Connecticut’s Governor signed two executive orders to directly address healthcare costs, primary care spending and quality of care for individuals, businesses and the state government, according to Robert Wood Johnson’s State Network. The orders direct the Office of Health Strategy to establish statewide healthcare cost growth and quality benchmarks in addition to a primary care spending target, and direct the Department of Social Services to improve public transparency of Medicaid costs and quality.
UVM Health Network’s system-wide consolidation has resulted in longer wait times for patients seeking diagnosis and treatment and could increase healthcare costs for Vermonters down the line, according to the VT Digger. This is becuse hospitals that dominate local healthcare markets have greater leverage in negotiations with insurance companies, which can ultimately lead to higher prices per procedure. These higher prices trickle down to patients in the form of higher deductibles, copays and premiums. Barriers to access have caused some Vermont residents to seek care across state lines.
Washington State launched a collaborative regional Accountable Communities of Health (ACH) model in 2015 to improve the health of communities across the state. These ACHs have evolved into independent organizations that are integral to the state’s health system transformation efforts. A 2019 evaluation by the Center for Community Health and Evaluation found this ACH model has largely succeeded in building robust regional coalitions to improve the health of their communities. This blog by NASHP highlights the ACHs’ diverse approaches to improving health.
Huntsville Hospital and University of Alabama Birmingham Health System (UAB) are partnering to create a value-based Medicare Advantage plan through managed care company Viva Health, according to HealthPayerIntelligence. Though uninsurance in the state has decreased, outcomes for seniors have gotten worse in Alabama, according to the UnitedHealth Foundation’s 2019 Senior Report. The Medicare Advantage plan will serve seniors in the North Alabama region, through which hospitals will focus on value-based care, population health and rural health, including services such as home health agencies, skilled nursing facilities, pharmacies and durable medical equipment providers.
While Connecticut has led national efforts in public insurance reform, research shows that significant health disparities persist between the state’s residents of color and white residents, reports the CT Mirror. Specifically, Black and Latino residents are more likely than white residents to be uninsured, to die before reaching adulthood and to report being in poor health. Latino adults, in particular, were more than twice as likely as white residents to say they went without seeing a doctor in the past 12 months because of the cost.
While California has made impressive strides in increasing the number of residents who have health insurance coverage, healthcare is still far too expensive for the three million Californians who lack coverage and the 37 million who do not. A report from RAND and the California Healthcare Foundation provides a snapshot of health spending trends in California; explores how healthcare costs are affecting the state’s residents and forcing state officials to make unnecessary trade-offs; and identifies six areas of focus for understanding cost containment approaches targeting unnecessary spending.
While higher inpatient spending in Massachusetts has been linked to rising prices and patient acuity levels, a recent report from the Massachusetts Health Policy Commission reinforces previous findings that state residents may not actually be getting sicker, according to Modern Healthcare. Indeed, the report shows that while inpatient acuity grew by over 10 percent from 2013 to 2018, the length of stay increased only 1.5 percent. The two largest health systems in the state and the state’s Health and Hospital Association stated that new or improved EHRs have increased the ability to document diagnostic information and are a major factor in rising acuity levels and risk scores.
Researchers found that spending on public health significantly reduced the maternal mortality rate (MMR) among black mothers and narrowed black-white outcome disparities in Florida, according to Milbank Quarterly. U.S. MMRs reveal considerable racial disparities and exceed those of other developed countries. Moreover, while worldwide MMRs have dropped sharply since the 1990s, the U.S. MMR appears to be rising.
A newly implemented California law limits what consumers owe if they’re transported by an out-of-network air ambulance to what they would pay an in-network provider, reports Kaiser Health News. However, the law won’t protect approximately 6 million consumers whose health plans aren’t regulated by the state, such as self-funded employer-sponsored plans regulated by the federal government. Additionally, federal law prohibits states from regulating the “rates, routes or services” of air carriers, including air ambulances. It is unclear whether California’s law, which doesn’t spell out a payment rate for a health plan, would be preempted by federal law if challenged in court.
Since Keshee Dozier-Smith took over Rural Health Medical Program four years ago, the company has opened three new clinics in Alabama, according to AL.com. This group of South Alabama community health clinics serve some of the state's poorest and most rural communities. Thirteen Alabama hospitals have closed since 2011, with more than half of those once serving rural populations, and of the rural Alabama hospitals still open, almost 90% operate in the red. Dozier-Smith and Rural Health Medical Program provide an example of how to assuage the health access issues impacting rural America.