State News

A first-in-the-nation measure in Maryland to create a prescription drug affordability board will become law without the Governor’s signature, according to The Associated Press. The law creates an independent board with the authority to evaluate expensive drugs and recommend methods for addressing high costs. The measure was scaled back significantly from an initial proposal. For one thing, it will only apply to state and local governments, not all Maryland residents. Also, the board could only set upper-payment limits with approval from a legislative panel beginning in 2022. 

Colorado Governor Jared Polis signed legislation that caps insurance co-payments on insulin at $100 a month, no matter the type of insulin. According to The Denver Post, the measure goes into effect in January and insurers are expected to pay the difference in price. The cost of insulin has continued to increase in the U.S., with prices doubling since 2012. 

Montana has seen an increase in the number of direct primary care facilities, where the billing and payment agreement made between a doctor and their patient does not involve insurance. According to KULR 8 News, these direct primary care facilities provide monthly membership plans and are now being offered in several cities in the state. One of the founders of a Montana direct primary care facility claims that they are already seeing a huge decline in emergency room visits and hospitalizations in their community, saving the healthcare system money.  

New York City has the largest homeless population in the country, an issue the city has tackled through prevention, affordable housing and healthcare initiatives, according to this article in Harvard Business Review. The safety-net health system for the city, New York City Health + Hospitals, which serves more than one million people a year, is using data science to identify homeless patients and tailor their care and match them to the right hospital or community-based supports—ultimately including housing itself. 

48 of Minnesota's 87 counties have no practicing psychiatrists and most psychiatrists in the state practice in the major metropolitan areas. According to MinnPost, telepsychiatry may be a workable option for many rural Minnesotans, in which psychiatrists see patients remotely via video uplink and help them manage their symptoms through the use of carefully monitored medications. Some clinics and practices in Minnesota have begun using telepsychiatry, but the technology has yet to take off in the state. 

Early results of Minnesota’s certified community paramedic programs indicate that these house calls improve patient satisfaction and reduce spending on medical care. According to Minnesota Public Radio, these paramedics visit patients at home to help them transition out of the hospital and manage chronic conditions. A local hospital, Region Hospital, implemented a three-year pilot project that made nearly 1,000 home visits to help people manage diabetes and high blood pressure and resulted in large improvements in patient health and cost savings.

Healthcare spending in Texas grew 18.5 percent between 2013 and 2017 and many factors contribute to that growth, according to Dallas News. Texas ranked 37th last year in the overall health of its residents, according to America’s Health Rankings. Texas ranked near the bottom on many measures—it has many more adults with diabetes and obesity, and far fewer primary care doctors and mental health providers for the population. Additionally, 17 percent of the population in Texas has no health insurance—the largest in the nation. The state is one of 14 not expanding Medicaid, but experts assert that coverage is the biggest determinant of health outcomes. “Once people land in the hospital, they’ll spend a lot of money,” Lynn Quincy, director of the Healthcare Value Hub at Altarum, said. “Anything that keeps them healthy often costs less at the end of the day.”

Johns Hopkins Hospital has filed more than 2,400 lawsuits in Maryland courts since 2009 against patients with unpaid bills. According to The Baltimore Sun, patients being sued include many residents from distressed neighborhoods surrounding the East Baltimore medical campus. A report from the Coalition for a Humane Hopkins, National Nurses United, and AFL-CIO reveals that the number of cases has been increasing, from 20 in 2009 to a peak of 535 in 2016.

Washington state has a history of leading the way on healthcare by seeking innovative approaches to expand coverage and ensure affordability, according to NPR. This includes the establishment of a "public option" health insurance plan that, in theory, will be more affordable for consumers. Public option plans will be available in all 39 counties, eliminating “bare counties” where one or no private insurance carriers provide coverage. Washington is the first state law to authorize the creation of a public insurance plan of this type, although other states are following suit. Colorado lawmakers approved legislation directing state agencies to develop a proposal for a public health coverage option and other states, including Connecticut, are considering public option legislation.