California hospitals provide significantly less free and discounted care to low-income patients since the Affordable Care Act (ACA) took effect, according to Kaiser Health News. As a proportion of their operating expenses, in 2017 general acute-care hospitals spent less than half as much on charity care as they did in 2013. Experts believe that the ACA is largely responsible for the reduction in charity care spending–with fewer uninsured patients, fewer patients seek financial assistance through the charity care programs. Currently, neither the state nor federal governments impose minimum requirements for charity care spending by hospitals, although the California Attorney General has created standards for a few nonprofit hospitals that have changed ownership in recent years.
The Center for Disease Control & Prevention recommends that Iowa spend $30 million annually on tobacco prevention efforts, but the state spends just $4 million, according to the Telegraph Herald. A report by the American Cancer Society shows that about 5,100 adults die in Iowa each year due to smoking and that Iowa has a relatively low tobacco tax rate: just $1.36 per pack, while the national average is $1.81.
A new law in New Hampshire seeks to add primary care physicians and pediatricians to the list of doctors who can bill Medicaid for visits that happen by phone or video conference, according to New Hampshire Public Radio. Previously, only certain specialists could bill Medicaid for telemedicine visits - in 2018, less than 1 percent of all doctors' visits for people on Medicaid happened via telemedicine. Supporters hope this law will increase access to healthcare in rural areas of the state.
A looming physician shortage in Ohio could make it difficult for patients to see a primary care physician, increase health disparities and raise costs as people are forced to turn to emergency room care, according to The Plain Dealer. By 2025, Ohio is projected to be short 1,200 primary care physicians (those in family medicine, internal medicine or pediatrics), estimates the U.S. Department of Health and Human Services. Recruiting primary physicians can be challenging due to pay inequities (primary care physicians make 30 percent less than specialists) and increased workload. Medical schools such as Case Western Reserve University School of Medicine are changing their recruitment and curriculum strategies to encourage more students to choose primary care.
A new law in New Hampshire would give the director of the New Hampshire Charitable Trusts Unit the specific authority to ask merging health care organizations how the transaction will affect the community’s access to quality and affordable physical and mental health care services, according to Valley News. The law also increases the time the director has to review these proposed transactions and requires more than one public hearing on the proposals. Mergers have become more commonplace in New Hampshire and the U.S., though their value to consumers has been questioned, as exemplified in a 2018 analysis that found hospital mergers can eliminate competition and cause price increases.
A $1 million grant to the University of Arkansas for Medical Sciences (UAMS) from Arkansas Blue Cross and Blue Shield will enable the UAMS Institute for Digital Health & Innovation to advance digital health statewide to provide more streamlined access to healthcare for patients, reports UAMS News. The first phase of the plan will focus on urgent care, in which patients will be able to consult with a medical professional by voice or video call to determine whether they need immediate care and how to obtain follow-up care. The second phase will develop digital approaches to providing primary care and certain specialized care, such as gynecology, ophthalmology, gastroenterology, oncology and orthopedics. Digital health approaches can reduce the cost of healthcare and improve access for patients, especially in a largely rural state like Arkansas.
Dozens of Oklahoma hospitals have filed more than 22,000 lawsuits against their former patients over unpaid medical bills since 2016, according to Oklahoma Watch. These billing practices highlight a heated debate in the medical community across the country. Consumer advocates argue that hospitals, especially those that are nonprofits, sue too often and should prioritize their moral obligation to their patients. Hospital officials say they already offer millions of dollars in charity care for those who meet certain income standards and that they only take legal action when necessary. Patients sued are at a disadvantage in court, because few people in these situations can afford a lawyer or know what steps to take.
Connecticut’s Office of Health Strategy launched a free, online tool intended to help consumers, businesses and healthcare providers navigate the state’s vast system of care, reports The CT Mirror. The website’s two key elements–a quality scorecard and a cost estimator–will allow users to compare the quality and cost of medical care at 19 of the state’s healthcare organizations. Organizations are also evaluated on patient experience in four categories: office staff, provider communication, timely care and overall patient experience. In addition, users can compare the overall performance rating of provider networks across all quality measures. Connecticut is one of the first states to create a rating system that evaluates the performance of provider networks rather than individual providers.
Horizon Blue Cross Blue Shield – New Jersey’s largest health insurance company – has developed a software tool that enables prescribers to get quick access to a list of lower-cost drug options tailored to address a patient’s unique needs and definitively covered by their specific prescription drug plan, according to NJ Spotlight. The rising price of prescription drugs has triggered problems for patients and their physicians: high out-of-pocket costs can lead individuals to skip or ration their medications. The pilot, launched in April, has since spread to some 5,000 prescribers, with Horizon hoping to double that usage by the end of 2019.
The Centers for Medicare and Medicaid Services approved North Dakota’s request to develop a state-based reinsurance program under Section 1332 of the Affordable Care Act, according to a Health Affairs blog post. North Dakota’s reinsurance program will operate through 2024 and is expected to reduce 2020 premiums by 20 percent. The North Dakota Insurance Department waiver application stated that this program will encourage additional insurers to write business in North Dakota’s individual market, improve consumer access and lower rates.