Alabama Medicaid reforms will bring regional control and coordination of primary care services through seven Alabama Coordinated Health Networks (ACHNs) serving more than 700,000 Alabama Medicaid enrollees, according to Alabama Arise. Every ACHN will have a Consumer Advisory Committee, a new accountability provision that advocates hope will increase consumer oversight. Moreover, each ACHN will receive funding to develop and implement Quality Improvement Projects focused on three initial priorities (childhood obesity, infant mortality and birth outcomes, and substance use disorders). Alabama’s Medicaid reforms are an encouraging move toward improved patient-centered care.
A report forecasting the implications of Medicaid expansion in Florida predicts that over 800,000 Floridians would gain coverage within the first five years of expansion. Additionally, the move could free up $119.3 million in state funds and fiscal gains may occur in corrections, public health, and uncompensated care for uninsured Florida residents.
A study of California’s 2017 surprise billing law – which requires fully-insured plans to pay out-of-network physicians at in-network hospitals – found significant reductions in the share of services delivered out-of-network by certain specialties at inpatient hospitals and ambulatory surgical centers since the law went into effect. The decline ranged from 15 percent (for pathology services) to 31 percent (for neonatal-perinatal medicine). Additionally, the share of emergency medicine services delivered out-of-network dropped by 5 percent in the period after the law took effect.
Connecticut’s “Centers of Excellence” network will enable state residents to identify which providers perform best for certain procedures, helping them make informed decisions about where to receive their care, reports The CT Mirror. By steering patients to providers who offer cost-effective treatments, the state hopes to reduce its healthcare costs by millions of dollars in the 2019 and 2020 fiscal years combined. The resource will be released in 2020 and will serve an estimated 210,000 state employees, retirees and dependents.
For the third year in a row, the number of people without health insurance in North Carolina remained roughly the same, according to North Carolina Health News. More than 1 million North Carolinians, or 10.7 percent, did not have health insurance in all of 2018, reports the U.S. Census Bureau, who attributed the national trend in increasing uninsured rates to a decline in Medicaid enrollment. By contrast, North Carolina's Medicaid enrollment hasn't changed significantly in three years, and the state has the 9th highest uninsured rate in the country. It's estimated that expanding Medicaid in North Carolina would reduce the state's uninsured rate by 3 percent.
Blue Shield of California launched a 12-month pilot program that will allow more than 1,300 Sacramento-area residents to get free Lyft rides to primary care appointments; X-ray or lab visits; and to pick up prescriptions at the pharmacy, reports The Sacramento Bee. Blue Shield will pay for eligible members’ rides directly and will allow members to bring a caregiver to help with walkers and other aspects of their medical care. The program, called RideQ, will be evaluated on its ability to improve health outcomes and care experience, reduce costs and increase physicians’ job satisfaction. RideQ is part of a larger initiative to identify and eliminate the non-medical barriers that keep people from receiving needed care.
A proposed merger between the parent companies of Exeter Hospital and Wentworth-Douglass Hospital in Dover is being called unlawful by the Attorney General's office, according to the New Hampshire Union Leader. The Charitable Trusts Unit of the Attorney General's office claims that the merger threatens even higher healthcare costs for New Hampshire consumers, owing to the fact that they are only 18 miles apart, offer many of the same inpatient and outpatient services and both own a significant number of healthcare professional practices.
Certificate of need (CON) laws are restricting access to innovative cancer immunotherapies in Michigan, according to Reason. Immunotherapies attempt to program the body's own immune system to attack and kill cancer cells, and have become an increasingly attractive way to combat cancer. However, under new rules adopted by the Michigan Certificate of Need Commission, hospitals will need to go through third-party accreditation processes before being able to offer these CAR T-cell therapies. Though cancer research organizations, patient advocates and pharmaceutical companies oppose the new accreditation requirements, the University of Michigan Health System, the largest in the state, argue they are necessary for patient safety. CON laws vary from state to state but require that hospitals get a state agency’s permission before offering new services, expanding facilities or installing new medical technology.
For the second year in a row, Marylanders will see cheaper premiums for Affordable Care Act policies purchased on Maryland's health insurance exchange, according to the Washington Post. State officials announced that over 190,000 people will experience lower premium costs, with an average decline of 10.3 percent for individual plan prices. Insurance regulators attribute the decline to the healthcare reinsurance plan that state officials created in 2018, paid for by a tax on insurance companies. However, the cost for around 269,000 small-group plans in the state will increase by 3 percent, significantly less than what insurance companies had proposed.
The Wisconsin Collaborative for Healthcare Quality issued a report identifying where gaps in health outcomes and care exist within the state. The report highlighted widespread racial and ethnic disparities, with American Indian/Alaskan Native children experiencing much lower childhood vacination rates, Asian/Pacific Islander adults having much lower rates of breast and colorectal cancer screenings and Black adults with diabetes or heart disease being much less likely to be tobacco-free. The report also highlighted payer disparities, noting that those with Medicare had much lower cervical cancer screening rates. Finally, the report noted limited rural/urban disparities, but that these ay have been related to the use of only two categories to describe rural and urban areas, potentialy masking disparities in these areas.