A popular home test to screen for colon cancer has come with an unexpected bill for some people - leading to fears they may put off life-saving treatment, reports CBS News. While experts say Cologuard is a good screening tool, some users have faced a high bill, like Missouri resident Lianne Bryant did when she received a bill of $1,900 from the hospital that performed her subsequent colonoscopy, due to her positive Cologuard result. Under the Affordable Care Act, only routine screening tests are covered, and because Bryant's Cologuard result was positive, her colonoscopy was coded as a diagnostic test, which was not fully covered by her insurance. She would have been fully covered had she not used Cologuard first. Experts worry that when people find out their colonoscopies might not be covered, they won't get them.
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.
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.
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.
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.
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.
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.
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.
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.
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.