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The religious right in Indiana has long been a powerful political force. But now a progressive interfaith movement, called Faith In Indiana, is trying to challenge that foothold, according to WBUR News. The group, consisting of a broad political spectrum of Muslims, Jews and Christians, has organized in minority communities on issues like immigration, universal health care, criminal justice reform, and early childhood education. Indiana's branch of Faith In Action launched statewide this year. It targeted five races in the general election, with the ambitious goal of ending the Republican supermajority in the statehouse.
The Free Clinics, serving Henderson and Polk counties, has seen success in caring for the areas most complex patients through its “Bridges to Health” program. The Bridges program works as drop-in sessions where patients can discuss social and emotional issues as well as medical concerns with an integrated care team, according to Robert Wood Johnson Foundation. In the first nine months of the project, the clinic reduced per-patient ER use by 72% and approximately 80% of the participants saw underlying health conditions improve. Bridges also made improvements in social determinants of health, such as housing and employment, for patients, which has helped build robust community support for the program. The Bridges to Health Program received the Robert Wood Johnson Foundation Award for Health Equity in 2017.
Women leave the correctional system a lot heavier than when they arrived, reports the Washington Post. In an effort to stem weight gains and improve chronic health conditions like heart disease and diabetes that disproportionately affect people who are incarcerated, the Warden of the Maryland Correctional Institution for Women worked with a dietitian to retool meals for women by cutting around 1,000 calories a day (previously a 3,200 calorie menu). The warden expects this initiative will show savings on healthcare costs, including medications, which is the biggest line item in the budget. And, women in the facility already report greater satisfaction with the healthier meals, changing their actions by eating in the dining hall rather than eating unhealthy food from the commissary. This has improved morale in prison, which could translate to heightened safety. Significant challenges remain including a lack of funding: an increase is unlikely even if there are the potentials for saving money down the road.
The Oregon Health Authority is moving to expand treatment for hepatitis C, a disease that affects nearly 30,000 of the state’s Medicaid beneficiaries, to everyone on the Oregon Health Plan who’s infected, according to The Lund Report. In 2017, Oregon’s Medicaid program spent $45 million, about 7 percent of the total prescription budget, on hepatitis C drugs. The Governor has requested $107 million from the health authority in her budget proposal, one which the Authority plans to approve. Experts hope that treating hepatitis C will save Oregon the cost of treating people with severe complications while stemming the spread of the virus.
Specialty care accounts for a significant and growing portion of year-over-year Medicaid cost increases. Some referrals to specialists may be avoided and managed more efficiently by using electronic consultations. A study in Health Affairs found that linking primary care providers with specialists in dermatology, endocrinology, gastroenterology and orthopedics in Connecticut using an electronic platform reduced the need for face-to-face visits, saving an average of $82 per patient per month. Researchers concluded that expanding the use of electronic consultations for Medicaid patients and reimbursing the service could result in substantial savings while improving access to and timeliness of specialty care and strengthening primary care.
Healthcare spending at Minnesota clinics slowed sharply last year as physicians discouraged wasteful services and encouraged patients to choose lower-cost sources for prescription drugs, labs and imaging, according to the Minnesota Star Tribune. Per patient costs varied widely based on where patients received their primary care, ranging to a two and a half times difference in price, according to the total cost of care report. For example, specialty clinics, like the Mayo Clinic as well as rural providers tended to have higher prices. The report suggests that doctors managed costs by steering patients to low cost clinics instead of hospitals for outpatient services which declined spending on those outpatient hospital services by 1 percent in 2017 following a 7.3 percent increase in 2016. Business leaders said this comparison information is vital as health care costs increases and the payment burden falls more heavily on patients. Minnesota is currently the only state where detailed price information is published.
The governor of Iowa projected his Medicaid privatization program would save the state $232 million, but a report by the state auditor found that only around $126 million was saved, according to the Lexington Herald. The report also found that officials and lawmakers failed to file state-required quarterly financial reports. Iowa, like 39 other states, adopted a privatized, managed care system as a way to address Medicaid cost growth. But opponents questioned whether privatization actually producing any savings and pointed out that some insurance companies were sustaining losses.
The Virginia Department of Medical Assistance Services has asked the governor to include $19.1 million in his budget proposal to boost Medicaid reimbursements for primary care doctors in order to prevent a physician shortage, according to the Richmond-Times Dispatch. With Medicaid expansion set to begin on January 1, state legislators are concerned about the widening gap between reimbursement rates to doctors in Medicaid and those in Medicare and inconsistent access to care under the Medicaid program. For the current fiscal year, Medicaid reimbursement was 71 percent of the rates paid by Medicare. The state expects to enroll 360,000 people under expanded Medicaid eligibility.
Connecticut’s U.S. congressional delegation is at odds with the governor over the failure to apply for an expansion of the HUSKY program that would give low-income residents access to new telemedicine services, especially for psychiatric care and substance abuse treatment, reports The CT Mirror. Five Democrats representing Connecticut in the U.S. House of Representatives are pressing the Malloy administration to apply for the waiver, which would allow the state’s doctors and hospitals to receive Medicaid reimbursements for their services when they treat HUSKY patients through telemedicine. The Malloy administration says the process for obtaining permission to add these services is lengthy, may not achieve the desired results and is not currently a priority. Connecticut is the only state in the nation that has not requested a waiver from the Department of Health and Human Services to incorporate telemedicine into its Medicaid program.
In 2010, South Carolina launched the Safe Surgery South Carolina program to promote the implementation of the World Health Organization Surgical Safety Checklist. The checklist is a patient safety tool to improve safety in all care settings for patients undergoing surgical procedures. The hospitals that have reported full implementation of the checklist had significantly higher rates of physician and CEO engagement as well as high-touch activities, such as in-person meetings, than comparison hospitals, according to Health Affairs.