Public and private employers and two purchasing coalitions have joined the Colorado Purchasing Alliance and Purchaser Business Group on Health, reports Modern Healthcare. The goal of the group is to negotiate directly with health systems to set prices for common procedures. Larimer County, who joined the group, hopes that the partnership will drop its $25 million annual healthcare costs by another 10 percentage points. The group hopes that by staying local, they can get better care for people with chronic conditions and allow regional employers to enter a common purchasing coalition but still customize their individual companies’ benefits. The group will identify high-quality medical providers in Colorado, and the not-for-profit's national employer members will also be able to opt in to the contracts that the local business group negotiates.
Some private insurance companies in Colorado will soon be required to offer a state-regulated health insurance plan, reports the Colorado Sun, now that the governor has signed House Bill 1232. Insurance companies will be required to offer it in 2023 at a cost reduction of at least five percent, and the total reduction must meet 15 percent starting in 2025. The governor also signed Senate Bill 175, which creates a five-member Prescription Drug Affordability Board that will have the authority to cap the price of prescription drugs that the panel determines are too expensive. The Board is also tasked with making policy recommendations to state lawmakers on how to make prescription drugs more affordable.
A new report from the Center for Improving Value in Health Care shows that Colorado could save up to $140 million annually and reduce potential harm to patients by minimizing low-value healthcare services, reports abouthealthtransparency.org. The report analyzed claims from 2015-2017 from Colorado’s APCD for both private and public health insurance and found that 1.36 million Coloradans received one or more low-value care service and more than half (53%) of the care was identified as wasteful or likely wasteful. The report found the top low-value services in Colorado were concurrent use of antipsychotics and opioid use for back pain.
Connecticut’s Office of Health Strategy (OHS), tasked with reducing health disparities within the state, will receive $3.3 million of a $17 million grant from the Centers for Disease Control and Prevention, reports NBC Connecticut. The grant money will be spent on work by OHS and community organizations, focusing on reducing maternal and nutritional disparities, food insecurity and overcoming language and transportation barriers. Much of the grant money will go to addressing these issues in communities of color, as people of color experience significant health disparities often caused by social determinants of health.
Approximately 18 percent (or 165,000) of households in Connecticut with adults under the age of 65 face unaffordable healthcare costs, reports CT News Junkie. These data, from a report issued by the Office of Health Strategy and the Office of the State Comptroller, show that many families in the state are spending more for healthcare than they can afford. An estimated 42 percent of households who purchase their insurance through the state’s insurance exchange face costs that exceed the affordability target, while 16 percent of households with employer-sponsored insurance experience the same burden. Officials revealed a new tool to help lower these costs, the CT Healthcare Affordability Index, which measures the impact of healthcare costs on a household’s ability to afford all basic needs.
Connecticut has no statewide standards for the way its medical facilities gather, report and use patient data on race, ethnicity and language, reports the CT Mirror. Though collecting these data won’t by itself solve health disparities, a new report commissioned by the Connecticut Health Foundation explains that this step enables providers to target gaps in care experienced by people of color. The foundation stressed that collecting and analyzing such data can lead to better care and reduce inequities. While many Connecticut healthcare systems do collect some of this data, the amounts vary, and fewer organizations are using the information to address care disparities. Connecticut recently passed a bill that would require the improved collection of this data among state agencies, boards and commissions, in a way that allows for aggregation and disaggregation, as well as other mandates on data collection.
Hawaii’s Department of Health is reestablishing its Office of Health Equity in light of many long-standing health inequities that were highlighted by the coronavirus pandemic, reports Honolulu Civil Beat. The Office of Health Equity will work with community leaders and seek to understand the disparities experienced by many Filipinos and non-Hawaiian Pacific Islanders during the coronavirus pandemic.
Illinois passed legislation, HB 158, to expand services from community health workers, which advocates hope will lessen health inequities, reports the State Journal Register. The bill was a part of a package of bills aimed at reducing systemic racism and inequities faced by Black, Hispanic and low-income people. The law will devote $2.5 million in fiscal year 2022 to reimburse community health workers for their services to Medicaid clients in order to better address social determinants of health. The law will also boost state funding for home-visiting services by $38 million and provide $15 million in Medicaid reimbursements for doula services for women who are pregnant and parenting. In addition, the law mandates anti-bias training for doctors and other healthcare professionals before their state licenses are renewed.
The Community CAre Transitions (C-CAT) clinical trial, which paired community health workers with patients admitted to Massachusetts General Hospital, found that fewer intervention group participants were readmitted within 30 days than control group participants. The study, published in JAMA Network Open, revealed a significant effect for patients discharged to short-term rehabilitation but not for those discharged home. In the study, community health workers trained in basic knowledge of clinical conditions provided health coaching and connected patients to specific low and no-cost resources (like food, transportation and housing) that were contributing to gaps in their care, seeking to strengthen patient connections to primary care while addressing unmet needs. Just 12.6 percent of intervention group participants were readmitted in the 30 days following hospital discharge, compared to 24.5 percent of control participants. In addition, fewer intervention than control patients had missed appointments (22% vs. 33.7%) and ED visits (11.2% vs. 16.8%).
