State News

Maryland | April 11, 2019 | News Story

Maryland Legislature Passes Laws to Make Health Insurance Enrollment Easier and Create Drug Price Board

The Maryland General Assembly passed a slate of related measures to make health coverage easier to secure for uninsured Marylanders and prescription drugs cheaper for government workers, reports The Baltimore Sun. One law would require uninsured people to check a box on their state tax returns to report whether they’re interested in obtaining health coverage through the state. Another would establish a board to study the controversial idea of capping prescription costs for state and municipal employees. The legislature also enacted a patient’s bill of rights and approved sustained funding for a reinsurance program that helps insurers offset costs for the biggest healthcare users. Collectively, these measures are expected to make a significantly improve healthcare access and affordability for consumers.


Maryland | April 11, 2019 | News Story

Maryland Legislature Passes Laws to Make Health Insurance Enrollment Easier and Create Drug Price Board

The Maryland General Assembly passed a slate of related measures to make health coverage easier to secure for uninsured Marylanders and prescription drugs cheaper for government workers, reports The Baltimore Sun. One law would require uninsured people to check a box on their state tax returns to report whether they’re interested in obtaining health coverage through the state. Another would establish a board to study the controversial idea of capping prescription costs for state and municipal employees. The legislature also enacted a patient’s bill of rights and approved sustained funding for a reinsurance program that helps insurers offset costs for the biggest healthcare users. Collectively, these measures are expected to make a significantly improve healthcare access and affordability for consumers.


Virginia | April 9, 2019 | News Story

Six Provider Organizations to Use Data to Trim Low-Value Care in Virginia

Using a $2.2 million grant from Arnold Ventures, the Virginia Center for Health Innovation (VCHI) is launching a statewide pilot to reduce the use of low-value services, according to Health Data Management. In 2012, the American Board for Internal Medicine identified 550 tests and procedures as having a low value. Accessing insurance claims data, VHCI looked at 42 measures for 5 million patients using a health-waste calculator and found more than 2 million unnecessary services, costing approximately $747 million. The pilot will be implemented across 900 clinical sites in Virginia and will involve an employer task force on low-value healthcare.  VCHI will initially focus on providers and seven sources of low-value care and then will expand to include a set of consumer-driven measures.


Oklahoma | April 9, 2019 | News Story

Bill Would Give Doctors in Rural Areas $25,000 Tax Credit

Proposed legislation in Oklahoma would establish a pilot program to attract physicians to rural parts of the state, according to The Journal Record. If signed into law, the bill would provide an income tax credit of up to $25,000 annually for up to five years for doctors who set up practices in communities of less than 25,000 people. To qualify for the income tax credit, doctors would have to have completed their medical training or medical residency in Oklahoma and would have to live in the same rural counties where they practice.


Oklahoma | April 7, 2019 | News Story

OSDH Awarded Grant to Aid Access to Healthcare

The Oklahoma State Department of Health was awarded a five-year grant from the U.S. Health Resources and Services Administration totaling more than $890,000 to improve access to healthcare services for people who are uninsured, isolated or medically vulnerable, reports The Oklahoman. The health department will work with the federal agency to produce a statewide primary care needs assessment, identify unmet healthcare needs and barriers to care (like workforce shortages) and advance strategies which improve access to comprehensive primary healthcare services in Oklahoma.


Maryland | April 7, 2019 | News Story

Maryland’s Experiment with Capitated Payments for Rural Hospitals: Large Reductions in Hospital-Based Care

In 2010 Maryland, for some rural hospitals, replaced fee-for-service payment with a global budget approach called Total Patient Revenue (TPR) to incentivize hospitals to manage resources more efficiently. A study in Health Affairs found evidence consistent with both the incentive to provide care more efficiently and the incentive to provide less care during the 2010-2013 study period. For TPR hospitals, service use fell sharply – ED admissions declined 12 percent, direct (non-ED) admissions fell 23 percent, ambulatory surgery center visits fell 45 percent and outpatient clinic visits/services fell 40 percent. The authors conclude that most of the drop in inpatient admissions at TPR hospitals was offset by higher admissions at Maryland hospitals outside the global budget or moved to neighboring states.  Since hospital revenues are maintained under TPR, if care that is no longer provided within budget moves off budget, total healthcare costs could rise. The authors found evidence of higher overall healthcare spending for the FFS Medicare population. Unfortunately, no published studies have examined the effect of TPR on population health or on overall healthcare costs. In 2014, Maryland replaced the limited TPR program with Global Budget Revenue (GBR) for all Maryland Hospitals. The authors conclude that capitation models require strong oversight to ensure that hospitals do not respond by shifting costs to other providers.


Oklahoma | April 3, 2019 | News Story

Cherokee Nation Prepares for Major Health Complex Opening

Cherokee tribal land in Oklahoma will soon be home to the largest Native American health facility in the U.S, according to FOX 25 News. The facility will include the country’s first tribally affiliated medical school with the goal of training more future doctors in Oklahoma and getting them to stay. Cherokee officials hope the medical school will help bridge the gap when it comes to doctor shortages, which are a serious issue in rural communities.


Washington | March 26, 2019 | News Story

Price Variation and Plan Performance in WA

The Washington Health Alliance has released several new reports on negotiated reimbursements from commercial payers, reports State of ReformOne report shows that reimbursement for a vaginal delivery at one medical center varies from $7,196 to $19,402, depending on the commercial payer. Another report reveals that overall inpatient utilization from 2015-2016 was down enough ($51.2 million) to offset price growth ($21.7 million). A third report analyzing “how well health plans are meeting the needs of their members and working to improve quality and reduce the cost of healthcare" identified Kaiser's HMO product as the overall top rated insurance plan, with Regence the top rated PPO plan.


Texas | March 26, 2019 | News Story

West Texas Senator Seeks Solution to Rural Hospital Crisis

A new bill proposed in the Texas Senate would direct the state health commissioner to develop a method to ensure that rural hospitals get full Medicaid reimbursement, according to an editorial in the Orange Leader. Since 2013, 21 rural hospitals have closed in Texas. Legislators believe that a major reason for these closures is an underpayment for Medicaid reimbursements. Over three million people live in the state’s 170 rural community—a population that tends to be older, poorer and less healthy than urban communities. About 50 percent of infants in the state are delivered to patients covered by Medicaid and in rural regions that rate is about 70 percent—demonstrating a need for rural hospitals. Though a budget provision requiring reimbursement for the full allowable cost of a service for Medicaid patients exists, managed care organizations omitted the budget provision after they began administering the Medicaid program in 2012. Legislators emphasized the need for coordination between agencies to agree on what rural hospitals are owed to avoid future hospital closures.


Oregon | March 26, 2019 | Report

Oregon Builds Consensus to Expand Cost Control Efforts

Legislators in Oregon have called for the development of plan to achieve a “predictable and sustainable” annual growth rate for statewide healthcare spending, according to Milbank Memorial Fund. The plan would be developed by a public-private advisory group and implemented, at least initially, by the Oregon Health Authority within existing laws. Enforceable limits on cost growth will take effect in 2022. Other states, like Massachusetts, Rhode Island, and Delaware, have already implemented healthcare cost growth benchmarking.