- Cost and Quality Problems
- Improving Value
- Advocate Resources
- State News
A new poll from the University of Michigan has revealed that older Americans, between ages 50 and 64, are worried about healthcare coverage as they head towards retirement, according to FierceHealthcare. About a quarter of respondents feared that they wouldn’t be able to afford their insurance and nearly half expressed little to no confidence in being able to afford their insurance when they retire. Additionally, 13 percent said they postponed medical care due to cost concerns. Nearly 20 percent said they were delaying retirement to keep their employer-sponsored health plan.
California released a pair of reports detailing spending on medicines, the costliest drugs and the treatments most frequently prescribed, reflecting requirements in a state law to increase transparency on prescription drug pricing, reports STAT. The reports contribute to an ongoing battle between state lawmakers and the pharmaceutical industry over the rising cost of medicines.
Aledade and Blue Cross Blue Shield of North Carolina are co-leading a new initiative to support physician-led accountable care organizations (ACOs). The aim is for physicians and other care providers to work collaboratively as a team to improve quality of care, improve management of chronic conditions and ultimately reduce costs. Participating physicians will have the opportunity to earn increased reimbursement rates and share in any health care cost savings achieved, according to Blue Cross Blue Shield.
The Delaware Economic and Financial Advisory Council (DEFAC) set the state’s target healthcare spending growth at 3.8 percent for 2019. This is the first year of the healthcare spending benchmark, established in response to Delaware’s historical ranking in the top 10 states in per-capita spending. Over the next 3 years the benchmark is expected to decline to 3 percent to match the state’s estimate of overall state spending increases, according to the Office of the Governor.
Attorney General Lori Swanson, who is leaving office next year, is reminding lawmakers that legislation blocking nonprofit health plans from becoming for-profit companies will expire next year, and requires follow-on legislation, according to the Star Tribune. For decades, Minnesota required HMOs to be nonprofit, but Republicans pushed for opening the market to investor-owned companies. Swanson highlighted this issue in a letter to Governor-elect Tim Walz, noting the importance to protect Minnesota taxpayers from having billions of dollars in nonprofit health plan assets converted to for-profit use, without providing sufficient compensation to the public.
A new analysis from the Urban Institute revealed that Texas has both the largest number and highest percentage of uninsured residents under age 65 in the country. Additionally, patients often struggle to pay their bills, according to Kaiser Health News. Part of the problem may be “entrepreneurial healthcare practices” like freestanding emergency rooms, doctor-owned hospitals and balance billing. At last count, 214 freestanding ERs, which are generally highly profitable, have popped up across the state, in addition to hundreds of urgent care clinics and surgery centers. Employers are also continuing to eliminate subsides for employee premiums and shifting to high-deductible health plans. Without policy changes, Texas’ working poor and uninsured will find it difficult to access quality care.
Forty-one of Oklahoma's 77 counties are designated “maternity deserts,” meaning they lack a hospital performing deliveries or an obstetrics provider, reports NewsOK. Most of the counties are rural, and women who live there are more likely to live in poverty than the statewide average. The decline in hospitals performing deliveries is partially due to the economics of running a maternity unit – for example, they must be staffed around the clock, which isn't feasible in areas that don't have a large enough population. Ideas to expand maternity care in rural areas include: offering incentives for doctors to work in rural areas; training doctors who grew up in rural areas and are more likely to return to practice; and expanding Medicaid to increase the number of women receiving coverage for prenatal care.
A survey of Vermont households revealed that cost is the primary barrier to health insurance coverage for Vermonters without insurance. More than half of uninsured respondents rated costs as the only reason they do not have insurance, an additional quarter say cost is one of the main reasons they do not have insurance and 11% said it is one reason among many for being uninsured. Vermont residents without health insurance are more likely than those with insurance coverage to delay healthcare due to cost, regardless of the type of healthcare.
CMS recently approved Hawaii’s 1115 waiver amendment request to use Medicaid funds to help those experiencing chronic homelessness and mental health issues find housing, according to State of Reform. Services that will be covered by Medicaid include assistance with housing searches, job skills training, moving and education/training on tenant responsibilities. Officials hope to see reductions in healthcare costs for eligible individuals by addressing a prominent social determinant of health. Hawaii is one of the few states approved to use CMS funds for these kinds of supportive housing services.
A study conducted by the University of Michigan Institute for Healthcare Policy & Innovation found that nearly half of the people covered by Michigan’s expanded Medicaid program felt their physical health improved in the first year or two after they enrolled. Of those who were employed, more than two-thirds said having Healthy Michigan Plan coverage had helped them do a better job at work, according to the Institute’s analysis. Another quarter of the respondents were out of work when they took the telephone survey—yet more than half of them said their Healthy Michigan Plan coverage improved their ability to look for a job.