Montana recently passed a law, SB 374, that would allow all Montana physicians, starting in Fall 2021, to dispense medications they prescribe to patients, not just those whose offices are at least 10 miles away from a pharmacy, reports U.S. News and World Report. The new law requires physicians who dispense medication to be regulated like a pharmacy and requires opioids to be dispensed by pharmacies. Another new law, SB 395, aims to reduce prescription drug prices by allowing the state to regulate pharmacy benefit managers. The Governor hopes that by increasing transparency and oversight of the middlemen in the pharmaceutical supply chain, the state will bring generic drugs to market faster, increase pricing transparency and promote accountability.
New Jersey has passed a law creating the Coronavirus Disease Pandemic Task Force on Racial and Health Disparities. New Jersey’s Governor initially returned the bill to the legislature with recommendations to strengthen the task force by adding additional members, including representation from the Division on Civil Rights and the Division of Consumer Affairs, reports the Governor’s Office. The task force’s purpose is to conduct a thorough study on the reasons why the COVID-19 pandemic has disproportionately affected the state’s minority and vulnerable communities, and the short- and long-term consequences on those communities. In addition, the task force will improve existing data systems to ensure that the health information collected on COVID-19 infections and deaths includes specific race, ethnicity and demographic identifiers. The data will be used to better understand, as well as develop effective strategies, to address and reduce racial, ethnic and health disparities, as along with the historic and systematic inequalities that amplified the COVID-19 experience for minority and vulnerable communities.
Individuals living in neighborhoods in Brooklyn with a high incidence of cancer experience significant barriers to care, according to a study published in Ethnicity & Disease. The study, conducted by researchers at New York-Presbyterian and Weill Cornell Medicine found that barriers include economic stability, education and community and social context (like stigma, bias and discrimination, eroding support systems and cultural misconceptions). To address the financial challenges related to cancer care, researchers point to changes that would reduce the need to take time off work, such as extended clinic hours, flexibility in scheduling and setting up interdisciplinary appointments so that patients can meet the entire health team at once. However, the researchers also point to advocating for policies that make high-quality healthcare more affordable, which would significantly help patients struggling with financial barriers to cancer care.
Oregon lawmakers passed legislation that will require healthcare providers to be reimbursed at the same rate for telehealth services as in-person services, according to the Lund Report. The law, HB 2508, comes during the coronavirus pandemic, when use of telehealth services increased significantly.
The Tennessee General Assembly passed a certificate of need reform bill to reduce requirements and costs associated with opening, reopening or expanding a hospital, reports the Murfreesboro Post. The law changes the fee schedule associated with obtaining approval for a new healthcare service or facility, reduces the application process from 135 days to 60 days, exempts services in counties with populations above 175,000 people and allows rural hospitals to reopen without restarting the certificate of need application process.
Vermont has spent $29.8 million supporting OneCare, the state’s only accountable care organization, and has yet to realize any healthcare savings as a result, reports the Burlington Free Press. These findings, from a final report from the state auditor, will influence the state’s decision by the end of 2021 whether to continue the program for another five years. OneCare Vermont is supposed to cut the cost of healthcare by keeping people healthier through more preventative care. Also, rather than receiving a fee for service, healthcare providers receive lump sum payments that should encourage them to be more efficient in providing care. However, there has been no complete analysis on the program from the Centers for Medicare and Medicaid Services, which oversees the program. The Agency of Human Services, however, believes that these early-years' operating costs should not be a leading factor in determining whether the state should enter into a subsequent agreement.
Though breast cancer screenings dropped sizably among all Washington women, women of color and those living in rural communities experienced the steepest drop-offs, according to a study by researchers at Washington State University Health Sciences Spokane and a not-for-profit healthcare system, MultiCare. The study, published in JAMA Network Open, used medical records data from MultiCare patients who had screening mammograms completed between April and December of 2019 and during the same months in 2020, after the World Health Organization declared COVID-19 a global pandemic. The number of completed screening mammograms across Washington fell by 49 percent, but these results were not consistent across racial groups. Breast cancer screening declined by 64 percent in Hispanic women and 61 percent in American Indian and Alaska Native women. In addition, screenings dropped by almost 59 percent for rural women, versus about 50 percent for urban women. This is the first study to examine racial and socioeconomic differences in missed cancer screenings during the pandemic.
West Virginia has passed legislation to extend Medicaid coverage to low-income women up to one year after giving birth, reports U.S. News & World Report. The state’s Governor indicated that the state’s health department will opt into the state plan option indicated in the American Rescue Plan, noting that the state’s population has many lower-income families and pregnant women in need of comprehensive health coverage.
The Wisconsin Department of Health Services has announced the creation of a new branch to improve health outcomes of historically underrepresented groups—The Office of Health Equity—reports Spectrum News 1. The Office of Health Equity will conduct research and policy analysis to address the social determinants, or root causes, of health, including access to housing, stable income and healthcare. The new Office will coordinate existing and new efforts on equity and inclusion across the Department of Health Services, including implementing strategies to build an infrastructure and culture committed to equity and inclusion along with minimizing the impacts of health disparities in Wisconsin communities by evaluating and proposing changes to Department of Health Services policies and budget.