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Mandating nurse staffing ratios for all hospitals and nursing homes in New York would cost providers $3 billion a year, according to Modern Healthcare. This cost estimate comes from the Greater New York Hospital Association in response to legislation being considered by the City Council hospitals committee. The Greater New York Hospital Association argues that mandating ratios results from California, the only state to impose nurse staffing ratios on all units of hospitals, have not proven that such ratios improve care across the board. In contrast, the New York State Nurses Association supports the measure, noting that hospitals in California actually did better financially post-implementation.
Maine governor signed LD1263 into law, which requires any private payer to cover any telehealth services that that would cover in person, based on six conditions outlined by the law. According to mHealth Intelligence, the bill also allows reimbursement for healthcare providers who use phone-based telehealth when scheduled telehealth services are technologically unavailable at the time of the scheduled telehealth service for an existing enrollee and the telephonic services are medically appropriate for the corresponding covered health care services. This new piece of legislation opens the door to more remote patient monitoring programs.
Researchers at Massachusetts General Hospital have found that electronic consultations (e-consults) in allergy and immunology can simplify the process of providing the most appropriate care, according to The Harvard Gazette. The recent study reports on the first two years of the program, finding that these e-consults can often reduce the need for in-person specialist visits, as well as a significant reduction in the time needed to access specialist guidance.
In one year in Massachusetts, patients experienced nearly 62,000 preventable medical errors, which resulted in $617 million in additional healthcare costs, according to a new report by the Betsy Lehman Center for Patient Safety. The report, based on an analysis of health insurance claims data and a phone survey, noted that 12 percent of these errors resulted in death. Although 27% of respondents said the medical error had no impact on their physical health – for example, they caught a pharmacist’s medication error before taking the medicine – 28% reported having physical impacts a year after the error. Three to six years after the error, more than 20% of patients reported feeling lingering emotional effects, such as anger, depression or anxiety.
Pennsylvania is moving to take over the online health insurance exchange that has been operated by the federal government since 2014, saying it can cut health insurance costs for the hundreds of thousands who buy individual Affordable Care Act policies, according to the Lexington Herald Leader. State leaders assert that this move will reduce premiums for residents. Currently, the federal government takes 3.5 percent of the premium paid on plans sold through the exchange, or an estimated $94 million this year, though state can operate the exchange for $30 million to $35 million and use the difference to draw down extra federal dollars for a reinsurance program that reimburses insurers for certain high-cost claims. The state's share would be about one-quarter of the reinsurance program cost, according to estimates. Those reimbursements allow insurers to lower premiums across the board within the state's insurance marketplace. Evidence from seven states that already have reinsurance program shows that they reduced insurance premiums paid by consumers.
For the majority of the population not on Medicaid, the Wisconsin Institute for Law and Liberty has proposed seven reform measures to lower costs and increase access to care, according to KPVI. The Wisconsin Institute for Law and Liberty points to a recent report by the Institute for Reforming Government, which states that Wisconsin’s state-based healthcare reforms offer a model other states can follow, in addition to saving taxpayers money and representing zero coverage gaps. In 2017, Wisconsin applied for an exemption waiver from Medicaid expansion, which was approved in 2018. The Wisconsin Institute for Law and Liberty’s recent report recommends that the state allow for direct primary care to reduce costs and increase access to healthcare.
All-payer claims databases (APCDs) are a promising, high-quality tool for cancer surveillance, according to a Utah study published in Health Services Research. Medicare data has previously proven beneficial in capturing cancer treatment that is under-reported to cancer registries for the 65 and over population. Researchers looked at the Utah APCD to assess the potential of these databases to offer similar benefit to cancer surveillance, including information on comorbidities at diagnosis, recurrence and late effects of treatment. The study concluded that an APCD can act as a high-quality surveillance tool when accurate identifiers exist to support linkage to cancer registry data, if claims for the same patient can successfully be linked in the ACPD, and if the population of patients diagnosed with cancer have adequate coverage.
A first-in-the-nation measure in Maryland to create a prescription drug affordability board will become law without the Governor’s signature, according to The Associated Press. The law creates an independent board with the authority to evaluate expensive drugs and recommend methods for addressing high costs. The measure was scaled back significantly from an initial proposal. For one thing, it will only apply to state and local governments, not all Maryland residents. Also, the board could only set upper-payment limits with approval from a legislative panel beginning in 2022.
Colorado Governor Jared Polis signed legislation that caps insurance co-payments on insulin at $100 a month, no matter the type of insulin. According to The Denver Post, the measure goes into effect in January and insurers are expected to pay the difference in price. The cost of insulin has continued to increase in the U.S., with prices doubling since 2012.
Montana has seen an increase in the number of direct primary care facilities, where the billing and payment agreement made between a doctor and their patient does not involve insurance. According to KULR 8 News, these direct primary care facilities provide monthly membership plans and are now being offered in several cities in the state. One of the founders of a Montana direct primary care facility claims that they are already seeing a huge decline in emergency room visits and hospitalizations in their community, saving the healthcare system money.