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A new Alaska law requires healthcare providers to publicly post the costs of common medical procedures and provide cost estimates to patients within 10 days of being asked, according to State of Reform. The law is meant to help patients make more informed decisions about the costs behind their care. The bill also includes provisions related to the licensure of and billing for marital and family therapists and establishes a measure related to ACES (adverse childhood experience syndrome), encouraging lawmakers to make policy decisions in a trauma-informed way.
In an effort to better serve rural populations, South Carolina will now allow nurse practitioners (NPs) to travel further to serve clients and increased, from 3 to 6, the number of NPs a physician can supervise. Previously, NPs had to practice within 45 miles of the supervising physician. The new law, which took effect July 1, has the potential to increase access to care in all 46 of South Carolina’s counties which are considered “medically underserved” by the State Department of Health and Environmental Control, according to the Post and Courier.
The Los Angeles County Health Agency and community partners recently announced the release of a new plan that promotes health equity across the county, according to State of Reform. The five-year plan seeks to reduce and eliminate some of the county’s biggest gaps in health outcomes. Priorities include: reducing the gap in black infant mortality; eliminating congenital syphilis; reducing hazardous exposures to harmful toxins in low-income communities; improving health outcomes for residents with complex health needs; and ensuring health agency services are accessible and culturally and linguistically appropriate.
In Minnesota, hospital bills for the same surgery can vary dramatically from one patient to another, even the procedure is performed at the same facility, according to a report from The Star Tribune. The findings from the state Health Department, came from a study of thousands of records detailing payments by private health insurers and consumers to hospitals for four common procedures: a simple appendectomy, spinal fusion, major bowel surgery, and removal of uterine fibroids. The report found that the differences patients paid for an appendectomy can range from $6,600 to $35,000 at the same hospital. Researchers did not find any significant difference between the patients to account for the large difference in price. Rather, these variations reflect a market that is not working well. There are many factors to account for the price variation, but the largest reason is through the negotiation of fees between hospitals and insurers.
Ohio is fighting to release a report detailing what it paid to two PBMs, CVS Health and Optum, to manage its Medicaid program’s prescription drug plans. According to NPR, the report shows that the companies charged the state 8.8 percent more than they paid to pharmacies to fill prescriptions. The companies kept the more than $224 million difference between what they charged the state and paid for the drugs. Ohio's Medicaid program is run almost completely through private managed care insurance companies, who contract with CVS Health and Optum to manage the prescription drug portion of recipients’ coverage. CVS Health representatives have argued that the company saved the state $145 million compared to an alternative and releasing the report would harm the company’s ability to negotiate low prices.
The Federal Trade Commission (FTC) has cleared a deal for UnitedHealth Group to purchase Peoples Health Inc., a Louisiana-based HMO operating in one of the few states where the health insurer isn't already one of the three largest sellers of Medicare Advantage health plans. According to the Star Tribune, UnitedHealth Group already runs the nation's largest health insurer, UnitedHealthcare, plus a fast-growing division for health care services called Optum. UnitedHealth wasn't in the top three in terms of market share in Louisiana, where Peoples Health ranked No. 2 last year, according to a Kaiser Family Foundation report.
Louisiana is evaluating a subscription-based payment model for high-cost drugs targeting Hepatitis C, according to the state’s Department of Health. The cost of Hepatitis C treatment, which affects 30,000 people in the Louisiana Medicaid program and prison system, creates barriers for the most vulnerable populations suffering from the disease. Under this payment model, the state would pay a drug manufacturer or manufacturers for unlimited access to the treatment for the individuals in Louisiana who are enrolled in Medicaid or in Louisiana’s correctional system. The total payment to the manufacturer would be equal to or less than what the state is currently spending, but by paying less per person, would reach many more patients.
Maine is the nation's 12th best state for healthcare and No. 1 in terms of access, according to a survey done by WalletHub. According to WalletHub, access to healthcare was measured according to factors including the number of hospital beds per capita, average response time for emergency medical services, the average emergency-department wait time, physicians, nurse practitioners and urgent-care centers per capita, and the share of insured adults and children.
North Carolina is transforming its Medicaid program to focus on patients’ social determinants as a main driver of health outcomes, according to a Modern Healthcare story. One of the changes to North Carolina’s managed care organizations would be a mandate to screen every Medicaid beneficiary for access to food, stable housing and transportation, though this change is dependent on regulatory approval to change their fee-for-service Medicaid program to managed care in 2019. The state has already developed a standardized tool for physicians and case managers to screen patients for social determinants of health and is piloting it in approximately 50 locations. They are also building a resource platform to help connect patients to various resources. According to the Secretary of Health and Human Services for North Carolina, “In a value-based context, the folks who figure out how to buy health and not just healthcare are going to be most successful.”
After seeing firsthand the repeated health problems faced by nail salon workers, leadership at the HOPE Clinic and the Episcopal Health Foundation tried to find out why. According to an article in STAT, researchers visited nail salons across the Houston area and interviewed almost 400 workers about their physical and mental health, exposure to chemicals, access to healthcare, workplace safety, and more. The survey showed that a large number of salons use potentially hazardous chemicals and workers suffered from repeated health problems. As a result of the survey, HOPE clinic created a curriculum focusing on health education in nail salon schools.