State News

Montana | September 17, 2018 | News Story

Psych Program to Benefit Rural Montana Towns

Billings Clinic is launching its first psychiatry residency program, dedicated to bringing trained psychiatric medical professionals to rural eastern Montana, according to the Lewiston Tribune. Montana has the highest suicide rate in the country, and is also one of three states that has no psychiatry residency program. Montana has seven psychiatrists for every 100,000 residents, and the desired number should be fourteen or more. Due to this shortage, quality mental healthcare has lagged behind the rest of the country. Access to good mental health services can result in fewer emergency department visits, shortened hospital stays, better interactions between patients and staff and other health benefits. This program will benefit rural communities and improve mental health across Montana. 

California | September 16, 2018 | News Story

As Opioid Death Toll Worsens, California Doctors Will Soon be Required to Perform Database Checks

Beginning Oct. 2, California doctors are required to consult the state’s prescription drug database—known informally as CURES—before prescribing opioids and other potentially addictive drugs, reports the Los Angeles Times. CURES enables physicians to view patients’ prescriptions, the doctors who prescribed them and the pharmacies that filled them to help spot signs of “doctor shopping” and identify potentially dangerous medication combinations. Theoretically, this will improve quality by enabling doctors to provide drug safety warnings, deny a patient’s request for prescriptions and even offer help when drug abuse is suspected. But some have expressed concerns over the tool’s design, which may not be user-friendly to providers. States such as New York, Kentucky and Tennessee have passed similar legislation.

California | September 15, 2018 | Report

The California Competitive Model: How Has it Fared, and What’s Next?

California has been successful in controlling rising healthcare costs by promoting price competition through market-based, managed care policies, according to a study in Health Affairs. However, recent data revealed that the state has not been able sustain its initial success in controlling growth in hospital prices. This article explores two trends that researchers suggest are responsible for the erosion of the conditions needed to sustain price competition within the state: hospital consolidation and regulations to ensure timely access to emergency hospital services that increased hospitals’ bargaining power over health plans.

California | September 15, 2018 | Report

California’s Drug Transparency Law: Navigating the Boundaries of State Authority on Drug Pricing

California’s drug transparency law, passed in October 2017, aims to promote transparency in pharmaceutical pricing, enhance understanding about pharmaceutical pricing trends and help manage pharmaceutical costs. While it might not significantly reduce drug prices, the law represents a meaningful step towards navigating the challenging political and legal environments preventing state action to rein in drug prices. This Health Affairs article examines the legal and regulatory aspects of the law, compares it to other state efforts to address rising drug prices and provides recommendations for maximizing impact by coupling transparency with other incentives.

Massachusetts | September 13, 2018 | News Story

Growth in State Health Care Spending Drops to Lowest Level in Five Years

Massachusetts made progress in controlling healthcare costs, according to a recent report. Total health spending increased 1.7 percent in 2017, the lowest the state has seen in the past five years, though healthcare costs remain a burden for many residents. A 2012 state law requires Massachusetts to contain the growth in medical spending to 3.6 percent a year, and the chairman of the state Health Policy Commission said this report shows Massachusetts is leading the country in lowering the rate of growth in medical spending. The president of the Massachusetts Association of Health Plans noted that “This is good news for employers and consumers, but today’s report also demonstrates that more work needs to be done to address health care cost drivers in our marketplace.”

Pennsylvania | September 12, 2018 | Report

PHC4 Examines Opioid Overdose Hospital Admissions in Pennsylvania

A new study released by the Pennsylvania Health Care Cost Containment Council (PHC4) to look at heroin and pain medication overdose patients by age, ethnicity/race and socio-economic status found that pain medication overdose admission rates had the highest increases among Hispanic residents, followed by low income residents, according to the Philadelphia Business Journal. Male residents had a higher rate of hospitalization for heroin overdose last year at 24.1 per 100,000 residents, compared to 9.4 per 100,000 for females. In a comparison by county, Philadelphia had the state’s highest heroin overdose hospitalization rate at 54.7 per 100,000 residents. PHC4 is an independent state agency based in Harrisburg that collects, analyzes and reports information that can be used to improve the quality and restrain the cost of healthcare in Pennsylvania.

California | September 10, 2018 | News Story

California Governor Signs into Law New Insurance Merger Protections

California has enacted a law that will require HMOs seeking to merge plan offerings to get permission from the state's Department of Managed Health Care, reports Modern Healthcare. The new law also gives the department the ability to veto mergers that negatively impact competition. Plans seeking to merge must outline any potential impact to access, network adequacy, handling of consumer complaints and claims processing. It also requires insurers to host public hearings. Supporters claim that the bill’s passage provides an important consumer protection, as three insurers control nearly 90 percent of the state’s HMO market.

Pennsylvania | September 10, 2018 | News Story

Philadelphia’s Tax on Sweetened Beverages Raises Prices of Taxed Products and Affects Product Availability

Manufacturers, distributors and retailers in Philadelphia are passing the full amount of the city’s newly implemented sugar-sweetened beverage tax on to consumers, according to Mathematica Policy Research. Although the data revealed some variation across stores, the tax of 1.5 cents per ounce typically raised retail prices by roughly 1.5 cents per ounce. As a result of the tax, sweetened drinks are more expensive and less available in stores. These findings come at a time when a growing number of communities are considering beverage taxes as a solution to rising rates of obesity and diet-related chronic diseases, such as Type 2 Diabetes.

California | September 6, 2018 | News Story

Consolidation in California’s Health System Leads to Higher Prices and Premiums

Hospital acquisition of physician practices–particularly in markets with limited hospital competition–was associated with higher prices for outpatient visits and higher insurance premiums on California’s individual marketplace from 2010-2016, according to a Commonwealth Fund study published in Health Affairs. Prices for outpatient visits were 5-10 percent higher in areas with high hospital-physician employment, while premiums for individual coverage rose the most in areas with both high consolidation among hospitals and a high percentage of hospital-owned physician practices. While integration and consolidation among providers and health plans has the potential to improve care coordination and quality, these findings indicate a need for careful scrutiny of healthcare mergers and acquisitions.

Virginia | September 5, 2018 | News Story

How Charlottesville Consumers Fought the Most Expensive Health Plans in the Country

After premiums in Charlottesville rose more than 300 percent in 2018 and became the most expensive in the country, advocates successfully challenged Optima and state regulators about how premiums were set, according to The Washington Post. Thanks to their efforts, the city’s rates are coming back down ahead of open enrollment for 2019 and Anthem has decided to reenter the Virginia market. The group of consumer advocates also helped pass legislation to allow solo entrepreneurs to purchase health insurance on the small-group market.