Maine released a SIM Core Measures dashboard that shows trends on core healthcare measures selected by a statewide group of healthcare leaders. The state also releases an annual report analyzing the data. Compared to the control group, one of MaineCare’s Health Homes succeeded in decreasing non-emergent emergency department use and a smaller percent increase in facility outpatient clinic costs, according to the first annual report. However, the population also faced increased care fragmentation, decreased pediatric access to primary care, and mixed results relating to provider engagement of patients. The MaineCare Behavioral Health Homes showed notable cost avoidance compared to the control group, and differed in quality only by the level of fragmentation in care. While the experimental group’s fragmentation stayed stagnant, the control group experienced significantly less fragmentation, which benefits the consumer.
In an effort to spark innovation for improving health and curbing healthcare costs, the Rhode Island Working Group for Healthcare Innovation issued a series of recommendations, including creating an Office of Health Policy to set and oversee statewide health policy goals, establishing a spending target, expanding the state’s healthcare analytic capabilities, and aligning policies around alternative payment models, population health, and health information technology, among other priorities.
A new survey of Massachusetts residents finds that about one in six did not get healthcare they said they needed in 2015 because of the cost. The survey from the state’s Center for Health Information and Analysis highlights a trend showing more people have high-deductible plans in which insurance covers less care and patients pay more out of pocket.
New research shows that while the healthcare marketplace in Minnesota is lower cost for those who are a part of the Medicare program, those privately insured pay more for their care reports The StarTribune. This research calls into question the long held belief that the region is an area that should be modeled in many areas of federal health policy. The Minnesota Hospital Association disputes this recent research claiming that the research focused too closely on the list prices and did not take into account the long-term quality and cost metrics.
A bill intended to prevent costly surprise medical bills is on hold following resistance from the healthcare and insurance industries, according to The Record. Advocates argue that as a result patients will continue to be on the hook for excessive bills.
Health Affairs Blog: The Foundation for a Healthy Kentucky held its second healthcare price transparency symposium on October 16. This convening occurred a year after the foundation’s first symposium, in which state and national speakers discussed the need for price transparency in the collective effort of healthcare leaders to meet the unmet healthcare needs of Kentuckians through policy work. These symposia are part of the foundation’s broader Promoting Responsive Health Policy initiative, which has the goal of making policy more responsive to the health and healthcare needs of Kentuckians. Since the first price transparency symposium, the state of Kentucky has engaged the University of Kentucky in a process of creating a Kentucky-based and -designed all-payer claims database (APCD).
The Office of the Insurance Commissioner revised Washington's network adequacy rules in 2014 and added concrete distance standards, established provider ratios for primary care physicians, and defined allowable wait times, according to Washington Healthcare News. The rules apply to all health insurance plans issued in Washington, not just ACA plans. The OIC’s 2017-2023 Strategic Plan affirms that it will “monitor how narrow networks affect access” and maintain its network standards.
Modern Healthcare spoke with Marty Fattig, CEO of Nemaha County Hospital—a 20-bed, county-owned critical-access hospital in Auburn, Neb.,—about rural hospitals' challenges in recruiting staff, Nebraska's refusal to expand Medicaid to low-income adults, and how he motivates his employees.
Madison Memorial Hospital’s acquisition of the Rexburg Medical Center clinic is going to bring little change to patients, including no changes to prices or services, according to EastIdahoNews.com. Similar acquisitions are occurring across the country, the result of the perceived growing importance of integration, primary care physicians, and changes in payment systems that no longer reward providers based on the volume of services provided.
A new guide from the United Hospital Fund distills information about the State’s value-based payment roadmap for several critical audiences, including healthcare providers, health plans, policymakers, and other Medicaid stakeholders. Navigating the New York State Value-Based Payment Roadmap frames the State’s plans to transform the way it finances healthcare services, moving from volume- to value-based payments—a payment transition broadly recognized as essential for delivery system reform.