Following months of negotiations, the contracts are set to expire between UnitedHealthcare and several University of Alabama Birmingham Health System entities this month, according to WSFA12. UnitedHealthcare claims that the UAB Health System is more expensive than other facilities – if no agreement is reached, UnitedHealthcare members who receive care at UAB facilities may be personally responsible for the cost of services received, though the emergency department at each hospital will remain open to members without additional out-of-pocket costs.
The state of Washington is praised for creating the country’s first “public option,” but a closer look at the law reveals tradeoffs that could curb potential savings for consumers, reports The New York Times. Although the law allows the state to regulate some healthcare prices, the prices were set significantly higher than drafters originally hoped in order to gain enough support to pass. As a result, the public option may not deliver the steep premium cuts that supporters want. Estimates suggest that individual market premiums will fall 5-10 percent when the new public plan begins.
With the rising costs of healthcare concerning most residents, New Jersey may be surprised to learn it ranks as one of the most affordable when it comes to home healthcare, according to ROI-NJ. Using data from the U.S. Census Bureau, Genworth and the Centers for Medicare and Medicaid Services, SeniorLiving.org released a study describing that New Jersey patients spend nearly 72 percent of their annual household income on care inside the home. This score places New Jersey as 5th in the nation for most affordable home healthcare, while the national median percentage is 91 percent. Demand for home health aides is expected to surge through 2027, rising by 47 percent.
Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract (AQC) population health program with two-sided risk cut per-enrollee spending by as much as 11.9 percent compared to a control group, according to Healthcare Dive. Researchers from Harvard and Tufts University medical schools, Massachusetts General Hospital and Haven Boston, published a study in the New England Journal of Medicine looking at eight years of AQC data. Along with the cost savings, the quality of care improved – researchers saw a 7-percentage point increase in patients with diabetes receiving high quality disease management after the AQC program was implemented.
Rural and mountain region emergency medical services are trying just about anything to keep their money-losing ambulances running across Colorado’s rugged or remote terrain, according to The Colorado Sun. High costs, low reimbursement rates and scarce job applicants are forcing ambulance services to consolidate with fire responders, take on new tasks between emergency runs, and outsource fast-growing transport runs to bigger metro hospitals. Rural counties tend to have higher percentages of low-reimbursement insurance such as Medicare, Health First Colorado (Medicaid) or veterans care, making every ambulance run a money loser for the local hospital or emergency services district.
For the North Carolina Cherokee, self-governance has meant adopting an integrated care model designed by Alaska Natives to deliver care that not only improves patients’ health, but is also tailor-made for the needs of the tribe, according to Kaiser Health News. The Cherokee have opened a 20-bed hospital and have started construction on an 18-bed mental health clinic scheduled to open in 2020. Self-governance also allows tribes to be eligible for Medicare, Medicaid, private-sector health insurance, partnerships with larger health systems, and even federal grants that are designed for underserved communities – all of which can be limited for the Indian Health Service. Half of the Indian Health Service budget is now managed by Indian tribes to various degrees, but it remains to be seen how widely the full control, which has worked out well for tribes with resources like the Eastern Cherokee, can be applied. For instance, geographic isolation, poverty and a lack of resources make new healthcare investments difficult for tribes such as the Rosebud Sioux or the Oglala Lakota on the Pine Ridge Indian Reservation.
State Treasurer Dale Folwell reopened enrollment in the North Carolina State Health Plan with increases in how much medical providers could charge for their services, according to News & Record. According to the State Health Plan, the revision would increase what 727,000 current and retired state employees covered by the plan pay by $116 million. However, with coverage details for next year in limbo, thousands covered do not know for sure whether their local hospital and current medical providers will be in network or not. Folwell and the State Health Plan have been disagreeing with major health systems across the state, some of which have declined to enroll.
New York is facing a shortage of healthcare workers because fewer people are choosing healthcare careers as the workforce ages and retires, according to the Observer-Dispatch. Additionally, demand has soared as the population ages and the increased turnover costs money, making it the biggest source of cost increases and including money on ads, recruitment and retention tools, lost productivity, and the cost of training employees.
Indiana and Minnesota offer examples of how state policymakers are using budget appropriations, executive orders and legislation to improve social equity and reduce disparities, according to NASHP. In Indiana, the governor and legislators are tackling disparities in infant mortality, aiming to reduce the state’s infant mortality across all zip codes by improving services for expecting mothers by establishing a perinatal navigator program. The program provides wraparound services and community-based, home-visiting programs, while a new law also establishes a program to provide more nurses and community health workers to help young women throughout pregnancy. In Minnesota, initiatives proposed in the budget or enacted through executive orders are designed to reduce disparities in educational attainment and employment among racial minorities in Minnesota. Though not directly tied to health, these disparities can lead to income inequality and other stressors strongly associated with poor health outcomes. The approaches taken by Minnesota’s and Indiana’s governors demonstrate how state leaders can push for social equity with targeted or broad systemic changes to improve overall social conditions.
A new law requires clinics that are part of a larger hospital or health system to publicly disclose that patients may receive a separate charge for the facility, resulting in higher out-of-pocket costs, according to the Grand Forks Herald. The hope is that these disclosures will lower the number of Minnesotans who experience surprise medical bills. A Healthcare Value Hub survey of adult Minnesotans in 2019 revealed that nearly half experienced healthcare affordability burdens in the past year.