State News

Maryland | August 22, 2018 | News Story

CMS Approves Maryland Reinsurance Waiver for Obamacare Markets

The Centers for Medicare and Medicaid Services (CMS) approved Maryland's waiver to start a reinsurance pool for the Affordable Care Act exchange, according to Modern Healthcare. The state estimates that the program will cancel out the previously projected 30 percent average rate hike for individuals on the exchange for 2019. Officials estimate this waiver will lower premiums by about 30 percent and raise enrollment by about 6 percent. The executive director of the Maryland Health Benefit Exchange called the program, "The largest of it's kind in the country to bring rate relief... to residents who don't qualify for financial help with monthly premiums."


Louisiana | August 22, 2018 | News Story

Louisiana Uninsured Rate Cut in Half Due to Medicaid Expansion

Louisiana's Medicaid expansion cut the state's uninsured rate among adults by half in two years, plummeting from more than 22 percent to just over 11 percent. According to FierceHealthcare, the lowest rate can be found in the Houma-Thibodaux region, where only 8.5 percent of adults lack coverage. This data was uncovered by the most recent Louisiana Health Insurance Survey, which is sponsored by the Department of Health and conducted by Louisiana State University. Medicaid expansion made geographic discrepancies in coverage across the state “much more muted in 2017,” the report notes, adding that the statewide uninsured rate “may drop further in future years as residents become more informed of Medicaid options and eligibility.” 


Vermont | August 21, 2018 | News Story

Vermont Pilot Program Seeks to Lessen Hospital Stays for Medicare Patients

Medicare rules dictate that patients must stay at a hospital for at least three consecutive days before the program will cover treatment at a skilled nursing facility. However, OneCare Vermont, a statewide network of insurers and medical facilities, granted Brattleboro Memorial Hospital and three local facilities a waiver that reduces that requirement to one day, reports the Sentinel Source. The waiver is expected to decrease unnecessary hospital stays, cut costs and potentially improve quality by protecting patients from hospital-borne infections.


Vermont | August 21, 2018 | News Story

Vermont Pilot Program Seeks to Lessen Hospital Stays for Medicare Patients

Medicare rules dictate that patients must stay at a hospital for at least three consecutive days before the program will cover treatment at a skilled nursing facility. However, OneCare Vermont, a statewide network of insurers and medical facilities, granted Brattleboro Memorial Hospital and three local facilities a waiver that reduces that requirement to one day, reports the Sentinel Source. The waiver is expected to decrease unnecessary hospital stays, cut costs and potentially improve quality by protecting patients from hospital-borne infections.


Oklahoma | August 20, 2018 | News Story

Oklahoma is Implementing a New Program that Only Pays Big Pharma Full Price if Their Drugs Work

Oklahoma's Medicaid program is implementing a first-in-the-nation drug pricing policy where the state only compensates drug companies the full price for their medications if they work as advertised, according to Business Insider. While the program is designed to hold pharmaceutical companies accountable for the efficacy and safety of their drugs, participation is voluntary—potentially mitigating the desired effect. But drug companies that do sign up will have their effective products included in a “preferred drug list,” which could result in a greater long-term profits.


New Jersey | August 20, 2018 | News Story

New Jersey Gains CMS Approval For Reinsurance Program

New Jersey has received approval from CMS to implement a five-year reinsurance program that aims to lower individual health plan premiums by 15 percent. The program will operate from 2019 to 2023 and provide $218 million in reinsurance assistance to New Jersey’s individual health plans during the first year of operation. With lower premiums, the state predicts that enrollment in the individual market will rise by 2.7 percent in 2019, 2.6 percent in 2020, and 2.6 percent in 2021.


Vermont | August 19, 2018 | News Story

Vermont Seeks to Boost Mental Health, Addiction Workforce

Vermont has dedicated $5 million in its fiscal 2019 budget to expand efforts to find and retain clinicians to help address the state's mental health crisis and opioid addiction epidemic, according to the Battleboro Reformer. The legislation outlined some potential solutions for combatting provider shortages, including new scholarships, stronger loan-repayment programs and "strategic bonuses" for professionals in Vermont's existing workforce. Funding for the initiative will be spread over four years "to ensure successful and sustainable implementation" of the new workforce programs.


Michigan | August 17, 2018 |

Expanded Medicaid Boosted Finances of Michigan's Poor

A University of Michigan study has revealed that enrollment in Michigan's expanded Medicaid program boosted the finances of many low-income residents as well as their healthcare status, according to The Detroit News. Residents who gained coverage through the state’s Healthy Michigan Plan have experienced fewer financial issues, like unpaid debts, medical bills, overdrawn credit cards, evictions and bankruptcies. One of the main goals of the Healthy Michigan Plan is to address social determinants of health in order to promote positive health outcomes. The greatest financial gains were experienced by people with chronic illnesses or ones who had a hospital stay or emergency department visit after they enrolled.


Missouri | August 16, 2018 | Report

Primary Care Physicians: Missouri Workforce Update

Missouri’s primary care provider landscape has changed considerably over the past few years, with an increased number of physicians throughout the state—particularly in rural areas. However, shortages remain and are anticipated to continue into the future, which will require diligent efforts to maintain and increase the state’s supply. A recent report by Missouri Hospital Association discusses Missouri’s current and future primary care workforce needs and highlights successful strategies to improve recruitment and retention. 


Missouri | August 15, 2018 | Report

How Effective are Medicaid MCOs at Managing Care in Missouri?

Statewide expansion of Medicaid managed care in May 2017 resulted in 240,000 Missourians being shifted from traditional Medicaid to coverage from one of three for-profit corporations. But despite the rapid growth of managed Medicaid delivery models in the U.S. and Missouri, limited evidence exists on the actual effectiveness of MCOs to deliver efficiencies and cost savings while improving health outcomes for enrollees. A new report by the Missouri Hospital Association evaluates recent trends in hospital utilization for the Medicaid managed care population compared to other Missouri Medicaid patients and describes observed differences regarding clinical, behavioral and sociodemographic risk factors. The study found that observed differences in hospital utilization for MO HealthNet beneficiaries can be explained by higher rates of clinical, behavioral and social complexity among fee-for service enrollees. Although Medicaid managed care patients have significantly lower clinical and behavioral risk factors, they have higher rates of emergency department utilization and inpatient readmissions, compared to the fee-for-service population.