- Cost and Quality Problems
- Improving Value
- Advocate Resources
- State News
Maryland’s Governor is expected to sign the Maryland Easy Enrollment Health Insurance Program (MEEHP), which will use income tax filing as an immediate onramp to health coverage. An uninsured tax filer will be able to check a box on their state income tax return asking the Maryland health insurance exchange to determine their eligibility for free or low-cost insurance and have relevant information from their tax return sent to the exchange, according to Health Affairs. It is expected that this new enrollment system will go into effect in January 2020, when returns are filed for tax year 2019, but implementation may be delayed to January 2021 if the state tax agency finds the original timeline infeasible.
Montefiore Health Systems worked with a startup, Valera Health, using a HIPAA-compliant app to better engage patients and give them more context about their care. According to MedCity News, Montefiore began working with Valera Health after receiving a grant from the CMS Innovation Center to develop a financially sustainable way to integrate behavioral care and primary care. Montefiore began using the Valera app during a pilot study that began in July 2016, which found that patients using the app missed fewer appointments, connected more frequently with their care teams than with phone calls, and experienced significant improvement in depression and anxiety scores, as well as remission rates.
A new Washington law will direct money to tribal healthcare systems and create a council focused on improving health outcomes for members of Washington’s 29 tribes, reports The Seattle Times. The program will dedicate $3-$5 million in the first year (and potentially more in subsequent years) to implement an Indian Health Improvement Advisory Plan, designed by the Governor’s Indian Health Advisory Council. The council, also established by the law, will include a representative from every tribe in the state, CEOs of the state’s two Urban Indian Health Boards, legislators from both parties and a representative from the governor’s office.
Montana’s Governor has signed a package of healthcare bills, including the reauthorization of Medicaid expansion and a program to lower insurance premiums on the individual market. Other legislation was aimed at lowering prescription drug prices and increasing access to medical, mental health and substance use treatment in rural and American Indian communities, according to the Governor’s Office. Other legislation would protect federally qualified health centers from discrimination in prescription drug pricing, hold accountable pharmacy benefit managers by applying protections to their billing practices and preventing surprise fees, and prohibit pharmacy benefit managers from requiring pharmacies to charge consumers more in copayments than it costs to make a drug.
The Integrated Healthcare Association’s third California Regional Health Care & Cost Quality Atlas found that provider risk sharing arrangements are associated with higher quality, at the same or lower cost, reports State of Reform. This free report includes two dozen measures of cost, quality and utilization from more than 30 million Californians with commercial insurance, Medicare and/or Medi-Cal.
A new Colorado law protects patients from surprise medical billing by prohibiting healthcare providers from sending consumers a bill when they’ve unknowingly received out-of-network care. According to High Plains Public Radio, the law also sets a reimbursement rate that insurers pay to out-of-network hospitals and doctors. Researchers with the Center on Health Insurance Reforms at Georgetown University have found Colorado is more protective of consumers with respect to surprise medical billing, than other states in the region.
Delaware state legislature easily passed a measure to establish the Interagency Pharmaceuticals Purchasing Study Group, according to the National Academy for State Health Policy. The group is tasked with an ambitious agenda, expected to submit recommendations to leverage bulk purchasing of pharmaceuticals to meaningfully lower drug prices by the end of 2019. The strategies to leverage the state’s combined purchasing power will hopefully help bring down the cost of health care in the state, where health care spending traditionally grows faster than the state’s economic growth and currently exceeds the national average.
An analysis of New York's 2014 surprise medical bill law found that insurer, provider, and consumer stakeholders generally agree that the implementation of the law went smoothly, and that consumer complaints declines dramatically, according to a report from the Georgetown University Health Policy Institute, Center on Health Insurance Reforms. However, there continue to be significant gaps within the law concerning surprise balance bills due to patient misinformation about a provider's network status and use of out-of-network facilities during emergencies. The law protects consumers from charges for out-of-network services not paid by an insurance plan in cases of emergency or circumstances in which the patient did not have a reasonable choice between an in-network and out-of-network provider.
A study by AARP North Carolina found that more than 80 percent of family caregivers in North Carolina support expanded roles for advanced-practice registered nurses (APRNs). The survey, in response to the SAVE Act currently under consideration in the North Carolina legislature, also found that 90 percent of NC residents rated care they received from APRNs as “excellent” or “good.” The bill would allow APRNs to offer primary care services without physician oversight. Expanding the role of APRNs would help address doctor shortages in the state as well as increase access to care in the state’s rural communities, according to Public News Service.
Consumers in Illinois have been bogged down with steep price increases when buying health insurance on the Affordable Care Act (ACA) marketplace. According to the Chicago Tribune, new proposed legislation would give the Illinois Department of Insurance the power to say “no” to certain sky-high price increases proposed by insurance companies for plans sold to individuals and small businesses. The bill wouldn’t apply to plans offered by large employers. Opponents of the bill say it does nothing to address the rising prices of healthcare that can lead to higher insurance prices, and it could limit the types of plans insurers are able to offer.