among states, Ohio’s approach includes assessing the potential effect of these reforms on outcomes and evaluating gains after reform implementation.

The University of Maryland School of Medicine will receive $750,000 in federal funds from the U.S. Health Resources and Services Administration to train more doctors for posts in rural areas, according to The Baltimore Sun. The residency program will send doctors-in-training to the University of Maryland Shore Regional Health and the Choptank Community Health System, which are in the Eastern Shore region facing significant provider shortages, an aging population, and high levels of chronic diseases.

A state sponsored report curated by Deloitte provides an environmental scan of current uninsured Georgians. This study focuses on the uninsured rate if Georgia does not expand Medicaid, according to AJC. Researchers found that 666,000 Georgians could benefit from Medicaid expansion, indicating that uninsured rates are higher than previous estimates. Additionally, this study provides recommendations on waivers that state agencies and policymakers could pursue to seek more federal funding for their Medicaid program.

New York’s 2013 mandate for protocolized sepsis care produced sepsis mortality rates significantly lower than those in four states without such regulations, according to FierceHealthcare. New research published in JAMA found that the unadjusted 30-day in-hospital mortality rates in New York dropped from 26.3 percent before the regulations were implemented to 22 percent afterwards. However, these results may not be guaranteed for other states, as New York had a specific environment in which to implement the regulations. First, mortality rates in New York were already higher than most other states, and secondly, this solution came during “a perfect storm,” with an engaged department of health, active hospital associations, willing partners and grassroots advocacy.

The Idaho Department of Health and Welfare recently enacted new rules bolstering patient access to their Electronic Health Record (EHR) data, according to EHR Intelligence. Previously, many of the EHR access regulations didn’t apply to critical access hospitals, which will need to implement new procedures to comply with the new rules. For example, one rule gives patients more control over their health information, while another requires healthcare organizations to send patients their EHRs within three business days of submitting a request. Other aspects of the new rules address patient privacy, video and audio monitoring and recording and patient safety and informed consent.