State News

California passed a measure to require Kaiser Permanente to join other insurers in providing more detailed information on expenses and revenue, reports The Sacramento Bee. Moving forward, Kaiser must report expenses and revenue for each of its facilities; break down revenue by type of payer (Medicare, Medi-Cal or private insurance) at each facility; and break down rate increases by type of service (hospital, physician services, pharmacy, radiology and laboratory). Consumer advocates support the increased transparency, citing that Kaiser has had a fairly broad exemption from much of the state’s rate review processes that other insurers have to follow. This bill ensures that Kaiser will provide the same types of information justifying their rates as other health insurers. 

The University of Missouri is one of five institutions nationwide to receive nearly $5 million in federal funds to address the looming shortage of primary care physicians, reports the St. Louis Post Dispatch. Most of the money will go toward the expansion of programs already in progress to recruit college students from rural areas to pursue rural medicine; while also exposing more medical school students to doctors in small-town clinics instead of specialists at large teaching hospitals. A smaller portion of the money will fund the development of a new family medicine residency program at the Bothwell Regional Health Center in rural Sedalia.

More than 100,000 Alabamians are employed but cannot afford healthcare, according to the Alabama Political Reporter. Around 50,000 Alabamian women who are employed cannot afford the healthcare provided by their employers or private insurance, as well as 58,000 employed men in the state, according to a report by Alabama Arise. Alabama is one of 14 states that has yet to expand Medicaid, which advocates and the Alabama Hospital Association say would help provide affordable and rural medical care to those who are working but cannot afford care. 

Hospital members of GraniteOne Health and North Country Community Care Organization - a total of eight healthcare organizations in all - have formed the New Hampshire Value Care accountable care organization, according to the NH Business Review. The ACO was approved by the Centers for Medicare & Medicaid Services, with hospital members promising an increase in quality and value for New Hampshire Medicare patients. Together, these hospital members serve approximately 20,000 Medicare beneficiaries. 

Half of Ohio residents surveyed experienced healthcare affordability burdens in the prior year: they either went uninsured, struggled to pay for medical care, or avoided or delayed it, according to new Altarum Healthcare Value Hub survey data released by the Universal Health Care Action Network of Ohio. A quarter of respondents said they did not fill prescriptions, cut their medications in half or skipped doses due to cost, Statehouse News Bureau reports. Additionally, about a third of privately insured Ohioans said they'd gotten a bill they didn't anticipate, and only a third of those were solved satisfactorily. 

The Nebraska Health Information Initiative (NEHII), a nonprofit statewide health information exchange, has partnered with Secure Exchange Solutions (SES) to streamline communication among clinicians in Nebraska and neighboring states, reports EHRIntelligence. NEHII aims to facilitate community collaboration while also protecting the security and privacy of patient health information. SES Direct will provide an accelerated path to seamless integration of direct communications with any healthcare application. The solution will enable providers to exchange critical information at the point of care, allowing clinicians to optimize care transitions and accelerate provider-payer data exchange, review, and decision-making. 

The homeless population of New York City has long used the emergency department at higher rates than the non-homeless population, but new research indicated that this may be connected to first-time shelter use, according to the Wall Street Journal. Thirty-nine percent of adult homeless shelter users visited the emergency department for treatment or were hospitalized in the year before they entered a shelter. In fact, the number of hospital visits began to increase in the months leading up to shelter entry. The study, published in Health Affairs, also shows that in the year after leaving a shelter, 43.4 percent of first-time shelter users went to the emergency department or were hospitalized. These significant spikes in visits to the emergency department just before first-time shelter use and just after leaving a shelter indicate that these may be opportunities to connect individuals with interventions and social services to prevent individuals from becoming homeless.

Low-income adults in Texas were much more likely to be uninsured and to experience financial barriers to care than their counterparts in the three states that expanded Medicaid, according to a new analysis from the Commonwealth Fund. Moreover, most low-income Texans support Medicaid expansion, which could extend coverage to 1.2 million uninsured individuals and increase affordability. The report includes a discussion of potential expansion effects on hospitals and the state’s economy. Studies show that Medicaid expansion reduces the share of uncompensated hospital care, which totaled $6.8 billion in Texas in 2016. Expansion has also been associated with fewer rural hospital closures (80 percent of which happen in nonexpansion states), where these entities account for 14 percent of total employment on average. Since 2013, 19 rural hospitals in Texas have closed due to financial difficulties. 

Despite efforts to increase the number of doctors in rural areas, many Oklahoma counties still lack the physicians needed to provide sufficient care for residents, reports The Oklahoman. Seventy-two of the state's 77 counties are designated as primary health-professional shortage areas by the federal government and 30 of them have 10 or fewer doctors of any type. Oklahoma has been creating incentives for doctors to practice in rural areas since the 1970s, but big-city amenities and educational and professional resources draw many physicians to other areas. Additionally, new physicians are increasingly choosing specialty practice so they can earn more and pay off sizable debt from medical school more quickly. This exacerbates the rural-urban divide because most specialty practices are located in urban areas. As a result, the state is funding a $5 million, five-year program to help pay off doctors' student debts if they agree to practice in a rural area.